Healthcare context and nursing workforce in a main city of Angola.

BACKGROUND: Angola is one of the largest African countries with continuing levels of insecurity, considerable weakness in terms of respect for human rights, destroyed infrastructure and low transparency and social accountability levels. The health system displays gaps and nursing represents the main contingent among human resources in health. AIM: This research aims to understand the healthcare context in Angola from the perspective of Brazilian nurses who were involved in helping their Angolan colleagues. This general view of health services is followed by a description of nursing workforce particularities at a tertiary health service in the province of Luanda. METHODS: Data were extracted from the database of the Global Network of World Health Organization Collaborating Centres for Nursing and Midwifery Development, constructed based on technical visits to Angola in 2009. Information related to health service characteristics was used, focusing on nursing human resource activities at two tertiary, one secondary and one primary health institutions located in the province of Luanda. The study data were analysed through descriptive statistics. FINDINGS: Among the problems the nursing workforce faces, the lack of human, material and financial resources stands out, as well as insufficient professional qualification, excessive work journeys, low remunerations, non-valuation of professionals, leading to unsatisfactory work environments and discouraged human resources. CONCLUSIONS: Nursing in Angola is conquering its professional space. Therefore, regulatory policies are fundamental, defining the rights and obligations of all categories involved, with a view to determining nurses' function in the health team, including respect for and acknowledgement of their role in the community.

Sobre a criação e a gestão do conhecimento organizacional

Destaca o papel da enfermeira no processo de gestão do conhecimento, posicionando-a na interseção dos fluxos horizontais e verticais de informação, e na criação de uma vantagem competitiva sustentável.

[Communication with the patient. A question of quality]. / Comunicación con el paciente. Una cuestión de calidad.

Interpersonal communication as a means to promote health and well-being is presented as a strategical orientation in the nursing care process. Meanwhile, in our medium, we have observed the development of communication from a perspective much more related to complying with a service. This article has these objectives: a) to investigate this theme by highlighting analytical instruments of interaction found in bibliographical references, b) to disclose the results of research about nurse-patient communication indicators, in the context as a forum for reflection, bearing in mind the quality of treatment. The authors highlight the need to assume a responsibility shared by teaching nurses and assistants, with the goal to constantly seek to develop communicative competence and thus to contribute to a greater efficiency and an improvement in the quality of nursing care.

[Analysis of expectations on the nurse's leadership in the light of Grid's theories]. / Análise de expectativas sobre a liderança do enfermeiro à luz das teorias Grid.

Based on the understanding that leadership is a fundamental resource for nurses in health institutions, the aim of the authors was to analyze, under the light of Blake & Mouton's Grid Theories, the expectations of the Nursing team regarding nurse's leadership. The analysis was based on four investigations performed in different contexts of Brazilian Nursing and data were collected through the application of the "Grid & Leadership in Nursing Instrument" developed by Trevizan. Results show that the subjects prefer the Grid style 9.9. The authors discuss the results and emphasize the need for the development of leadership in Nursing.

[Strengthening the interdisciplinary process in student's research programs]. / Fecundando o processo da interdisciplinaridade na iniciação científica.

The modern disciplinary focus is based on specific processes and presents a tendency to reduce knowledge by describing it as a consequence of a highly rational scientific posture that has promoted excessive specialization and fragmentation in detriment of the human being. With the development of societies and the perspective of knowledge interconnection which searches for institutions with global and broad dimensions in the spheres of knowing and doing, disciplinarity will be transcended. In this sense, the purpose of this work is to report the experience of an undergraduate students' research program in the view of interdisciplinarity. Playing the roles of advisor and student from different areas--Nursing and Administration respectively--we are experiencing an interdisciplinary process through the exchange of ideas, actions and the investigation on human resources and their management in the Nursing area. We believe that the dissemination of this experience can contribute to strengthen interdisciplinarity in the context of research in undergraduate programs.

[Brazilian nursing leaders -- their view about leadership issues and their perception of the nursing-leadership relationship]. / Líderes da enfermagem brasileira--sua visão sobre a temática da liderança e sua percepção a respeito da relação liderança & enfermagem.

Fourteen Brazilian nurses singled out for their leadership skills were asked about their view on leadership issues and about their perceptions of the relationship between nursing and leadership. The analysis of the data provided by the professionals showed that the interviewed leaders had a clear-cut view of these issues and of their important role in the nursing profession. They understood leadership as a group process through which people or behaviors are influenced. Such a process is carried out aiming to reach a goal. They also realized a close relationship between leadership and nursing.

[Contribution of teaching organizations to the process of partnership between faculty and clinical nurses]. / Contribuição das disciplinas da organização de aprendizagem ao processo de parceria docente-assistencial na enfermagem.

The rapid changes that are occurring in the societies have affected daily life of organizations that also need to equip and adapt themselves to correspond to this need. The first initiatives were related to the search for transformations in the organization structure and in the applied management model in order to form work teams, exchange and share information. The main purpose of this study is to point out five disciplines on the learning organization proposed by SENGE (1990) as a reference that can contribute to the process of faculty and clinical nursing partnership. Authors believe that continuous development and learning of those disciplines by nurses can enable the consolidation of this partnership between academic and clinical nursing institutions.

[Quality management: its use in nursing]. / Gerenciamento da qualidade: utilização no serviço de enfermagem.

The Quality Management has been used and it is a reality in the hospitals. Thus the authors comment about its importance for Nursing and analyse its utilization in a Nursing Service of a private hospital, with purpose to evaluate the implementation form, nurses' involvement and the Deming' Principles application. Data show that the implementation has brought good results, nurses are engaged in the process and the Deming's Principles have been utilized, adequate or inadequately.

[Recruitment and selection of human resources in a psychiatric hospital at a municipality of São Paulo]. / Recrutamento e seleção de recursos humanos em um hospital psiquiátrico de um município paulista.

This paper aims at disseminating the experience of recruiting and selecting human resources in a psychiatric hospital in the city of Ribeirão Preto, a philanthropic institution with one hundred and four beds that assists pharmaco-dependent patients with mental problems. It presently has eighty-four employees and a high staff turnover in different sectors. As trainees, we realized that the high turnover impaieds the development of activities at the organization as well as prevented a better care delivery to clients. Therefore, we were invited to integrate a team that was made responsible for the recruitment and selection of human resources for this institution. After these procedures and the respective follow-up by those in charge of different sectors, our purpose is to reduce the turnover, implement larger institutional engagement and more synchrony among employees, reduce expenses and bureaucratic activities related to hiring and laying off personnel, reduce operational work and implementing more assisting activities in terms of planning, orientation, execution and evaluation.

[Nurses' leadership in the perspective of postmodern ethics]. / Liderança da enfermeira na perspectiva da ética pós-moderna.

The administrative models arising from modernity are becoming increasingly obsolete in view of the needs of organizations, especially those which provide health care such as health institutions and their human capital. Since rationality is an essential element for the accomplishment of organizational objectives, modern ethics requires only that workers adjust to their prescribed functions and perform their tasks according to the rules. Post-modernity is characterized by saturation of information and consumption, pleasure of using goods and services, lack of values and meaning of life, reflecting a post-modern apathy. Without projects man's interior life has no substance. Health organizations are being strongly influenced by this context. Hence, ethics needs to be treated in a new way. Thus, the purpose of this paper is to approach nurse's leadership in light of post-modern ethics.

[Humanistic approach to nursing communication: the case of a hospitalized adolescent female]. / Enfoque humanístico à comunicação em enfermagem: o caso de uma adolescente hospitalizada.

Nursing is a profession committed to the promotion of human beings. It takes into consideration their freedom, uniqueness and dignity. Therefore, communication plays an important role within the nursing process and its results, and it is also a fundamental component of the treatment. However, in the context of Brazilian hospitals, communication between nurses and patients is limited to the performance of these professionals' technical role. The purpose of this study is to analyse the case of a hospitalized female adolescent, focusing on the communication that happens between her and the nursing professionals who provide her assistance. This analysis was based on Bales' categories. Through the technique of direct observation, the behavior resultant from the interaction between nurses and the adolescent was analysed on a total of 30 hours during five days. The observation showed 428 units of interaction which were classified, by qualified professionals, in positive, negative and neutral socio-emotional areas. Considering the high incidence of interactions in the neutral area (89.2%), authors recommend a humanistic correction in the communication during the nursing process. This change in communication can qualify patient's care as well as generate satisfaction at work through empathy and solidarity.

Humanizing nurse-patient communication: a challenge and a commitment.

Nurse-patient communication has been a pre-established, unvarying, technical professional and impersonal form of manifestation, reflecting mainly the achievement of nurse's instrumental role. This situation is opposed to our nursing concept as well as to the professional values that we incorporated during our professional life, all of which emphasize the importance of the person and the patient and the meaning of the visualisation of care to a total human being. The present study aims at discussing this question, propitiating an opportunity of reflection about the necessity of humanizing this relationship in the Brazilian scenery. Thus, we focused on the importance of nurse-patient relationship not only as an essential component of nursing assistance but also as a treatment in itself. In addition, we stimulate nurses to examine the way they are taking care of human beings: as objects to be manipulated and treated or as persons that need care and comprehension. The article is concluded with the thesis that nursing is not a technical profession that manipulates knowledge and technologies but a work of valuing human beings, their freedom and dignity.

[Factual and virtual dimension in nursing management]. / Dimensões factual e virtual no gerenciamento da enfermeira.

Through an historical analysis of the hospital organization as well as of nursing practice in the bureaucratic context of hospitals, authors found that the studied institution delegates to nurses several management functions, mainly bureaucratic ones. This was verified through empirical data about nurse's role in the units, demonstrating that, among her functions, the management ones are privileged in that institution. Results showed that in the hospital field, nurses can not avoid the management function, although there is an expectation of a different management role than the one normally found. Considering this factual dimension, authors also analyse the virtual dimension of this process, in order to investigate the expectations of the nursing personnel regarding nurses' behaviour as managers/leaders. Authors conclude the study demonstrating the importance of the conciliation of the factual-virtual duality in female nurse's management and leadership.

[Situational leadership: structures of reference for the work of head nurses in a hospital context]. / Liderança situacional: estrutura de referência para o trabalho do enfermeiro-líder no contexto hospitalar.

Authors studying the theme of leadership developed models that can be applied in the organizational context. In the present study, we selected the model proposed by Hersey and Blanchard, named Situational Leadership. Through the technique of critical incidents, we identified and analyzed the behaviour of nurses from surgical units. Based on the analysis of data, we were able to infer that situational leadership can be used as a theoretical structure to base nurses' leadership skills, in order to improve the quality of nursing care and the development of nursing personnel.

[Leadership and communication in nursing management]. / Liderança e comunicação no cenário da gestão em enfermagem.

Considering communication and leadership, authors examine the role of the leader as a focus of reception and transmission of information, based on the classification of Mintzberg related to their informative roles, such as the leader acting as monitor, disseminator and spokesman. Contextualizing this approach in the scenery of nursing management, authors study the dimension of nurses-leaders role as an essential element of communication in the systems of organization of nursing care.

[Leadership of nurses in the XXI century: various considerations]. / A liderança do enfermeiro no século XXI: algumas considerações.

The present article approaches the theme of leadership in it essential aspects and considers the transformations contemporary organizations are experiencing. Based on the literature authors found the role of the nurse--leader of the future and the importance of the auxiliary personnel--led to the efficacy of the leading process and the need of learning on leadership.

[Situational leadership: a model for application in Brazilian nursing]. / Liderança situacional: um modelo para aplicação na enfermagem brasileira.

Leadership is a very important theme to the management of nursing care provided to the patient. This study aimed at presenting key-concepts of the leadership model developed by Hersey and Blanchard, entitled Situational Leadership. We believe that this model can bring relevant contributions to nurse's leadership skills.

[The leadership style exercised by nurses in surgical wards focuses on situational leadership]. / O estilo de liderança exercido pelo enfermeiro de unidade de internação cirúrgica sob o enfoque da liderança situacional.

The present study was oriented to the leadership theme focussing nurses inside surgical ward unities. As a theoretical reference, the authors used the Situational Leadership Model proposed by Hersey and Blanchard. This study aimed at analysing the correspondence between the opinions of nurses and auxiliary personnel about the leadership style exerted by nurses in the surgical ward unit regarding the six categories of the assistance activity that were studied. Authors noticed that nurses, from the two studied hospitals, adopted the directive leadership styles (E2/selling or E1/telling) with the auxiliary personnel.

[The surgical nurse: his/her leadership of auxiliary nursing personnel]. / Enfermeiro cirúrgico: seu estilo de liderança com o pessoal auxiliar de enfermagem.

This investigation as carried out in order to promote follow-up in the studies concerning nurse's leadership in the hospital context. Emphasys is given to the nurses that works in surgical ward unities. As a theoretical framework, authors utilized the model of leadership proposed by Hersey and Blanchard, named Situational Leadership. The objective was to analyze the correspondence of opinion between nurses and nursing auxiliary personnel about the leadership style of nurse should adopt in accordance with the maturity level of an element of the auxiliary personnel based on six categories of activities that were studied. Authors found out that nurses should adopt the styles of participant leadership, such as E3 (participating) and/or E4 (delegating).

[Expectations of hospital administrators about administrative functions of nurses]. / Expectativa do administrador hospitalar frente as funções administrativas realizadas pelo enfermeiro.

The objective of the present study was to investigate hospital administrator's expectations about the administrative role played by nurses, utilizing functions proposed by the Neoclassical Theory of Administration: planning, organization, direction, and control as theoretical references. An instrument established in TREVIZAN (1989) was applied to 11 hospital administrators. The results showed they expect the four functions to be done by nurses. Therefore, the interaction between nurses and hospital administrators is critical to improve the patient's assistance.