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A realização deste relatório surge no âmbito do14º curso de Mestrado em Enfermagem com especialização em Enfermagem Médico-Cirúrgica na área da Enfermagem à Pessoa em Situação Crítica, do Instituto de Ciências da Saúde (Porto) da Universidade Católica Portuguesa e tem como objetivo apresentar todo o percurso desenvolvido ao longo do mesmo, abordando as principais competências desenvolvidas no caminho para me tornar Mestre em Enfermagem, bem como Enfermeiro Especialista. Este relatório tem por base uma análise criticoreflexiva, suportada pela evidência científica, das atividades desenvolvidas ao longo deste percurso académico. O estabelecimento de objetivos baseados nas competências do Enfermeiro Especialista, desenvolvidas pela Ordem dos Enfermeiros, serviu de fio condutor tanto para a realização do relatório, como para a minha orientação enquanto formando. O relatório englobou uma breve contextualização do desenvolvimento de competências no estágio do 1º ano em Unidade de Cuidados Intensivos Monovalente, seguida da caracterização dos locais de estágio, desenvolvendo posteriormente uma descrição crítica das atividades desenvolvidas. A abordagem do estágio do 2º ano centrou-se no Serviço de Urgência e na Unidade de Cuidados Intensivos Polivalente, tendo como principais objetivos o desenvolvimento de competências relacionadas com o cuidado à Pessoa em Situação Crítica, no desenvolvimento de competências, especialmente na deteção e intervenção em situações de possível debilidade de forma diferenciada e especializada, mobilizando o máximo de conhecimentos e capacidades adquiridas ao longo de todo o percurso profissional e académico. Mantendo a Pessoa em Situação Crítica como foco ao longo do meu percurso, foi dada a devida importância ao estabelecimento de uma adequada relação terapêutica com a mesma, assim como, a inclusão da família no cuidado e como alvo de cuidados do Enfermeiro Especialista. Associado aos cuidados nos contextos específicos de estágio, a abordagem do controlo da dor, sedação e dellirium tornaram-se ainda focos de atenção de forma a mobilizar estratégias direcionadas para as necessidades da Pessoa em Situação Crítica e família, assim como a abordagem do Controlo de Infeção e Resistência a Antimicrobianos da aquisição de competências como Enfermeiro Especialista. Também foi abordado o papel do Enfermeiro Especialista na gestão de serviços. Foi realizada uma revisão da literatura sobre a importância da monitorização do Índice Bispectral no cliente neurocrítico e projetos de intervenção nos vários contextos: comunicação e integração da família nos cuidados, carta de alta de enfermagem e manipulação da derivação ventricular externa. O Enfermeiro Especialista deverá cuidar a Pessoa em Situação Critica de forma holística, deferência e especializada de forma a colmatar as suas necessidades, mantendo uma visão crítica e baseada na evidência. Os objetivos a que me propus foram cumpridos, apesar de alguns constrangimentos, maioritariamente relacionados com a pandemia por COVID 19 que colocou alguns entraves, principalmente na relação com a família.
The realization of this report comes within the scope of the 14th Master's course in Nursing with a specialization in Medical-Surgical Nursing in the area of Nursing for the Critical Ill Patient, from the Institute of Health Science (Porto) of Universidade Católica Portuguesa and aims to present the entire course developed throughout the internship, addressing the main skills developed on the way to becoming a Master in Nursing as well as a Specialist Nurse. This report is based on a critical-reflexive analysis, supported by scientific evidence, of the activities developed along this academic path. The establishment of objectives based on the competences of the Specialist Nurse, developed by the Ordem dos Enfermeiros, served as a guideline both for the realization of the report and for my guidance as a student. The report includes a brief contextualization of the competence’s development in the 1st year internship in a Monovalent Intensive Care Unit, followed of the internship locations characterization, posteriorly developing a critical description of the developed activities. The 2nd year's approach focused on the Emergency Service and the Polyvalent Intensive Care Unit, having as main objectives the development of skills related to the care of the Critical Ill Patient, developing competences in detection and intervention, mobilizing the maximum of knowledge and skills acquired throughout professional and academic career. Keeping the Critical Ill Patient as the focus throughout my journey, it was given the due importance to the establishment of an adequate therapeutic relationship with them, as the inclusion of the family in the care and as a target of care of the Specialist Nurse. Associated with care in specific internship contexts, the approach to pain control, sedation and dellirium have also become focuses of attention in order to mobilize strategies aimed at the needs of the Critical Ill Patient and family, such as the approach to the Infection Control and Antimicrobial Resistance as an area of great importance when acquiring skills as a Specialist Nurse. Was also talked about the role of the Specialist Nurse in the services management. A literature review was carried out on the importance of regulating the Bispectral Index in the neurocritical client and intervention such as projects in various contexts: communication and family integration in care, nursing alternation chart and manipulation of the external ventricular shunt. The Specialist Nurse should take care of the Critical Ill Patient in a holistic, deferential and specialized way in order to meet their needs, maintaining a critical, and evidence-based view. The goals I set myself were met, despite some constraints, mostly related to the COVID 19 pandemic, which put some obstacles, especially in the relationship with the family.
The realization of this report comes within the scope of the 14th Master's course in Nursing with a specialization in Medical-Surgical Nursing in the area of Nursing for the Critical Ill Patient, from the Institute of Health Science (Porto) of Universidade Católica Portuguesa and aims to present the entire course developed throughout the internship, addressing the main skills developed on the way to becoming a Master in Nursing as well as a Specialist Nurse. This report is based on a critical-reflexive analysis, supported by scientific evidence, of the activities developed along this academic path. The establishment of objectives based on the competences of the Specialist Nurse, developed by the Ordem dos Enfermeiros, served as a guideline both for the realization of the report and for my guidance as a student. The report includes a brief contextualization of the competence’s development in the 1st year internship in a Monovalent Intensive Care Unit, followed of the internship locations characterization, posteriorly developing a critical description of the developed activities. The 2nd year's approach focused on the Emergency Service and the Polyvalent Intensive Care Unit, having as main objectives the development of skills related to the care of the Critical Ill Patient, developing competences in detection and intervention, mobilizing the maximum of knowledge and skills acquired throughout professional and academic career. Keeping the Critical Ill Patient as the focus throughout my journey, it was given the due importance to the establishment of an adequate therapeutic relationship with them, as the inclusion of the family in the care and as a target of care of the Specialist Nurse. Associated with care in specific internship contexts, the approach to pain control, sedation and dellirium have also become focuses of attention in order to mobilize strategies aimed at the needs of the Critical Ill Patient and family, such as the approach to the Infection Control and Antimicrobial Resistance as an area of great importance when acquiring skills as a Specialist Nurse. Was also talked about the role of the Specialist Nurse in the services management. A literature review was carried out on the importance of regulating the Bispectral Index in the neurocritical client and intervention such as projects in various contexts: communication and family integration in care, nursing alternation chart and manipulation of the external ventricular shunt. The Specialist Nurse should take care of the Critical Ill Patient in a holistic, deferential and specialized way in order to meet their needs, maintaining a critical, and evidence-based view. The goals I set myself were met, despite some constraints, mostly related to the COVID 19 pandemic, which put some obstacles, especially in the relationship with the family.
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Enfermeiro especialista Pessoa em situação crítica e família Doente neurocrítico Specialist nurse Critical Ill patient and family Neurocritical patient