Papel do enfermeiro especialista no processo de transição saúde-doença da pessoa em situação crítica

Abstract

This report aims to describe the academic path carried out in the two internship contexts of the curricular unit "Final Internship and Report", reporting the process of acquiring the competencies defined by the Order of Nurses in 2019, for the Specialist Nurse. The two internship contexts took place in a Multipurpose Intermediate Care Unit and an Intensive Care Service, in which it was possible to reflect and acquire knowledge and practice in Medical-Surgical Nursing to the person in critical situation. The methodology chosen was descriptive and critical and the report is chronologically structured by introduction, beginning of the route and competencies, being subdivided by the 4 domains of the Specific Competencies of nursing specialist nurses to the person in critical situation. In each Domain and for each specified objective, a critical-reflective analysis was carried out on the activities and the most relevant aspects of the internship. Finally, there is the conclusion. As a future Specialist Nurse, the indepth themes have allowed us to obtain skills capable of responding to the critical person in the transition processes, through proposals for improvement on risk management in drug preparation and effective communication with the implementation of the ISBAR tool, digitally. A literature review was also carried out on the criteria attributed to the end-of-life person in the screening. We highlight the critical reflections produced on safe practices and the path to the development of skills capable of giving answers to the person in critical situation and/or family. In professional, ethical and legal practice, proposals for improvement were promoted, and functional and organizational dynamics were contributed; decision-making strategies were developed based on principles, values and ethical norms and a critical discernment was demonstrated for the problems of professional practice. In the domain of quality, improvement programs were proposed, interpersonal communication, situations of instability were managed and emerging medication was managed with safe practices, based on the acquisition of scientific knowledge. In nursing care management, interpersonal communication was managed; safety and quality in care has been ensured; reflected on the adequacy of resources, among others. Finally, the development of learning in the provision of quality care has allowed us to contribute to the resolution of problems with assertiveness and responsibility in situations of risk, optimizing the work of the team and promoting evidence-based interventions among people in critical situations at the end of life. Also the proactivity in the search for evidence for the promotion and implementation of the best techniques and scientific standards, allowed us to collaborate with interventions aimed at improving surveillance, monitoring and management of therapy. Examples of this: invasive monitoring, electrocardiogram monitoring, hemofiltration, placement of the central venous catheter, etc. These learnings contributed to an advanced, safe and differentiating nursing in the needs of the person in critical situation and through the reflection-criticism of the experiences experienced it was possible to expose the outdated challenges and the opportunities provided for the acquisition of differentiating skills in the provision of care to the person in critical situation.

Date of Award	30 Jun 2022
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Sílvia Patrícia Fernandes Coelho (Supervisor)