Percepção de enfermeiros do trabalho sobre a prática profissional em empresas no Estado do Rio de Janeiroo / Perception of nurses of the work on the professional practice in companies in the State of Rio de Janeiro

Este estudo tem por objeto "a percepção dos enfermeiros do trabalho sobre o seu saber-fazer profissional, tendo como pressupostos as bases teóricas e legais da enfermagem do trabalho". Objetivo geral: analisar o saber-fazer do enfermeiro do trabalho, a partir da percepção de enfermeiros do trabalho que atuam nos Serviços de Atenção à Saúde do Trabalhador em empresas no Estado do Rio de Janeiro. Trata-se de um estudo descritivo, com abordagem quanti-qualitativa, estruturado em duas etapas: a primeira refere-se ao desenvolvimento de um instrumento de coleta de dados sobre o saber-fazer de enfermeiros do trabalho e análise de evidência de validade de conteúdo do mesmo, no qual participaram 11 enfermeiros com formação na área de enfermagem do trabalho e/ou saúde do trabalhador que responderam um instrumento de validação, no mês de maio de 2019. Após as respostas procedeu-se os cálculos utilizando o Content Validity Ratio. A segunda etapa consiste na realização do Grupo Focal e aplicação do instrumento, em Café Científico, com oito enfermeiros do trabalho que atuam em Serviços de Atenção à Saúde do Trabalhador. A coleta de dados ocorreu nos meses de maio e junho de 2019. Os dados foram analisados estatisticamente e por meio da análise de conteúdo de Bardin. O estudo foi aprovado no Comitê de Ética em Pesquisa sob nº de Parecer 2.825.478. Após a análise da evidência de validade de conteúdo o instrumento sofreu ajustes quanto a clareza das terminologias. Em relação ao saber-fazer do enfermeiro do trabalho evidencia-se a atuação na gestão dos Serviços de Atenção à Saúde do Trabalhador e na educação através de ações de promoção da saúde e da prevenção. As atividades profissionais se sustentam por meio de arcabouços teóricos e legais fortemente influenciados pela regra trabalhista e previdenciária, havendo um distanciamento entre o trabalho real e o trabalho prescrito. Os marcos referencial, legal e teórico, que norteiam a prática profissional ancoram-se nas realidades práticas vivenciadas e experenciadas por estes profissionais, numa perspectiva do direito trabalhista, previdenciário e nas concepções de saúde do SUS. Conclui-se que esta pesquisa, através dos métodos utilizados, conseguiu demonstrar que há uma relação dialética na vertente atual Saúde do Trabalhador e a Saúde Ocupacional, no que concerne o saber-fazer dos enfermeiros do trabalho que atuam nos Serviços de Atenção à Saúde do Trabalhador em empresas; respondeu aos objetivos propostos e indicou aspectos relevantes do trabalho em Enfermagem no contexto das relações saúde-trabalho, ressaltando a importância de aprofundamento de estudos sobre o saber-fazer do Enfermeiro do Trabalho, com suas diversas peculiaridades no mundo do trabalho, na atualidade.

The objective of this study is "the perception of occupational nurses about their professional know-how, based on the theoretical and legal basis of occupational nursing". General objective: to analyze the know-how of the occupational nurse, from the perception of occupational nurses who work in the Occupational Health Care Services in companies in the State of Rio de Janeiro. This is a descriptive study, with a quantitative and qualitative approach, structured in two stages: the first refers to the development of an instrument for data collection on the know-how of occupational nurses and analysis of content validity evidence. 11 nurses with training in occupational nursing and / or occupational health who answered a validation instrument participated in May 2019. After the answers, the calculations were performed using the Content Validity Ratio. The second stage consists of the Focal Group and the application of the instrument, in Scientific Café, with eight occupational nurses who work in Occupational Health Care Services. Data collection took place in May and June 2019. Data were statistically analyzed and Bardin content analysis was performed. The study was approved by the Research Ethics Committee No. 2.825.478. After analyzing the evidence of content validity, the instrument was adjusted for clarity of terminology. Regarding the know-how of the occupational nurse, the performance in the management of the Occupational Health Care Services and in education through health promotion and prevention actions is evident. Professional activities are supported by theoretical and legal frameworks strongly influenced by the labor and social security rule, with a gap between real work and prescribed work. The referential, legal and theoretical frameworks that guide professional practice are anchored in the practical realities experienced and experienced by these professionals, in a perspective of labor, social security law and SUS health conceptions. It is concluded that this research, through the methods used, was able to demonstrate that there is a dialectical relationship in the current aspect of Occupational Health and Occupational Health, regarding the know-how of occupational health nurses who work in the Health Care Services of the Worker in companies; responded to the proposed objectives and indicated relevant aspects of nursing work in the context of health-work relations, emphasizing the importance of deepening studies on the know-how of the Labor Nurse, with its various peculiarities in the world of work, today.

A aplicação da precaução e da prevenção no ambiente de trabalho / Applying precaution and prevention in the workplace / La aplicación de la precaución y prevención en el lugar de trabajo

Objetivos: fortalecer o debate sobre a temática no campo da saúde e da enfermagem, práticas sociais que contribuem para a defesa de um projeto civilizatório democrático e um ordenamento social pautado pela justiça e equidade. Método: ensaio teórico-conceitual sobre o direito à vida, à saúde e autonomia à luz de argumentação jurídica recente, considerando os conceitos de meio ambiente, prevenção e precaução, articulando-os ao mundo do trabalho. Resultados: essa é a hora da tão discutida judicialização, uma forma de ativismo judicial que para alguns caracterizaria uma afronta ao princípio da separação dos poderes. Conclusão: essa posição deve ser relativizada, considerando que, para muitos, é a única maneira de se conseguir o acesso à saúde, a garantia à vida e a própria dignidade humana.

Objective: to strengthen the debate on the subject in the field of health and nursing, in social practices that contribute to defending a democratic project of civilization and a social order resting on justice and equity. Method: Theoretical and conceptual essay on the right to life, health and autonomy in the light of recent legal arguments, considering the concepts of environment, prevention and precaution, and linking them to the world of work. Results: these are times of judicialization, a much discussed form of judicial activism which to some constitutes an affront to the principle of the separation of powers. Conclusion: this position should be relativized, considering that for many it is the only way to gain access to health care, and to guarantee life and human dignity.

Objetivo: fortalecer el debate sobre el tema en el ámbito de la salud y de enfermería, las prácticas sociales que contribuyen a la defensa de un proyecto de civilización democrática y un orden social marcado por la justicia y la equidad. Método: ensayo teórico y conceptual sobre el derecho a la vida, la salud y la autonomía a la luz del argumento legal reciente, teniendo en cuenta los conceptos del medio ambiente, prevención y precaución, vinculándolos con el mundo laboral. Resultados: este es el momento de la legalización muy discutido, una forma de activismo judicial por alguna caracterizan una afrenta al principio de separación de poderes. Conclusión: esta posición debe ser relativizada, teniendo en cuenta que para muchos es la única manera de obtener acceso a la salud, para garantizar la vida y la dignidad humana en sí.

Decálogo de buenas prácticas para la protección de datos en Medicina del Trabajo y vigilancia de la salud / Ten tips for best practice for data proteccion in Occupational Medicine and occupational health

La protección de datos está presente en todo el ámbito sanitario. Médicos y enfermeros reciben formación específica en este sentido, dada la importancia que alberga unas buenas prácticas en materia de protección de datos. No obstante, no está demás recordar con cierta periodicidad una serie de cuestiones que ayudan a preservar la intimad y el secreto profesional en el ejercicio del trabajo a desempeñar. En el ejercicio de la Medicina del Trabajo en el aspecto de la vigilancia de la salud igualmente se hace necesario salvaguardar la gran cantidad de datos sobre trabajadores y las empresas atendidas en dicha actividad preventiva. Para ello se pretende dar a conocer un decálogo de buenas prácticas sobre protección de datos en vigilancia de la salud. Existe abundante bibliografía referente a la protección de datos en el ámbito sanitario, pero no tanta relativa a la actividad de la vigilancia de la salud dentro de la Medicina del Trabajo y la Salud Laboral (AU)

Data protection is a key issue for all the sanitary system. Doctors and nurses are thoroughly educated in this area due to the importance of the good practice in data protection. However, it is advisable for the medical and sanitary staff to regularly remind the basic aspects that will help to protect the confidentiality and professional secrecy. In Occupational Health, it is also required to protect the amount of data that are managed about many workers and businesses. This is intended to provide several good practices in this way. There are numerous references in the bibliography regarding general data protection in the healthcare system, but not so many about specific areas such as Occupational Medicine and Occupational Health (AU)

Revisión de aspectos normativos y funcionales del personal de los Cuerpos Facultativo y de Enfermeros de Instituciones Penitenciarias / A review of the regulatory and functional aspects of prison health care and nursing staff

Con relación a los funcionarios sanitarios penitenciarios encuadrados en los Cuerpos Facultativo de Sanidad Penitenciaria y de Enfermeros de Instituciones Penitenciarias, este trabajo tiene dos objetivos. El primero, anotar el régimen jurídico aplicable a los mismos como funcionarios de la Administración General del Estado al servicio de las Instituciones Penitenciarias, destacando las peculiaridades de la regulación normativa aplicable por el hecho de prestar ese servicio. El segundo, con el trasfondo de las normas generales que sobre sanidad penitenciaria contiene la Ley Orgánica 1/1979, de 26 de septiembre, General Penitenciaria y su Reglamento de desarrollo, aprobado por Real Decreto 190/1996, de 9 de febrero, efectuar un análisis crítico del cuadro obligacional y funcional del personal facultativo y de enfermería establecido en el viejo Reglamento Penitenciario de 1981, para determinar si, desde un punto de vista jurídico, puede erigirse en obstáculo o freno para que la Administración Penitenciaria proceda al desarrollo y ejecución de las funciones que tiene atribuidas en materia de planificación, organización y dirección de las actividades tendentes al mantenimiento y mejora de la higiene y de la salud en el medio penitenciario (AU)

The aim of this study of prison health care staff in Prison Health Care and Nursing Units is twofold. The first one is to consider those aspects of the legal system applicable to them as government employees of the General State Administration at the service of Prisons, highlighting the peculiarities of the legal regulations that can be applied as a result of providing said service. The second, based on the general regulations on prison health contained in Organic Law 1/1979, of 26 September, General Penitentiary Law and the implementing regulations thereof, approved by Royal Decree 190/1966, of 9 February, sets out to provide a critical analysis of the obligatory and functional framework for health care and nursing staff established in the old Penitentiary Regulations of 1981, to determine from a legal perspective if it is possible to impede or brake so that the Prison Administration may develop or carry out the functions for which it is responsible in terms of planning, organization and management of activities geared towards maintaining and improving hygiene and health in the prison environment (AU)

Whistleblowing--is it really worth the consequences?

This article explores general principles of state whistleblower laws and alerts nurses to considerations when deciding whether to report an employer violation. Reporting an employer violation can be difficult for any employee but especially for nurses because nurses are torn between their desire and duty to advocate for clients' safety and their desire to maintain employment. The author suggests questions to consider when deciding to "blow the whistle" and alerts nurses to statutes of limitations that may affect when nurses must report violations. The article also illuminates policy and procedural issues for various states that affect how and to whom nurses report violations to protect themselves under whistleblower protection laws. Finally, this article explores personal and professional consequences that nurses should consider before reporting violations.

International visitors and returning employees.

This article presents guidelines for possible exposures employees may encounter during travel or visitors may have encountered in their native country prior to entering the United States.

Scope of practice issues for occupational and environmental health nurses.

This article discusses scope of practice issues among various levels of professional nurses within the United States. It raises awareness that all occupational and environmental health nurses must be knowledgeable about workplace activities that may be permitted or prohibited by their state practice acts.

Delegation-better safe than sorry.

Occupational health nurses, like other registered nurses, often must decide whether to delegate. They must be familiar with the laws and standards governing delegation of nursing tasks. Many different resources exist for obtaining this information (e.g., jurisdictional nurse practice acts, position papers from boards of nursing, and publications from professional and regulatory organizations). Registered nurses who delegate must know which tasks may be delegated, how to determine the competence of delegates, and the level of supervision necessary.

HIPAA and the occupational health nurse.

Occupational health nurses routinely manage client records and apply confidentiality standards in their practice. The applicability of Health Insurance Portability and Accountability Act (HIPAA) regulations is often not well understood. Also, these regulations are frequently confused as being broader in scope.

Distribution of over-the-counter medications in the workplace.

Occupational health nurses can use dispensing models to assist their companies in generating revenue, decreasing liability, and facilitating appropriate medication choices by employees.

Los trabajadores de enfermería y las informaciones sobre sus derechos laborales / Nursing workers and information on their labor rights

El objetivo de esta investigación fue identificar las informaciones que los trabajadores de enfermería poseen sobre sus derechos laborales. El estudio fue seccional y no experimental, del tipo survey, desarrollado en dos hospitales brasileños de Recife (Pernambuco) – Brasil, en 2004; los sujetos fueron 324 trabajadores sometidos a una entrevista estructurada. Ellos identificaron sus derechos, con porcentajes entre 59,3 y 96,6. Consideran que tienen derechos a exámenes médicos, descanso semanal remunerado, gozo de vacaciones anuales, usufruto de licencias variadas, salario de cada mes, entre otros. Mientras tanto, los trabajadores confundieron los derechos con otros aspectos, lo que muestra su desconocimiento y los vuelven vulnerables y susceptibles de ser explotados y subyugados en su trabajo.

This research identifies what information nursing workers have on their labor rights. This study is a cross-sectional and non-experimental survey, conducted at two Brazilian hospitals in Recife, Pernambuco, Brazil, in 2004; 324 workers comprised the sample of subjects who underwent a structured interview. They identified their rights with percentages ranging from 59.3 to 96.6. They feel they are entitled to medical exams, remunerated weekly rest, annual holidays, different sources of leaves of absence, as well as a monthly pay, among others. However, they still could not tell a few of their rights apart from other aspects of their professional life, which indicates their lack of knowledge and makes them vulnerable and susceptible to exploitation and subjection in their work life.

O objetivo da investigação foi identificar as informações que os trabalhadores de enfermagem têm sobre seus direitos trabalhistas. O estudo foi seccional, não experimental, tipo survey, desenvolvido em dois hospitais brasileiros de Recife, Pernambuco, em 2004; os sujeitos foram 324 trabalhadores submetidos a uma entrevista estruturada. Eles identificaram seus direitos com percentuais entre 59,3 e 96,6. Entendem que possuem direitos a: exames médicos, repouso semanal remunerado, gozo de férias anuais, usufruto de licenças variadas, recebimento salarial mensal, entre outros. Entretanto confundiram os direitos com outros aspectos, o que indica desconhecimento, que os deixam vulneráveis e suscetíveis à exploração e jugo em seu trabalho.

Mandatory influenza immunization for health care workers--an ethical discussion.

Influenza is a serious vaccine-preventable disease affecting 20% of the U.S. population each year. Vaccination of high-risk groups has been called the single most important influenza control measure by the Centers for Disease Control and Prevention. Studies show that vaccination can lead to decreases in flu-related illness and absenteeism among health care workers, as well as fewer acute care outbreaks and reduced patient mortality in long-term care settings. However, to date, voluntary programs have achieved only a 40% vaccination rate among health care workers, causing concern among government and infectious disease organizations. This article addresses the ethical justification for mandating influenza vaccination for health care workers. Health care workers' attitudes toward vaccination are presented, as well as historical and legal perspectives on compulsory measures. The ethical principles of effectiveness, beneficence, necessity, autonomy, justice, and transparency are discussed.

Enfermagem de bordo: análise da legislação e normatização de proteção à saúde do trabalhador de enfermagem aquaviário / Nursing services on board: legislation and standardization analysis to waterway nursing workers' health protect

Este estudo tem como objetivo introduzir um debate sobre as questões relacionadas à legislação voltada para o trabalhador de enfermagem aquaviário, com ênfase na proteção da saúde deste trabalhador de enfermagem inserido em plataformas e navios de exploração de petróleo da costa brasileira. O método utilizado é a análise documental. É característica da pesquisa documental definir a fonte de coleta de dados, que deve estar restrita a documentos, escritos ou não, constituindo o que se denomina de fontes primárias. Analisou-se, inicialmente, como fonte primária, os seguintes documentos jurídicos da legislação trabalhista: as Normas Regulamentadoras do Trabalho Urbano (NR – 30 e NR – 32), a Resolução COFEN-146 e o Decreto N° 2.671, DE 15 DE JULHO DE 1998 do COFEN e a NORMAM. Ainda, como fontes internacionais, destacam-se as Convenções 164 e 147 da OIT. Constatou-se que dezesseis das normas estudadas (72,7 porcento) têm sua vigência definida a partir dos anos noventa, embora existam desde 1910, conforme a Convenção Internacional para Unificação de Certas Regras em Matéria de Abalroamento, Assistência e Salvamento Marítimo – Bruxelas (23 de setembro de 1910). Contudo, a maioria absoluta destes dispositivos não se refere ao trabalhador de enfermagem aquaviário, à exceção do Código Brasileiro de Ocupações, uma norma complementar que define apenas algumas competências do enfermeiro de bordo. Concluiu-se que existe escassez de instrumentos legais para este setor e a necessidade de mobilização para a criação de normas mais específicas para o enfermeiro aquaviário e, conseqüentemente, relativas à proteção da saúde deste profissional...

This study aims to introduce a debate on issues related to legislation focused on the worker of nursing aquaviário, with emphasis on the protection of the health of workers in nursing inserted into platforms and ships of oil exploration of the Brazilian coast. The method used is the document analysis. It is characteristic of desk research to define the source of collecting data, which should be limited to documents, written or not, is what is called primary sources. Examined is, initially, as primary source, the following legal documents labor legislation: the Rules Regulamentadoras Labor Urban (NR-30 and NR-32), the resolution COFEN-146 and Decree No. 2671, of 15 July 1998 of COFEN and NORMAM. Still, as international sources, it is the Conventions 164 and 147 of the ILO. It was noted that sixteen of the standards studied (72.7 percent) have defined his life from the nineties, although there since 1910, according to the International Convention for Unification of Certain Rules in Respect of Abalroamento, Assistance and Rescue Marine-Brussels ( on September 23, 1910). However, the absolute majority of these devices does not refer to the worker of nursing aquaviário, with the exception of the Brazilian Code of Occupations, a standard that defines only a few complementary skills of the nurses board. It is concluded that there is a shortage of legal instruments to this sector and the need to call for the creation of more specific rules for the nurses aquaviário and, consequently, on the protection of the health of this training...

Legislation affecting occupational health nursing: identifying relevant laws and regulations.

Occupational health nurses are challenged by the complexity of the laws and regulations governing their practice. Establishing a practice-based regulatory framework and applying an efficient review process simplifies that challenge. For those interested in expanding this framework beyond laws and regulations, a number of agencies and organizations that establish standards and recommendations relevant to the occupational health setting exist, such as the Centers for Disease Control and Prevention (www.cdc.gov), the National Institute for Occupational Safety and Health (www.cdc.gov/niosh), and the American Conference of Governmental Industrial Hygienists (www.acgih.org). Materials published by these agencies (e.g., the CDC "Adult Immunization Schedule;" NIOSH "Recommendations for Protecting Outdoor Workers from West Nile;" American Conference of Governmental Industrial Hygienists "Guide to Occupational Exposure Values," "TLVs," and "BEIs") are often of value to occupational health nurses and worth their attention.

Radiação ionizante e o cumprimento de resolução do Conselho Federal de Enfermagem / Ionizing radiation and the Nursing Federal Council's resolution fulfillment

Este estudo teve por objetivo verificar o cumprimento da Resolução do Conselho Federal de Enfermagem- 211/98 que dispõe sobre a atuação dos profissionais de enfermagem nas atividades envolvendo radiação ionizante. O referencial teórico fundamentou-se nas normas da Comissão Nacional de Energia Nuclear e na referida Resolução. Aplicou-se o método descritivo, por meio de observação indireta e entrevista com 14 profissionais de enfermagem dos quatro maiores hospitais públicos de Florianópolis - Santa Catarina, em 2004. O estudo mostrou que os profissionais de enfermagem estão expostos aos riscos de radiação ionizante, principalmente nos setores de hemodinâmica e nas atividades de contenção do cliente submetido a exames de radiodiagnóstico, e que a Resolução citada não está sendo cumprida nos hospitais pesquisados.