El cuidado de enfermería al paciente en proceso de fallecer: una dolorosa función profesional y humana

ABSTRACT: This work sought to describe the care functions of nurses with patients during the dying process. Methodology. This was a qualitative study with ethnographic approach stemming from the analysis of the culture of nurses; it was conducted in the city of Medellín, Colombia. Theoretical saturation was obtained with 23 interviews. Results. Nurses feel the duty to care for patients throughout the vital cycle through functions defined as: serving, helping, accompanying, offering support, advocating, educating, and representing, which they identify as indispensable. They also perceive as their own the social responsibility for some issues related to death and due to this they get involved at the personal level, appropriate care and are affected as persons. Conclusion. Patient care during dying processes transcends the limits of the nurse’s professional functions to become a human obligation.RESUMEN: Describir las funciones de cuidado de las enfermeras con el paciente en proceso de fallecer. Metodología. Estudio cualitativo con enfoque etnográfico partiendo del análisis de la cultura de las enfermeras, realizado en la ciudad de Medellín, Colombia. Se obtuvo saturación teórica con 23 entrevistas y 100 horas de observación. Resultados. Las enfermeras sienten el deber de cuidar del paciente a lo largo del ciclo vital mediante funciones que definen como: servir, ayudar, acompañar, brindar soporte, abogar, educar y realizar el rol de vicario, las cuales identifican como indispensables. También, sienten como propia la responsabilidad social por algunos asuntos relacionados con la muerte y por esto se involucran personalmente del cuidado cuyo resultado es su afectación como personas. Conclusión. El cuidado del paciente en proceso de morir trasciende los límites de las funciones profesionales de la enfermera para convertirse en una obligación humana

Therapeutic relationships in day surgery: a grounded theory study

Aim: The aim of the study was to explore patients’ experiences of day surgery. Background: Therapeutic relationships are considered to be a core dimension of nursing care. However in modern healthcare with short hospital stays the formation of these relationships may be impeded. A major theme to emerge from this study was the development of therapeutic relationships in the day surgery setting. Methodology: The Glaserian method of Grounded Theory was utilised. Semi –structured interviews with 145 patients took place from 2004-2006 in two day surgery units in the United Kingdom. Analysis involved transcriptions of interviews and memos. Lists of key words and phrases were made and constantly compared until core categories began to emerge. Results: Patients spoke highly of the relationships they developed with nurses during their stay in the day surgery unit. Analysis of the data revealed the core category of therapeutic relationships and four sub core categories: “presence,” “extra special” “befriending” and “comfort-giving.” Conclusion: This paper adds to the growing body of literature which demonstrates that therapeutic relationships can be developed within the short stay arena of health care : routine interactions which may not be considered to be significant by nurses may be of importance to patients. The patients in this study felt supported, comforted and befriended by day surgery nurses. However a minority of patients were disappointed with the nursing staff responses to patient needs. Relevance to clinical practice: Anecdotal and empirical evidence suggests that personnel working within day surgery are not always aware of their therapeutic potential. Therefore raising awareness of this through research generated from patients’ experiences might encourage nurses to further realise their capabilities in this fundamental area of nursing

Grupo de familiares na prática de ensino de graduação em enfermagem

Atualmente, os Centros de Atenção Psicossocial (CAPS) são dispositivos estratégicos para assistência em saúde mental no Brasil. Os enfermeiros são profissionais exigidos na equipe mínima deste dispositivo, que valoriza as atividades grupais na abordagem dos usuários. Relato de experiência de alunos do Curso de Graduação em Enfermagem da UFMT, na realização de grupo de sala de espera com familiares de usuários de um CAPS de Cuiabá-MT. Justifica-se em virtude das poucas oportunidades que alunos de enfermagem têm para desenvolver habilidades de abordagem grupal na sua formação, voltada prioritariamente para o cuidado clínico individual. O objetivo da experiência foi proporcionar aprendizado teórico-prático de todas as etapas do trabalho com grupos: reconhecimento da necessidade e possibilidade da atividade, planejamento, coordenação e avaliação do grupo. Os resultados confirmam a necessidade e possibilidade da realização de experiências grupais na assistência em saúde mental e no ensino de enfermagem.Los Centros de Atención Psicosocial (CAPS) son dispositivos estratégicos para la asistencia a la salud mental en Brasil en la actualidad. Los enfermeros son profesionales exigidos en el mínimo equipo de este dispositivo que valoriza las actividades grupales en el abordaje de los usuarios. Relato de experiencia de alumnos del Curso de Graduación en Enfermería de la UFMT en la realización de grupo de sala de espera con familiares de usuarios de un CAPS de Cuiabá, MT, Brasil. Se justifica en virtud de las pocas oportunidades que tienen los estudiantes de enfermería en el desarrollo de competencias de abordaje grupal en su formación, focalizada principalmente para la atención clínica individual. El objetivo de la experiencia era proporcionar aprendizaje teórico-práctico de todas las etapas del trabajo con grupos: reconocimiento de la necesidad y posibilidad de la actividad, planificación, coordinación y evaluación del grupo. Los resultados confirman la necesidad y la viabilidad de la realización de experiencias de grupo en el cuidado de la salud mental y la educación de enfermería.The Centers of Psychosocial Care (CAPS, acronym in Portuguese) are strategic devices for mental health care currently available in Brazil. Nurses are professionals required to compose the minimum staff of this device, which values the group activities involving users. This study presents a r report of the experience of nursing undergraduates from Universidade Federal do Mato Grosso(UFMT) on their conducting waiting-room group sessions with relatives of users of a CAPS from Cuiabá, Mato Grosso state. This experience is justified by the fact that nursing students have few opportunities to develop group approach abilities during their graduation course, which focuses mainly on clinical individual care. The aim of the experience was to provide theoretical-practical learning of all the work stages of group work: recognizing the need and possibility of conducting the activity, planning, coordination and group evaluation. The results confirm the need and possibility of performing group experiences in mental health care and in nursing education

Reclaiming the humanity in personality Disorder.

This paper provides a commentary upon the nursing care of individuals diagnosed with personality disorder and associated education courses. The discussion focuses upon recent policy trends in the UK as a point of departure. This policy discourse is critical of mainstream mental health services in previously operating to exclude such individuals. One of the consequences has been a recent growth in interest in relevant training courses, many of which devote significant attention to staff attitudes regarding this client group. Various previous researchers and commentators have remarked upon the implications for practice of a perceived negative attitude among care staff. We reflect upon our own anecdotal experience of developing and delivering new university-based courses for practitioners working in the field of personality disorder to offer a particular critique of the UK context, in which this policy, training, and practice is framed. Social constructionist theories are drawn on to offer insights into public and practitioner discourse and the possible effects on therapeutic relationships. The available discourse constructs individuals with a diagnosis of personality disorder as essentially different from other people. We argue that staff training and practice development initiatives are likely to be more successful if such discourse is challenged, and attempts are made in therapeutic encounters to recognize shared characteristics and positive attributes as much as perceived difference and negative attributes. We refer to this as a re-engagement with common humanity. Despite the singular national context, the discursive themes explored are not necessarily restricted to the UK