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O presente trabalho, desenvolvido no âmbito do Curso de Mestrado em Enfermagem, na área de Especialização de Enfermagem de Saúde Infantil e Pediátrica, pretende descrever, de forma analítica e reflexiva, o percurso formativo realizado, que conduziu ao desenvolvimento e aquisição de competências pessoais, do Enfermeiro Especialista e, particularmente, do Enfermeiro Especialista em Saúde Infantil e Pediátrica. Neste, sustentei a minha tomada de decisão na Teoria do Conforto, de Kolcaba, no Modelo de Parceria de Cuidados, de Casey, e numa revisão scoping que elaborei. O recurso da criança/jovem aos cuidados de saúde constitui, frequentemente, um momento envolto em stress e ansiedade, vivenciado de forma negativa e perturbadora, com repercussões no seu crescimento e desenvolvimento saudável. Neste âmbito, o enfermeiro deve adequar a sua intervenção, ajudando-a a gerir as emoções negativas, otimizando o seu conforto e bem-estar e proporcionando-lhe uma experiência o menos traumática possível, onde veja satisfeitas todas as suas necessidades, de forma integral. A temática do relatório centra-se na promoção dos cuidados atraumáticos, considerando-os fundamentais para assegurar cuidados de qualidade à criança/jovem e família e reconhecendo o seu cariz transversal a todos os níveis de prestação de cuidados (primário, secundário envolvendo ou não a hospitalização e terciário). Assim, desenvolvi atividades direcionadas a esta temática ao longo dos quatro estágios que compuseram este percurso, nomeadamente, numa unidade de cuidados de saúde personalizados, de cuidados intensivos neonatais, num serviço de internamento de pediatria e, por fim, de urgência pediátrica. Em cada um destes contextos, foram definidos objetivos consonantes com o meu projeto individual de aprendizagem, que foram atingidos através da consecução de atividades nas quais procurei atender aos pilares da enfermagem de saúde infantil e pediátrica, prestando cuidados atraumáticos e valorizando o envolvimento da família enquanto fonte de segurança e tranquilidade para a criança/jovem, reconhecendo a importância da parceria de cuidados. No âmbito do estágio na unidade de cuidados de saúde personalizados, destaco: a realização de sessões de educação para a saúde direcionadas aos cuidadores; a elaboração de medalhas e diplomas de bom comportamento. Relativamente às atividades desenvolvidas na unidade de cuidados intensivos neonatais, realço a realização de um plano de cuidados com ênfase no conforto do recém-nascido e a elaboração de um folheto informativo com vista à promoção de estratégias que visam minimizar o trauma vivenciado pela díade pais-bebé. No serviço de internamento de pediatria ressalvo a realização de uma sessão de formação à equipa de enfermagem acerca da utilização de estratégias não farmacológicas de controlo da dor. No contexto do serviço de urgência pediátrica, saliento a constante utilização do “kit sem dor”, bem como a elaboração de uma norma de procedimento referente à sua aplicação. Considero que este percurso teve um papel enriquecedor no meu desenvolvimento pessoal e profissional, tornando possível a consolidação de competências relacionais, técnico-científicas e ético-legais, desenvolvidas com base na partilha e reflexão acerca do papel do enfermeiro especialista ao nível da gestão e implementação de intervenções de enfermagem complexas, com recurso ao pensamento crítico e à tomada de decisão fundamentada e sustentada em evidência científica atual.
The present work, developed in the scope of the Master Course in Nursing with specialization in Child and Pediatric Health Nursing, intends to describe, in an analytical and reflexive way, the training course carried out that led to the development and acquisition of personal skills and competencies of the Specialist Nurse, in particular the Specialist Nurse in Child and Pediatric Health. I held my decision-making based on the K Comfort, Partnership in Care Model, and my own scoping review. The use of health care by the child/youth is often a time of stress and anxiety, experienced in a negative and disturbing way, with repercussions on their healthy growth and development. In this context, the nurse must adapt his/her interventions in order to help the child/youth to manage their negative emotions, to optimize their comfort and well-being, and to provide them with the least traumatic experience. The child has to meet all their needs, fully and completely. This report focuses on the promotion of atraumatic care, considering it fundamental for the provision of quality care to the child/youth and family and recognizing their crosscutting nature at all levels of care (primary, secondary whether or not involving hospitalization and tertiary care). Accordingly, I developed activities directly related with this theme throughout the four internships that composed this course, namely, in a personalized health care unit, in a neonatal intensive care unit, in a pediatric inpatient service and, finally, in a pediatric emergency department. In each one of these contexts, objectives were defined in accordance with my individual learning project. The objectives were achieved through the accomplishment of activities in which I tried to attend to the pillars of child and pediatric health, providing atraumatic care and enhancing the involvement of the family as a source of security and tranquility to the child/youth, recognizing the importance of care partnership. Under the internship in the personalized health care unit, I highlight: health education sessions directed to caregivers; the preparation of medals and diplomas of good behavior. Regarding the activities carried out in the neonatal intensive care unit, I underline the creation of a plan of care with emphasis on the comfort of the newborn, as well as the preparation of an information leaflet to promote strategies aimed at minimizing the trauma experienced by the father-baby dyad. In the pediatric inpatient service, I emphasize the training session to the nursing team about the use of non-pharmacological strategies to control the pain. In the context of the pediatric emergency department, I highlight the constant use of the “painless kit”, along with the preparation of a standard procedure about it. I believe that this journey had an enriching role in both my personal and professional development, making possible the consolidation of relational, technical-scientific and ethical-legal competences, developed based on the sharing and reflection about the role of the specialist nurse in the management and implementation of complex nurse interventions (with the use of critical thinking and informed decision-making based on current scientific evidence).
The present work, developed in the scope of the Master Course in Nursing with specialization in Child and Pediatric Health Nursing, intends to describe, in an analytical and reflexive way, the training course carried out that led to the development and acquisition of personal skills and competencies of the Specialist Nurse, in particular the Specialist Nurse in Child and Pediatric Health. I held my decision-making based on the K Comfort, Partnership in Care Model, and my own scoping review. The use of health care by the child/youth is often a time of stress and anxiety, experienced in a negative and disturbing way, with repercussions on their healthy growth and development. In this context, the nurse must adapt his/her interventions in order to help the child/youth to manage their negative emotions, to optimize their comfort and well-being, and to provide them with the least traumatic experience. The child has to meet all their needs, fully and completely. This report focuses on the promotion of atraumatic care, considering it fundamental for the provision of quality care to the child/youth and family and recognizing their crosscutting nature at all levels of care (primary, secondary whether or not involving hospitalization and tertiary care). Accordingly, I developed activities directly related with this theme throughout the four internships that composed this course, namely, in a personalized health care unit, in a neonatal intensive care unit, in a pediatric inpatient service and, finally, in a pediatric emergency department. In each one of these contexts, objectives were defined in accordance with my individual learning project. The objectives were achieved through the accomplishment of activities in which I tried to attend to the pillars of child and pediatric health, providing atraumatic care and enhancing the involvement of the family as a source of security and tranquility to the child/youth, recognizing the importance of care partnership. Under the internship in the personalized health care unit, I highlight: health education sessions directed to caregivers; the preparation of medals and diplomas of good behavior. Regarding the activities carried out in the neonatal intensive care unit, I underline the creation of a plan of care with emphasis on the comfort of the newborn, as well as the preparation of an information leaflet to promote strategies aimed at minimizing the trauma experienced by the father-baby dyad. In the pediatric inpatient service, I emphasize the training session to the nursing team about the use of non-pharmacological strategies to control the pain. In the context of the pediatric emergency department, I highlight the constant use of the “painless kit”, along with the preparation of a standard procedure about it. I believe that this journey had an enriching role in both my personal and professional development, making possible the consolidation of relational, technical-scientific and ethical-legal competences, developed based on the sharing and reflection about the role of the specialist nurse in the management and implementation of complex nurse interventions (with the use of critical thinking and informed decision-making based on current scientific evidence).
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Keywords
Enfermagem Criança/jovem Família Cuidados atraumáticos Conforto Nursing Child/youth Family Atraumatic care Comfort