O significado da gestão do cuidado para docentes de enfermagem na ótica do pensamento complexo

Abstract

Objective:To understand the meaning of care management attributed by faculty members of a nursing course from the viewpoint of complex thinking Methods: Qualitative and comprehensive research with case studies, and individual interviews with 17 faculty members of a nursing course of a public university in southern Brazil. The data were subjected to comprehensive analysis based on the principle of complex thinking of Edgar Morin. Results: Two categories emerged: "classical fragmentation versus the contemporary whole" and "teaching care management and the nursing work process", whereby it was observed that despite the integrating proposal of the curriculum, care management is viewed as fragmented. Conclusions: Care management must be redefined if it is expected to serve as an aggregator in education. It is necessary to create strategies that enable moments of reflection on the subject, and for education to provoke changes in the work process of nurses. Keywords: Practice management. Nursing. Knowledge. Teaching. Education, higher. RESUMO Objetivo:Compreender o significado da gestão do cuidado para docentes de enfermagem na ótica do pensamento complexo. Métodos: Pesquisa qualitativa e compreensiva, do tipo estudo de caso, na qual foram realizadas entrevistas individuais com 17 docentes do curso de enfermagem de uma universidade pública no sul do Brasil. Os dados foram submetidos à análise compreensiva à luz do Pensamento Complexo de Edgar Morin. Resultados: Emergiram duas categorias: "a fragmentação clássica versus o todo contemporâneo" e "o ensino da gestão do cuidado e o processo de trabalho do enfermeiro", por meio das quais se constatou que, apesar da proposta integralizadora do currículo, a gestão do cuidado ainda é visualizada de maneira fragmentada. Conclusões: Torna-se necessário ressignificar a gestão do cuidado para que esta tenha um caráteragregador ao longo do ensino. Devem ser criadas estratégias que possibilitem momentos de reflexões sobre a temática, permitindo que o ensino provoque mudanças no processo de trabalho do enfermeiro. Palavras-chave: Gerenciamento da prática profissional. Enfermagem. Conhecimento. Ensino. Educação superior. RESUMEN Objetivo:Comprender el significado de la gestión de la atención para los profesores de enfermería en la luz del pensamiento complejo. Métodos: Se trata de un estudio cualitativo y global, se llevó a cabo el tipo de estudio de caso, a través de entrevistas individuales con 17 profesores en un curso de enfermería en una universidad pública en el sur de Brasil. Los datos fueron sometidos a análisis exhaustivo a la luz del Pensamiento Complejo de Edgar Morin. Resultados: Surgieron dos categorías: "la fragmentación clásica versus el todo contemporáneo" y "la enseñanza de la gestión del cuidado y el proceso de trabajo del enfermero, " a través de las cuales se señaló que a pesar del plan de estudios de integralizadora propuesto, la gestión de atención todavía es vista de manera fragmentada. Conclusiones: Es necesario replantear la gestión de la atención, par...

Care management from the perspective of supervising nurses

“…The collective construction of the care management concept took into account individual opinions and knowledge acquired through discussions, which resulted in a conceptualization focused on the interdependence of care and management activities, intermediated by systematized care and management of resources necessary for care. Thus, the conceptualization elaborated by the group of nurses is in line with affirmations that care and management should be understood in a dialectical way (9)(10) , which confirms that care activities are closely related to management/administration activities. Thus, the collective concept contradicts the individual conceptions of care management initially constructed by nurses, which segregate such actions before care.…”

“…In the nurses' individual concepts, care management is seen as an issue divided into static activities such as team management, care/assistance, and properly administrative actions, listed as a "bureaucratic" part of their work. This perception is translated into a fragmented work practice, since the nurse's work, in a proactive perspective, should harmonize the dimensions of taking care/assisting, researching/teaching, and administering/managing in order to excel in the quality of care provided (9)(10)(11) .…”

“…Indirect care in this study refers to the so-called administrative and managerial activities, carried out by the nurse, necessary to adjust conditions and resources aiming at achieving the planned and quality care (6,(10)(11)(12) . Direct care refers to the implementation of nursing actions to meet all patient needs, including aspects related to dialogue, relationships, respect and individuality (10) .…”

“…Regarding the difficulty related to the lack of standardization of norms and routines, it is emphasized that the standardization of procedures/behaviors tends to homogenize the work process and this leads to the development of actions that avoid or minimize errors or failures in the care process, favoring managerial actions (10)(11)(12)(13) . However, the standardization of care processes should not be understood as a complication of the care process, but rather as a strategy to promote professional autonomy, in a way that it provides more safety in the performance of procedures, which consequently improves the quality of care provided (4,9) .…”

“…Once again, a permanent educational process stands as an important individual and institutional strategy to minimize the difficulty related to standardization, since the educational process based on the precepts of Permanent Health Education aims at learning at work, using dialogical methodologies. Thus, the team participating in the process of thinking about care can find, through permanent education, solutions to minimize and solve issues that interfere with care (8,10) .…”