RESUMO
OBJETIVO: Refletir sobre as ações de práticas avançadas de enfermagem no contexto das Unidades de Terapia Intensiva. MÉTODO: Trata-se de um estudo teórico-reflexivo embasado em literatura internacional, cujos artigos apontem ações do enfermeiro de prática avançada no ambiente de terapia intensiva, além do guideline de Prática Avançada de Enfermagem do International Council of Nurses. RESULTADOS: A união de informações acerca das ações de práticas avançadas de enfermagem no ambiente de terapia intensiva permitiu a reflexão que gerou nove categorias de ações: educação continuada, educação em saúde, ser referência especializada em terapia intensiva, atividade de pesquisa, gerenciamento do cuidado, liderança de equipe, cuidado com a família, atuação em equipe multidisciplinar e assistência direta ao paciente. CONCLUSÃO: A reflexão evidenciou que educação, gestão e assistência são eixos de competências encontradas nas práticas avançadas de enfermagem na terapia intensiva.
OBJECTIVE: To reflect on the actions of advanced practice nursing in the context of intensive care units. METHOD: This is a theoretical-reflective study based on international literature whose articles refer to the actions of advanced practice nurses in the intensive care environment. It is also based on the International Council of Nurses' Advanced Practice Nursing Guideline. RESULTS: The union of information about the actions of advanced practice nursing in the intensive care environment allowed a reflection that generated nine categories of actions: continuing education, patient education, being a specialized reference in intensive care, research activity, care management, team leadership, family care, multidisciplinary teamwork, and direct patient care. CONCLUSION: The reflection showed that education, management, and care are the axes of competencies in advanced practice nursing in intensive care.
Assuntos
Prática Avançada de Enfermagem , Unidades de Terapia Intensiva , Organização e Administração , Educação , Cuidados de EnfermagemRESUMO
OBJECTIVE: To reflect about the do-not-resuscitation order at COVID-19 in Brazil, under bioethical focus and medical and nursing professional ethics. METHOD: Reflection study based on the principlist bioethics of Beauchamps and Childress and in professional ethics, problematizing actions, and decisions of non-resuscitation in the pandemic. RESULTS: It is important to consider the patient's clinic, appropriation of treatment goals for people with comorbidities, elderly people, with less chance of surviving to resuscitation, or less quality of life, with the palliative care team, to avoid dysthanasia, use of scarce resources and greater exposure of professionals to contamination. CONCLUSION: COVID-19 increased the vulnerabilities of professionals and patients, impacting professional decisions and conduct more widely than important values ââsuch as the restriction of freedom. It propelled the population in general to rethink ethical and bioethical values ââregarding life and death, interfering in decisions about them, supported by human dignity.