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O presente relatório surgiu integrado no âmbito da unidade curricular – Estágio Final e Relatório, do 12º curso de Mestrado em Enfermagem, com especialização em Enfermagem Médico-Cirúrgica na área de enfermagem à pessoa em situação critica, do Instituto de Ciências da Saúde – Porto da Universidade Católica Portuguesa. Compreendendo o período de tempo entre 09/09/2019 e 04/01/2020 e tendo por base os contextos de estágio que compõem este ciclo de estudos, procedeu-se à análise das atividades e contributos desenvolvidos, com recurso a uma metodologia descritiva e critico-reflexiva, de forma a retratar o percurso e o processo de transição na obtenção de competências em Enfermagem Médico-Cirúrgica.
O documento elaborado encontra-se organizado em capítulos e de acordo com os Domínios de Competências Comuns do Enfermeiro Especialista, estabelecidos pela Ordem dos Enfermeiros. A consciencialização das oportunidades e experiências anteriormente adquiridas surge documentada no início do relatório e serviu de introdução e sustentação aos restantes capítulos. Os objetivos definidos na fase de projeto foram integrados em toda a narrativa tal como as diversas atividades desenvolvidas em cada contexto de estágio. Esta exposição, juntamente com o recurso a uma reflexão critica fundamentada na evidência científica atual, permitiu justificar a aquisição das competências especificas do enfermeiro especialista em enfermagem médico cirúrgica. Reconhecendo este percurso como um campo rico em experiências e repleto de características singulares passiveis de intervenção, não foi adotada uma temática única de estudo, sendo assumido que cada situação de aprendizagem e partilha, representa um papel relevante nas etapas que constituem o processo de transição vivenciado na obtenção de competências. No estágio de Cuidados Intensivos foi elaborado um estudo de caso tendo por base a Teoria das Transições de Meleis, que correlaciona uma situação critica de doença com todo o processo de mudança e transição inerentes a esta fase, demonstrando a importância de uma atuação de enfermagem especializada na obtenção de transições de sucesso. Durante o estágio no contexto de Cuidados Intensivos e no Serviço de Urgência, foi possível testemunhar uma necessidade efetiva de exames de diagnóstico e tratamentos que envolvem radiações ionizantes. Por conseguinte, foi desenvolvido um projeto de intervenção, no qual se definiu um plano de Segurança e Atuação na presença deste tipo de radiações. Este projeto teve como objetivo providenciar um ambiente de prática segura e otimizar a atuação do enfermeiro especialista. Terminado este processo, considera-se que foram adquiridas e desenvolvidas as devidas competências no âmbito da especialidade em Enfermagem Médico-Cirúrgica, com a integração fluida de novos conhecimentos e aptidões, essenciais à tomada de decisão devidamente fundamentada e a uma prática de enfermagem baseada na evidência científica que reflete o estado da arte.
The current assignment is integrated in the scope of the curricular unit - Estágio Final e Relatório, of the 12th Master's Degree in Nursing, with specialization in Medical-Surgical Nursing, from Institute of Health Sciences (Porto), Universidade Católica Portuguesa. Comprising the period of time held between 09th of September 2019 and 4rd of January 2020, and based on the placement settings that make up this field of study, an analysis of the developed activities and contributions was carried out, using a descriptive and critical-reflective methodology, in order to portray the path and the transition process when obtaining Medical-Surgical Nursing skills. The prepared document was divided into chapters, organized in accordance with the Common Skills Domains of the Specialist Nurse, established by the Order of Nurses, bearing in mind the Specific Skills of the Specialist Nurse in Medical-Surgical Nursing. The acknowledgement of the opportunities and experiences previously acquired, is documented at the beginning of the report and acts as an introduction and fundamental base for the following chapters. Both the objectives defined in the project phase, as well, as the multiple activities developed in each placement context, were integrated throughout the narrative. This exposure, alongside with the use of a scientific evidence-based rationale, allowed the acquisition of specific competencies of the nurse specialized in Medical-Surgical Nursing. The opportunities for intervention, found in the different placements, arise in order to develop a critical spirit, exploring vital areas and implementing strategies that enhance an improvement in the quality and safety of the care provided. Knowing that this field is rich in experiences and full of unique characteristics of endless interventions, a single theme of study wasn’t adopted, instead it is assumed that each learning and sharing moment represents a relevant role in the stages that take part in the transition process experienced when gaining competences. In the Intensive Care Unit, a case study was elaborated based on Meleis Theory of Transitions, which correlates a critical situation of disease with the process of change and transition inherent to this period, validating the importance of specialized nursing for obtaining a successful transition. Throughout observation moments in Intensive Care Unit and Emergency Department settings, it was possible to witness an effective need for the use of diagnostic examinations and treatments involving ionizing radiation. Therefore, an intervention project was developed, presenting a possible Action and Safety plan in the presence of this form of radiations. This project aims to provide a safe practice environment and optimize the performance of specialist nurses. Concluding this process, it’s considered that the appropriate competences were acquired and developed within the Medical-Surgical Nursing specialty, with the integration of new knowledge and skills, crucial in accurate decision-making and for a practice-based nursing grounded on scientific evidence reflecting the state of the art.
The current assignment is integrated in the scope of the curricular unit - Estágio Final e Relatório, of the 12th Master's Degree in Nursing, with specialization in Medical-Surgical Nursing, from Institute of Health Sciences (Porto), Universidade Católica Portuguesa. Comprising the period of time held between 09th of September 2019 and 4rd of January 2020, and based on the placement settings that make up this field of study, an analysis of the developed activities and contributions was carried out, using a descriptive and critical-reflective methodology, in order to portray the path and the transition process when obtaining Medical-Surgical Nursing skills. The prepared document was divided into chapters, organized in accordance with the Common Skills Domains of the Specialist Nurse, established by the Order of Nurses, bearing in mind the Specific Skills of the Specialist Nurse in Medical-Surgical Nursing. The acknowledgement of the opportunities and experiences previously acquired, is documented at the beginning of the report and acts as an introduction and fundamental base for the following chapters. Both the objectives defined in the project phase, as well, as the multiple activities developed in each placement context, were integrated throughout the narrative. This exposure, alongside with the use of a scientific evidence-based rationale, allowed the acquisition of specific competencies of the nurse specialized in Medical-Surgical Nursing. The opportunities for intervention, found in the different placements, arise in order to develop a critical spirit, exploring vital areas and implementing strategies that enhance an improvement in the quality and safety of the care provided. Knowing that this field is rich in experiences and full of unique characteristics of endless interventions, a single theme of study wasn’t adopted, instead it is assumed that each learning and sharing moment represents a relevant role in the stages that take part in the transition process experienced when gaining competences. In the Intensive Care Unit, a case study was elaborated based on Meleis Theory of Transitions, which correlates a critical situation of disease with the process of change and transition inherent to this period, validating the importance of specialized nursing for obtaining a successful transition. Throughout observation moments in Intensive Care Unit and Emergency Department settings, it was possible to witness an effective need for the use of diagnostic examinations and treatments involving ionizing radiation. Therefore, an intervention project was developed, presenting a possible Action and Safety plan in the presence of this form of radiations. This project aims to provide a safe practice environment and optimize the performance of specialist nurses. Concluding this process, it’s considered that the appropriate competences were acquired and developed within the Medical-Surgical Nursing specialty, with the integration of new knowledge and skills, crucial in accurate decision-making and for a practice-based nursing grounded on scientific evidence reflecting the state of the art.
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Enfermagem Médico-Cirúrgica Competências especializadas Transições Doente crítico Medical-Surgical Nursing Specialized skills Transitions Critical patient