El peor enemigo de la enfermera es / The nurse's worst enemy is

Mucho se comenta en los hospitales como dicho, tal vez sin sentido, que el peor enemigo de una enfermera es otra enfermera; sin embargo, es necesario hacer una reflexión, e incluso un análisis concienzudo, sobre estas palabras ya que descontextualizan el verdadero quehacer y objetivo de la enfermería. Personalmente, considero que no es así. En primera instancia porque una persona preparada en las ciencias de la enfermería no podría considerar válida esta creencia, ya que la esencia y los valores de la enfermera dista en demasía de la palabra enemigo. El peor enemigo de la enfermera es la falta de conocimiento, ya que, al permanecer con una actitud pasiva ante los avances científicos, no dimensionamos la importancia de estar en constante entrenamiento, para que el ejercicio de nuestra profesión se lleve a cabo con los más altos estándares de calidad, tanto académica como de cuidado enfermero, con el único objetivo de reestablecer la salud de las personas. El peor enemigo de la enfermera es la falta de conocimiento, pues no se debe ejercer la enfermería basada en ocurrencias, no se debe ejercer la enfermería basada en falsas eminencias, en negligencias, en complacencias y, sobre todo, la enfermería basada en el desconocimiento. El peor enemigo de la enfermera es la falta de conocimiento, dado que al desconocer de los procesos tanto fisiológicos como patológicos, no sabremos tomar decisiones basadas en la ciencia y, por consiguiente, esas decisiones repercuten en la salud y la vida de las personas.

Much is said in hospitals as a saying, perhaps without meaning, that the worst enemy of a nurse is another nurse; however, it is necessary to make a reflection, and even a conscientious analysis, on these words since they decontextualize the true task and objective of nursing. Personally, I consider that it is not so. In the first instance, because a person trained in nursing sciences could not consider this belief valid, since the essence and values of the nurse are too far from the word enemy. The worst enemy of the nurse is the lack of knowledge, since, by remaining passive in the face of scientific advances, we do not appreciate the importance of being in constant training, so that the exercise of our profession is carried out with the most high-quality standards, both academic and nursing care, with the sole objective of restoring people's health. The worst enemy of the nurse is the lack of knowledge because nursing based on occurrences should not be practiced, nursing based on false eminences, negligence, complacency and, above all, nursing based on ignorance should not be practiced. The worst enemy of the nurse is the lack of knowledge, given that by being unaware of both physiological and pathological processes, we will not know how to make decisions based on science and, consequently, these decisions have an impact on people's health and lives.

Contribuições do profissional de psicologia para o paciente em cuidados paliativos / Contributions of the psychology professional to the patient in palliative care / Aportaciones del profesional de la psicología para el paciente en cuidados paliativos

Os cuidados paliativos englobam uma filosofia de cuidados que objetivam a promoção da qualidade de vida e alívio do sofrimento, tanto para o paciente fora de possibilidades de cura quanto aos seus familiares, de modo que possa integrar aspectos de ordem física, psíquica, social e espiritual. O presente artigo buscou, a partir do estudo de revisão bibliográfica, compreender o processo da morte e sua implicância psíquica na vida do paciente em cuidados paliativos para, posteriormente, elencar as possíveis contribuições do profissional de psicologia ao mesmo. Observou-se que a atuação do psicólogo nesse âmbito é de imensa importância, uma vez que o processo de adoecer e morrer permeiam a vida do ser humano, causando-lhe grande sofrimento. Percebeu-se também que as ações do psicólogo se dão no sentido de tornar a morte e seus impactos mais suportáveis, por meio da escuta, do acolhimento emocional, dentre outros aspectos importantes que se referem à sua natureza científica.

Palliative care encompasses a philosophy of care aimed at promoting quality of life and alleviating suffering, both for the patient with no chance of cure and for their family members, so that they can integrate physical, psychic, social and spiritual aspects. The present article sought, from the study of literature review, to understand the process of death and its psychic implications in the life of the patient in palliative care to, later, list the possible contributions of the psychology professional to it. It was observed that the role of the psychologist in this context is of immense importance, since the process of falling ill and dying permeates the life of human beings, causing them great suffering. It was also noticed that the psychologist's actions take place in the sense of making death and its impacts more bearable, through listening, emotional reception, among other important aspects that refer to its scientific nature.

Los cuidados paliativos engloban una filosofía de atención que tiene como objetivo promover la calidad de vida y el alivio del sufrimiento, tanto para el paciente fuera de las posibilidades de curación como para sus familiares, de modo que puede integrar aspectos de orden físico, psicológico, social y espiritual. El presente artículo buscó, a partir del estudio de revisión bibliográfica, comprender el proceso de la muerte y su implicación psíquica en la vida del paciente en cuidados paliativos para, posteriormente, enumerar las posibles aportaciones del profesional de la psicología al mismo. Se observó que la actuación del psicólogo en esta área es de inmensa importancia, ya que el proceso de enfermar y morir impregna la vida del ser humano, causándole un gran sufrimiento. También se dio cuenta de que las acciones del psicólogo se dan con el fin de hacer más llevadera la muerte y sus impactos, a través de la escucha, el apoyo emocional, entre otros aspectos importantes que se refieren a su carácter científico.

Identification and characterisation of potential drug interaction in a Hospital in Jundiai, Sao Paulo State

Abstract To identify and characterize the most frequent Drug Interaction (DI) in a Jundiaí Hospital. Exploratory, descriptive, and analytical cross-sectional study with a quantitative approach. The source of the study is 100 prescriptions made by the medical service of a hospital in Jundiaí, dispensed from August to October 2018, by the pharmacy of the mentioned hospital for palliative care, mental health, and emergency care. Data plotting in Excel. Of the 100 prescriptions analyzed 60 had at least one type of interaction, 164 DI were found, 14.6% severe, 67.7% moderate, 17.1% minor and 0.6% unspecified. The mechanism of interaction that most appeared in the study was pharmacodynamics, 54.3%, pharmacokinetics were present in 34.1% of DI and 11.6% were not specified. The group most affected by DI was male 33% of prescriptions, female 27%, and 40% showed no interactions. The age group with the most interactions was from 50 to 59 years old. Of the prescriptions that had MI, those with 4 or more interactions were the ones that prevailed. The class of drugs that presented the most interactions was psychotropic drugs. A relevant frequency of interactions was identified by the present study, being the class of psychotropic drugs the most evident and interactions of medium severity the most found, which may be responsible for lowering the clinical condition of patients and the need of possible additional interventions. The data presented may contribute as epidemiological indicators, guiding corrective actions, aiming at the welfare of patients

Asignación ética de recursos sanitarios escasos en el contexto de crisis por COVID-19 / Ethical allocation of scarce health care resources in the context of the COVID-19 crisis

La actual pandemia por COVID-19 tiene el potencial de sobrepasar la capacidad de hospitales y unidades de cuidados intensivos en Chile y América Latina. Por lo tanto, las autoridades locales tienen la obligación ética de estar preparadas mediante la implementación de medidas tendientes a evitar una situación de racionamiento de recursos sanitarios escasos, y a través de la definición de criterios éticamente aceptables y socialmente legítimos para la asignación de estos recursos. Este artículo presenta una respuesta a orientaciones éticas recientes emitidas por una institución académica chilena y analiza los principios éticos relevantes para la fundamentación ética de criterios de racionamiento. Se argumenta que, frente a circunstancias excepcionales como la actual pandemia, la moral centrada en el paciente de la medicina tradicional necesita ser ponderada con principios éticos formulados desde una perspectiva de salud pública, incluyendo los principios de utilidad social, justicia social y equidad, entre otros. Se concluye con algunas recomendaciones sobre cómo llegar a acuerdo sobre criterios de racionamiento y sobre la implementación de estos en la práctica clínica.

The current COVID-19 pandemic has the potential to overwhelm the capacity of hospitals and Intensive Care Units in Chile and Latin America. Thus local authorities have an ethical obligation to be prepared by implementing pertinent measures to prevent a situation of rationing of scarce healthcare resources, and by defining ethically acceptable and socially legitimate criteria for the allocation of these resources. This paper responds to recent ethical guidelines issued by a Chilean academic institution and discusses the main moral principles for the ethical foundations of criteria for rationing during the present crisis. It argues that under exceptional circumstances such as the current pandemic, the traditional patient-centered morality of medicine needs to be balanced with ethical principles formulated from a public health perspective, including the principles of social utility, social justice and equity, among others. The paper concludes with some recommendations regarding how to reach an agreement about rationing criteria and about their implementation in clinical practice.