Gerenciamento em enfermagem no contexto hospitalar: o discurso do enfermeiro e sua equipe

Abstract

The Nursing management is a theme of extreme relevance on nursing professional practice and has suffered changes, given health organizations conditions on XXI century, marked by fast and meaningful transformations. This work was about the nursing management in hospital ward. The objective was to understand the meaning of managing hospital ward from the perspective of nurses, technicians and nursing assistants. It was a qualitative study, descriptive, exploratory and cross-sectional. As theoretical reference was used the Social Representation Theory of Serge Moscovici, as methodological reference to perform the analyses was chosen the discourse analysis that by Spink’s understanding uses the tool of the Association of Ideas Map. For data collection was applied a semi-structured interview guide to nurses, technicians and nurse assistants. The research was considered and approved by the Research and Ethics Committee of UNIFAL, MG. The interview analysis resulted in two maps of ideas association. The first map, derived from nurses talking, was named “The nursing management process”, it was composed by three axes that contained two sub axis each one. The axes were entitled: “The nurse practice”, “Feelings” and “The context”. As sub axis the themes identified were: “Technical dimension”, “Communicative dimension”, “negative affects”, “positive affects”, “facilities” and “difficulties”. The second map, originated from technicians and nurse assistant’s interview, got the title “The nursing managerial work process on perspective of technicians and nurse assistants”, this map associates three sub axis: “Practice dimension” “interpersonal relationship” and “Dimension of desired role”. The data analysis has unveiled a managerial process unconnected with the patient care that prioritizes the technical dimension, this process seemed to be based on rational model of management and biomedical model of assistance, and so, adapt just to the organizational needs. Thereby, this model cannot overcome the context contradictions. On the other hand, it was observed that there were, in this area, some possibilities of transforming action, which occurs in the daily practice and are drawn up from common sense of the actor’s involved. It supports openness to otherness through the nurse approaching to the care and to the team. One of the possible paths considered to overcome this crisis relies on the intersection between the research and teaching that take into account the reality of health services.