Professional Identity of Nurse Manager in the Light of the Structural Dialectic Care Model / Identidad profesional del enfermero gestor a la luz del Modelo Estructural Dialéctico de los Cuidados / Identidade profissional do enfermeiro gestor à luz do Modelo Estrutural Dialético dos Cuidados

ABSTRACT Objectives: To identify in the scientific literature the identity-related configurations inherent to the nurse's managerial practices of a professional that works in a hospital setting, and to analyze them in the light of the Structural Dialectic Care Model (SDCM). Materials and method: The article concerns about a qualitative research where an integrative review was made enabling the selection of 15 articles, analyzed in light of the SDCM. Results: From the 15 selected articles, three thematic axes were established: Leadership, care and conflicts. Conclusions: It was concluded that the SDCM has made it possible to discover the nurse's identity models as a managerial agent in the diverse pluralities articulated to the identity-related processes of such professional.

RESUMEN Objetivos: identificar en la literatura científica las configuraciones identitarias inherentes a las prácticas gerenciales del enfermero, que actúa en el entorno hospitalario, y analizarlas a la luz del Modelo Estructural Dialéctico de los Cuidados (MEDC). Materiales y método: investigación cualitativa en la que se realizó una revisión integradora que posibilitó seleccionar 15 artículos, analizados desde el MEDC. Resultados: a partir de los artículos seleccionados, se establecieron tres ejes temáticos: liderazgo, cuidado y conflictos. Conclusiones: el MEDC ha posibilitado averiguar los modelos identitarios del enfermero como agente gestor en las diversas pluralidades articuladas a los procesos identitarios de dicho profesional.

RESUMO Objetivos: identificar, na literatura científica, as configurações identitárias inerentes às práticas gerenciais do enfermeiro que atua em ambiente hospitalar e analisá-las à luz do Modelo Estrutural Dialético dos Cuidados (MEDC). Materiais e método: trata-se de uma pesquisa qualitativa. Foi realizada uma revisão integrativa que possibilitou selecionar 15 artigos, analisados à luz do MEDC. Resultados: a partir dos 15 artigos selecionados, foram estabelecidos três eixos temáticos: liderança, cuidado e conflitos. Conclusões: conclui-se que o MEDC possibilitou averiguar os modelos identitários do enfermeiro, como agente gestor, nas diversas pluralidades articuladas aos processos identitários desse profissional.

Brazilian registered nurses' perceptions and attitudes towards adverse events in nursing care: a phenomenological study.

AIM: To describe the perceptions and attitudes of registered nurses (RNs) towards adverse events (AEs) in nursing care. BACKGROUND: The professionals' subjective perspectives should be taken into account for the prevention of AEs in care settings. METHOD: Schütz's social phenomenology was developed. Interviews were conducted with nine Intensive Care Unit RNs. RESULTS: The following five descriptive categories emerged: (1) the occurrence of AEs is inherent to the human condition but provokes a feeling of insecurity, (2) the occurrence of AEs indicates the existence of failures in health care systematization, (3) the professionals' attitudes towards AEs should be permeated by ethical principles; (4) the priority regarding AEs should be the mitigation of harm to patients, and (5) decisions regarding the communication of AEs were determined by the severity of the error. CONCLUSIONS: The various subjective perspectives related to the occurrence of AEs requires a health care systematization with a focus on prevention. Ethical behaviour is essential for the patients' safety. IMPLICATIONS FOR NURSING MANAGEMENT: Activities aimed at the prevention of AEs should be integrated jointly with both the professionals and the health care institution. A culture of safety, not punishment, and improvement in the quality of care provided to patients should be priorities.

[Evaluation of the curricular clerkship in nursing administration: dialectical perspective]. / Avaliação no estágio curricular de administração em enfermagem: perspectiva dialética.

This experience report had as purpose to describe the evaluation process in curriculum clerckship of nursing administration in the Nursing Course of the School of Nursing at the University of São Paulo, in the light of dialectical methodology. In this perspective, knowledge is constructed in three stages: síncrese, analysis and synthesis, in which the pedagogical task of the teacher is mediating the steps of mobilization, construction and synthesis of knowledge through the doubt and criticism. It was concluded that assessment of learning valued interpersonal relations and participation of the subjects involved, through the host and establishment of links in the process, encouraging the development of knowledge from the practice of creating problem situations constructive and meaningful, developing multiple competences.

Daily activities of nursing auxiliaries and technicians in relation to ethical events.

This study aimed to know and understand the actions of nursing auxiliaries and technicians who work in the intensive care unit of the school hospital at the University of São Paulo in relation to ethical events. Data were collected through interviews with eight nursing auxiliaries and technicians (NAs and NTs), with experience with ethical events, and were analyzed according to sociological phenomenology. Participants' experiences permitted to uncover the following concrete categories of meaning: minimization of the risk in these events for patients, openness/dialog within the nursing team, nurses' guidance and supervision of activities performed by NAs and NTs, valuing justice in interpersonal relationships, and respecting the right of patients to be informed about such events. The actions of NAs and NTs in ethical events revealed their intention to ensure delivery of safe care to patients.

[Nurses' perception about diseases that are treated by acupuncture]. / Enfermidades tratadas e tratáveis pela acupuntura segundo percepção de enfermeiras.

The objective of this study was to identify and analyze nurses' perceptions about diseases that are treated by acupuncture, taking into consideration: (1) the diseases of nurses who had received acupuncture treatment; (2) nurses' diseases which might be treated by acupuncture; (3) suggestions of diseases treatable by acupuncture. This exploratory study was performed with 33 nurses working at 11 health units in southeast São Paulo; places in which acupuncture treatment was available. Results showed that acupuncture was mostly used for stress (10.7%), anxiety, migraines, lumbar pain, myoma and obesity (7.1% each). Acupuncture was suggested as treatments mostly for musculoskeletal diseases (42%), and chronic-degenerative diseases (10%).

[A closer look at the Mozambique reality: nursing and health]. / Um olhar sobre a realidade de Moçambique: a enfermagem e a saúde.

Identity and memory of Nursing are built through studies on historical, political and social aspects of the profession and its collective organizations searching to strengthening its values. In this view, goals of this study are: to share with nursing professionals and students an experience of visiting Mozambique and collecting some information on social, political, health and living conditions of people within this country; and, to disseminate this experience among nurses and colleagues in order to stimulate similar very enriching learning opportunities.

[Ethical occurrences involving nursing staff and professionals: a quantitative approach]. / Ocorrências éticas com profissionais de enfermnagem: um estudo quantitativo.

This study aimed at identifying characteristics of ethical occurrences related to nursing care in a large private hospital in the city of São Paulo. There were 190 occurrences reported to the hospital's Nursing Ethical Committee (NEC) between 1995 and 2004. Most occurrences caused no damages to the patient, the health institution, the nursing staff or the professional involved. From the total of 398 procedures taken, 94.5% of the cases were advices given to nursing staff members by the NEC, including advice from the immediate superiors to the staff members involved. In 93.7% of the occurrences only one staff member was involved. Clinical units accounted for 76.3% of the services involved with ethical occurrences. As a result, it may be said that the study showed the importance of giving advices to the staff in order to prevent customers from damaging occurrences.

[Building the knowledge of the nursing student: an ethical-social approach]. / A construção do conhecimento do graduando de enfermagem: uma abordagem ético-social.

This study aimed at knowing the relation between ethics and self care facing the construction of knowledge of nursing undergraduate and to identify values that conduct that construction. Data were collected through interviews and analysed under social phenomenological and the interviewee'speeches showed the following categories related to motivation for: lecture'posture in the construction of knowledge of student; project to become nurse; relationship between theory and practice; commitment with professional formation. Motivations because: construction of knowledge based on life experiences and self care supported by autonomy Theoretial and practical knowledge of nursing undergraduate was built up through of new challenges.

Nursing history: reflections on teaching and research at undergraduate level.

This study aims to contribute to the discussion on the development of a specific research line on Nursing History. It concludes by addressing the current situation of nursing teaching in undergraduate courses, its persisting difficulties and growing possibilities of this yet so little explored field.

[The regulation of labor relations and human resources management in nursing]. / A regulação das relações de trabalho e o gerenciamento de recursos humanos em enfermagem.

This paper is aimed at discoursing on the regulation of labor relations in Nursing and at giving subsidies to the nurse's managerial practice concerning the rights and obligations of employees and employers based on the Brazilian Labor Law and the Federal Constitution. It emphasizes some regulations that are not clear enough and give rise to doubts and conflicts on the nurse's daily professional activities, such as working hours, resting periods in and between journeys, extra pay for overtime work, weekly paid rest and changes in work schedule. The adequacy of nursing practice to legal rules should allow nurses to get more knowledge, resulting in more confidence and safer actions. By having professional and patient's rights respected, occasional juridical problems inherent to labor rights and obligations will be reduced.

Ethical events in nursing: Daily activities of nurse managers and nursing ethics committee members.

This study aimed to understand the meaning of nurses' actions related to ethical occurrences involving nursing professionals. Data were collected through interviews with nurse managers and members of a Nursing Ethics Committee who experienced the phenomenon. Data were analyzed in the framework of social phenomenology. The nurses' experiences gave rise to the following categories of meaning, as these professionals seek: the humanization of nursing care; continuous improvement of the care process; professional credibility; patients' satisfaction; demystification of the fear of punishment; partnership in the educational process; respect for ethical secrecy and expectation related to the event being forwarded to the Nursing Ethics Committee. The social typification was described at the end. Nurses' actions in cases of ethical events attract the interest of nursing professionals, who want to ensure a risk or damage-free care and to promote the valuation of these professionals.

[Sister Tereza Notarnicola]. / Irmã Tereza Notarnicola.

This paper aims at identifying the motivations which moved Sister Tereza toward nursing and her insertion into Brazilian Nursing Association contributing to disseminate her history as an example of professional life and dedication to nursing. This is a social-historical study based on historical-methodological reference approach of Oral History of Life for data collection. Sister Tereza worked over 33 years for the benefit of all nurses. During this period she contributed to build up the national headquarter of the Association, in Brasilia, not only collecting resources through several raising funds campaigns, but also administering the construction itself. She also was executive secretary of the Association for many years and worked with all main nurse-leaders and pioneers of the country, organizing national congresses, conferences and other scientific events. All nurses are in debt to this notable nursing figure, who at the age of 86, continues working in a nursing home caring old people. She is a living legend and model for young nurses.

[Negligence: a risk factor in caring]. / Ocorrências éticas na enfermagem.

Descriptive and exploratory study with a quantitative approach involving hundred fourteen causes of nursing ethical occurrences (or infractions) between 1995-2001. The objectives of the study were to: 1) characterize the nursing professionals involved in ethical occurrences; 2) identify causes of mistakes made. Outcomes obtained showed that: a) nursing auxiliaries were responsible for the majority of ethical occurrences: b) the main cause of occurrences were negligence, followed by imprudence: c) the more frequent technical mistake observed was in the preparation and/or administration of medicines. This study aims to contribute for a better understanding of the ethical issue involved in the daily nursing practice, as well as to alert professionals in order to not be involved in similar ethical events.