Um percurso de desenvolvimento de competências de enfermeiro especialista

Abstract

Medical-Surgical Nursing in the Care of the Critically Ill Person is a complex and demanding area of intervention that requires specialised skills, supported by advanced scientific knowledge, refined clinical reasoning, and the ability to respond quickly and effectively. Evidence-based practice involves the rigorous use of the best available research findings to support safe and effective clinical decisions. Critical reflection fosters the continuous analysis of interventions, identifying opportunities for improvement and adapting them to the clinical context. During the internship, this process was carried out through the critical analysis of complex cases, multidisciplinary discussions, and the optimisation of practices, such as the management of advanced devices and communication during nursing care transitions. This integration of evidence and reflection contributed to the quality of care and strengthened key competencies essential to the autonomous role of the specialist nurse. This report documents the process of acquiring and developing competencies during the final internship of the Master's Degree in Medical-Surgical Nursing in Critical Care. The clinical experience, undertaken in a Cardiothoracic Surgery Intensive Care Unit and in an Emergency Department, allowed for the consolidation of both theoretical and practical knowledge. Providing care to critically ill individuals proved to be a demanding challenge, where swift and well-founded decision-making, multidisciplinary collaboration, and the humanisation of care played a central role. The internship enabled the achievement of the defined objectives, including the delivery of specialised care, response in emergency situations, infection prevention and control, and nursing care management. Challenges were overcome, such as adapting to different clinical settings, managing advanced monitoring and support devices, and establishing a therapeutic relationship with the patient's family during emotionally intense moments. The experience gained was fundamental to consolidating the competencies of the specialist nurse in medical-surgical nursing, contributing to a safer and more evidence-based professional practice. Activities carried out during the internship focused on the delivery of specialised care to critically ill individuals, highlighting detailed clinical assessments, the implementation of differentiated therapeutic interventions, and the early identification of clinical deterioration. Close monitoring of emergent clinical situations and active collaboration in multidisciplinary teams also stood out, contributing to a more effective and integrated approach to care. An integrative literature review was conducted on communication during the transition of nursing care, aiming to identify strategies that promote patient safety in critical contexts. The results of this research were disseminated at the 7th Forum of Specialties in the form of a scientific poster, which enabled not only the sharing of up-to-date knowledge with other professionals but also critical reflection on current practice. The drafting of this report allowed for a reflective overview of the journey undertaken, reinforcing the importance of continuous training, research, and the improvement of the quality of care provided.

Date of Award	2 Jul 2025
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Rúben Encarnação (Supervisor)