Comunicação com o doente crítico

: promoção para uma prática especializada

Abstract

The process of training nurses has greatly evolved since the time of Florence Nightingale to the current time, having the scientific mark begin with the teaching directed for the development of process based on scientific principles. The embraced challenge when integrating the medical-surgical specialty was to integrate the principles of basic training and be able to develop and improve a scientific, technical, human and ethical understanding, intervening in the process of health-disease of humans, in a critical and transformative perspective oriented to care, decide, educate, manage and search significant aspects of this specialty area. With the preparation of this report it is intended to highlight the work developed in the Course Training (Palliative Care Unit, Emergency Department and Intensive Care Unit). In each “block” it was developed a portfolio showing the work done, as well as research and critical thinking, which allowed the development of critical reflective thinking of the experienced aspects in practice. In Palliative Care Unit I was able to identify the role of the Medical-Surgical Specialist Nurse in providing patient care at the end of life and family, developing skills and communication skills, teamwork, and monitoring symptoms through pharmacological and nonpharmacological measures. Developed interventions in the specialization area to be able to contribute for the improvement of care, mainly through: developing a film about communication, development of an ”Orientation Guide for the Provision of Patient Care with Neoplastic Wound" and the development and creation of the concept "communicating box." In the ER I was able to develop skills in the care of critically ill patients and resuscitation room, particularly in meeting the individual with Acute Myocardial Infarction, Stroke and cardiac arrest. Contributed to the rethinking of practices for the emergent patient and to some behavior change in the team through sharing scientific articles, updating norms of Basic and Advanced life support, and creation of a “Nursing Checklist in the PCR" and "Registration of Cardio-Respiratory Resuscitation”. In the context of screening beyond the care in that area, I was able to develop a study on "Communication Skills Used by Nurses in Screening Interview”, which result allowed me to do a team reflection on the importance of communication in the ER and specifically in this area. In the Intensive Care Unit I was able to use the knowledge acquired during the previous practices in the care of critically ill patients and family focused on early identification of outbreaks of instability and interpretation of invasive monitoring parameters. As part of the family I worked to identify the needs of families of critically ill patients admitted to the Intensive Care Unit, through an exploratory study, from which resulted the creation of a "host Checklist to the family of the admitted patient to the Intensive Care Unit". I detected some training needs of the staff that I was able to help with the development of a norm to "care in the patients eyes admitted in the ICU/IPCU" and "Post-mortem Care in the ICU/IPCU" that promptly led to a reflection on the care and dignity of death in Intensive Care

Date of Award	2012
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Georgiana Marques da Gama (Supervisor)