Meanings and senses of organisational silence by male nurses in the emergency department: an interpretative phenomenological study protocol.

INTRODUCTION: The organisational silence of nursing teams has received increasing attention from managers. Chinese nurses have a relatively high score for organisational silence, and male nurses score higher than female nurses. Lack of professional empathy, high pressure in the work environment, and traditional Chinese cultural factors suggest that Chinese male nurses' experiences of and reasons for organisational silence are complex and unique. Taking male nurses in the emergency department as an example, this study explores the experience and meaning of male nurses' organisational silence and provides ideas for nursing managers to understand the silence of male nurses. METHODS AND ANALYSIS: An interpretative phenomenological approach underpins the study design. In this study, the purposive sampling method will be used to select male nurses who meet the inclusion criteria with maximum differentiation as a strategy. Face-to-face semistructured interviews and Van Manen analysis methods will be used for data collection and analysis. ETHICS AND DISSEMINATION: The study was approved by the Ethics Committee of the First Affiliated Hospital of Zhejiang Chinese Medical University (ethical approval ID: 2019-KL-036-01). Participants will provide informed consent, will be able to withdraw at any time and will have their contributions kept confidential. The findings of the study will be shared with relevant stakeholders and disseminated in conference presentations and journal publications. TRIAL REGISTRATION NUMBER: Chinese Clinical Trial Registry (ChiCTR2100047057).

Perception and performance of the nursing team in caring for patients with suicide behavior

Objective: to understand the perception and performance of the Nursing team in a hospital emergency service in the care of patients after attempting suicide. Methods: exploratorystudy, with a qualitative approach, carried out through semi-structured interviews with Nursing professionals who work in an Emergency Service. The interviews were transcribed and analyzed as to their content following Bardin's thematic model. Results: seven nurses and four Nursing technicians participated in the study, with an average age of 36 years, most of them female. Suicide attempts are often associated with 'psychic pain' that is opposed to the principles of life preservation; such an attitude has caused suicidal behavior to be misinterpreted by health professionals. Conclusion: most professionals demonstrated a stereotyped 'pre-concept' and full of taboos about patients who attempted suicide, which triggered a service more directed to physical needs and protocol formalities. Few professionals reported carrying out holistic and empathic care, which is so necessary for these people. In this sense, the importance and urgency of training the team in the identification of suicide risks and in the continuity of treatment of surviving individuals is emphasized.

O enfermeiro no cuidado à pessoa idosa: construção do vínculo na atenção primária à saúde / El enfermero en el cuidado al adultomayor: construcción del vínculo en la atención primaria de salud / Nurses in the care of older adults: building a bond in primary health care

RESUMO Objetivo: compreender como o enfermeiro na Estratégia de Saúde da Família constrói o vínculo profissional com a pessoa idosa. Métodos: pesquisa qualitativa, com 30 enfermeiros de Estratégias de Saúde da Família de Joinville, entrevistados entre janeiro e março de 2018. Foi utilizado um instrumento de entrevista semiestruturado. Os dados foram analisados conforme a análise de conteúdo temática. Resultados: os resultados que emergiram das categorias apontam a importância de reconhecer o território de atuação, aprimorar a escuta sensível para questões do envelhecimento, valorizar a individualidade da pessoa idosa e seu contexto, a necessidade de trabalhar com parcerias intersetoriais e entre a equipe multiprofissional realizando atividades coletivas de promoção e prevenção da saúde, visando a qualidade no cuidado e, esse modo de trabalho possibilita que os enfermeiros tornem-se protagonistas, referências no cuidar, otimizando a construção e o fortalecimento de vínculo com as pessoas idosas e equipe o que pode proporcionar maior adesão a estilos de vida saudáveis e ao tratamento de saúde. Considerações finais: os enfermeiros estão imersos a um processo de construção de vínculo em suas unidades, são protagonistas, referência para sua equipe e para pessoa idosa. No entanto, há que se perfazer um longo caminho até que essas habilidades estejam de acordo ao que se postula como melhores práticas de enfermagem.

RESUMEN Objetivo: comprender cómo el enfermero en la Estrategia de Salud de la Familia construye el vínculo profesional con el adulto mayor. Métodos: investigación cualitativa, con 30 enfermeros de Estrategias de Salud de la Familia de Joinville, entrevistados entre enero y marzo de 2018. Se utilizó un instrumento de entrevista semiestructurado. Los datos fueron analizados según el análisis de contenido temático. Resultados: los resultados que surgieron de las categorías señalan la importancia de reconocer el territorio de actuación, mejorar la escucha sensible para cuestiones del envejecimiento, valorar la individualidad del adulto mayor y su contexto, la necesidad de trabajar con alianzas intersectoriales y entre el equipo multiprofesional, realizando actividades colectivas de promoción y prevención de la salud, buscando la calidad en el cuidado y, ese modo de trabajo posibilita que los enfermeros se vuelvan protagonistas, referencias en el cuidado, optimizando la construcción y el fortalecimiento de vínculo con los adultos mayores y el equipo que puede proporcionar mayor adhesión a estilos de vida saludables y al tratamiento de salud. Consideraciones finales: los enfermeros están inmersos en un proceso de construcción de vínculo en sus unidades, son protagonistas, referencia para su equipo y para la persona anciana. Sin embargo, hay que hacer un largo camino hasta que esas habilidades estén de acuerdo con lo que se postula como mejores prácticas de enfermería.

ABSTRACT Objective: tounderstand how Family Health Strategy nurses build a bond with older adults. Methods: qualitative research, with 30 nurses from the Family Health Strategies of Joinville, interviewed between January and March 2018. A semi-structured interview instrument was used. Data were analyzed according to thematic content analysis. Results: the results that emerged from the categories point to the importance of recognizing the territory of action, improving sensitive listening to aging issues, valuing the individuality of older adults and their context, the need to work with intersectoral partnerships and among the multidisciplinary team, carrying out collective health promotion and prevention activities, aiming at quality in care. This way of working allows nurses to become leaders, references in care, optimizing the building and strengthening of bonds with older adults and the team, which can provide greater adherence to healthy lifestyles and health care. Final considerations: nurses are immersed in a process of building a bond in their units, they are leaders, a reference for their team and for older adults. However, there is still a long way to go before these skills are in line with what is postulated as nursing best practices.

Supervisão de enfermagem: instrumento gerencial de qualificação da equipe e do cuidado / Nursing supervision: team management tool for qualification and care / Supervisión de enfermería: instrumento gerencial de cualificación del equipo y del cuidado

Objetivo: refletir sobre a supervisão de enfermagem como instrumento gerencial para qualificação da equipe e do cuidado. Método: estudo reflexivo, fundamentado em publicações científicas e vivência acadêmico-profissional. Resultados: para desenvolver a supervisão de enfermagem para além do controle de produção e reprodução de relações autoritárias, o enfermeiro precisa promover articulação entre os membros da equipe e adotar estratégias de corresponsabilização pelo cuidado de enfermagem, por meio de abordagens que promovam qualificação e segurança do cuidado, em uma perspectiva flexível, educativa, compartilhada, com vistas a avançar na utilização desse instrumento de gestão em novas dimensões, como a supervisão clínica e colaborativa. Conclusão: compreender as estruturas e os processos relacionados ao desempenho da supervisão pode favorecer a implementação de estratégias para apoiar os enfermeiros em suas funções, o que possibilita diminuir a distância entre teoria e prática profissional, superando adversidades do cotidiano de modo a qualificar a equipe e o cuidado.

Objective: to reflect on nursing supervision as a management tool for staff qualification and care. Method: reflective study, based on scientific publications and academic-professional experience. Results: to develop nursing supervision beyond the control of production and reproduction of authoritarian relationships, nurses need to promote articulation between team members and adopt strategies of co-responsibility for nursing care, through approaches that promote qualification and safety care in a flexible, educational, shared perspective, with a view to advancing the use of this management instrument in new dimensions, such as clinical and collaborative supervision. Conclusion: understanding the structures and processes related to the performance of supervision can favor the implementation of strategies to support nurses in their functions, which makes it possible to reduce the distance between theory and professional practice, overcoming daily adversities in order to qualify the team and the care.

Objetivo: reflexionar sobre la supervisión de enfermería como instrumento gerencial con el fin de cualificar al equipo y al cuidado. Método: se trata de un estudio reflexivo, basado en publicaciones científicas y en vivencia académico-profesional. Resultados: para desarrollar la supervisión de enfermería más allá del control de producción y reproducción de relaciones autoritarias, el enfermero necesita promover la articulación entre los miembros del equipo y adoptar estrategias de corresponsabilización en el cuidado de enfermería mediante enfoques que susciten cualificación y seguridad desde una perspectiva flexible, educativa, compartida, con miras al avance de la utilización del instrumento de gestión en nuevas dimensiones, como la supervisión clínica y colaborativa. Conclusión: comprender las estructuras y los procesos relacionados con el desempeño de la supervisión puede favorecer la implementación de estrategias que apoyen a los enfermeros en sus funciones, disminuyendo la distancia entre la teoría y la práctica profesional y superando las adversidades de lo cotidiano con el intuito de cualificar al equipo y al cuidado.

Supporting the Health of Our Nurses Using the 4A Model.

Despite the well-documented need for nurse-focused efforts on health and wellness, too few healthcare organizations have made a meaningful impact on this issue. Nurse health should be integrated into the strategic and operational workings of the organization. Environments of health and wellness require attention, accountability, action, and accessibility. Although individual choice is the starting point, true success will be achieved when nurse health is a nonnegotiable outcome consistent with quality, safety, finance, and patient experience.

Team working part 3: leading a team.

John Fowler, Educational Consultant, explores the qualities that enhance leadership in clinical practice.

COVID-19 Pandemic: Clinical Nurse Specialist Practice Supporting Preparedness in the Spheres of Impact.

PURPOSE/OBJECTIVES: The goal of this article is to describe how a high-functioning clinical nurse specialist (CNS) team rapidly responded to the needs of the patients, nursing staff, and organization as a whole to address the coronavirus disease 2019 (COVID-19) crisis. DESCRIPTION OF THE PROJECT: Using the advanced practice knowledge and skills, each CNS moved effortlessly between the 3 spheres of influence, patient, nursing, and organization, to address the unique needs of the COVID-positive patient, as well as the routinely ill who still needed care during a pandemic. In addition to observing and addressing opportunities at the bedside, the CNS team was essential in the development of plans of care, crisis care standards, and a structure for critical care cross-training. OUTCOMES: Five themes essential to success were identified: a common motivation and goal, collaboration, the importance of communication in utilizing established groups to create rapid change, power of influence, and the availability of a vast number of resources including professional nursing roles. CONCLUSION: Using the expertise of a specially trained team of CNSs, an effective plan was established to ensure safe, optimal care during the COVID-19 pandemic and effectively support frontline nurses.

Neumonía bilateral por SARS-CoV2: evolución radiográfica / SARS-CoV2 bilateral pneumonia: chest X-ray evolution

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A organização do trabalho, a carga de trabalho e o dimensionamento de pessoal de enfermagem em ambulatórios de quimioterapia em Minas Gerais / Work organization, workload and sizing of nursing staff in chemotherapy outpatient clinics in Minas Gerais

A organização do trabalho, a carga de trabalho e o dimensionamento de pessoal de enfermagem em ambulatórios de quimioterapia em Minas Gerais. 2021. 118 f. Dissertação (Mestrado em Enfermagem) ­ Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, 2021. Introdução: O tratamento quimioterápico no nível ambulatorial é um desafio, pois o câncer como um problema de saúde pública, no Brasil e mundo, tem crescido em número e complexidade. Neste contexto, a enfermagem se destaca, não apenas por sua quantidade de profissionais, mas pela capacidade de gestão da unidade e de casos, atuando com primazia no cuidado. Contudo, cabe ao enfermeiro, responsável técnico, a garantia de um adequado quantitativo de profissionais para a realização dos cuidados de forma segura e com qualidade. O gerenciamento de recursos humanos se inicia com a previsão quanti-qualitativa de profissionais e se mantém com a avaliação contínua da carga de trabalho a fim de se adequar o quantitativo conforme demanda. No entanto, esse dimensionamento constitui-se como um desafio para o trabalho do enfermeiro gestor, por impactar tanto na qualidade quanto nos custos assistenciais. Destaca-se que na oncologia ambulatorial há uma carência de evidências científicas, legislações e recomendações que balizem as tomadas de decisão para esse dimensionamento. Objetivo: Analisar a organização do trabalho e as formas de mensuração da carga de trabalho e dimensionamento de pessoal de enfermagem utilizados em ambulatórios de quimioterapia do estado de Minas Gerais. Método: Pesquisa descritiva de abordagem quantitativa, desenvolvida com 20 enfermeiros gestores de ambulatórios oncológicos de Minas Gerais. Os dados foram coletados por meio de formulário online, composto pelo TCLE e 54 perguntas concernentes ao perfil dos respondentes, dos serviços, organização do trabalho e do dimensionamento de pessoal. Os dados foram submetidos a análise estatística descritiva e de correlação, por meio de software IBM SPSS versão 23. Foram obedecidos os requisitos éticos. O projeto foi aprovado pelo COEP-UFMG. Resultados: 75% dos enfermeiros possuem mais de 6 anos de experiência na oncologia ambulatorial e 75% a caracterizaram como alta complexidade. 60% dos ambulatórios estão localizados na região metropolitana de Belo Horizonte, sendo 40% em clínicas oncológicas. 55% dos serviços não possuem certificado/ acreditação. A mediana do número de profissionais enfermeiros é de 5,5 e de técnicos é de 3. Quanto ao perfil estrutural, o número de leitos/poltronas para infusão de quimioterapia variou entre 10 e 30, sendo o quantitativo de pacientes/dia atendidos pelos ambulatórios variado de 10 a 100. 50% funcionam de segunda a sexta-feira das 07:00 às 19:00 horas. Todos conhecem as Resoluções ANVISA nº 220/2004 e Cofen nº 569/2018, enquanto 90% conhecem a Resolução Cofen nº 543/2017 e 55% dizem conhecer o método de Sítio Funcional. Contudo, apenas 10% relataram ter recebido capacitação para dimensionar equipe. 55% dos enfermeiros relataram não utilizar nenhum instrumento para dimensionamento. 65% não utilizam nenhum instrumento para monitorar carga de trabalho. Destaca-se que 66,7% consideraram o quadro de pessoal adequado e 65% sentiam segurança para dimensionar. Conclusão: A organização do trabalho de enfermagem e a realidade operacional dos ambulatórios estudados são heterogêneos, mas demonstram fragilidade no domínio dos enfermeiros quanto a formas de monitorização da carga de trabalho e dimensionamento de pessoal. Os resultados deste estudo constituem- se como importante alerta quanto a necessidade de aprofundamento desse conhecimento junto aos enfermeiros para que se estabeleçam melhorias no processo de organização do trabalho para manutenção de uma assistência de qualidade e segura.

Work organization, workload and nursing staff dimensioning in chemotherapy outpatient clinics in Minas Gerais. 2021. 118 f. Dissertation (Master in Nursing) ­ School of Nursing, Federal University of Minas Gerais, Belo Horizonte, 2021. Introduction: Chemotherapy treatment at the outpatient level is a challenge because cancer is a public health problem in Brazil and worldwide that has grown in number and complexity. In this context, nursing stands out, not only for the number of professionals but also for their capacity to manage both the unit and the patient care path. However, it is up to the nurse, the technical manager, to ensure adequate professionals to provide safe and quality care. This management of human resources begins with the quantitative-qualitative prediction of professionals and continues with the continuous evaluation of the team's workload to adjust the quantity according to demand. However, this staff dimensioning constitutes a challenge for the nurse manager, as it impacts both the quality and costs of care. It is noteworthy that in outpatient units, there is a lack of scientific evidence, legislation, and recommendations for guiding the decision making about nursing staffing requirements. Objective: To analyze the organization of work and the methods of measuring workload and nursing staffing used in chemotherapy outpatient clinics in Minas Gerais. Method: Descriptive research with a quantitative approach, developed with 20 nurse managers of oncology outpatient clinics in Minas Gerais. Data were collected using an online survey form composed of the TCLE and 54 questions concerning the respondents' profile, services and work organization, and staff dimensioning. Data were submitted to descriptive statistical and correlational analysis, using IBM SPSS software version 23. Researchers followed the ethical requirements for the development of the project, which was approved by COEP UFMG. Results: 75% of the nurses had more than 6 years of experience in the outpatient oncology unit, and 75% characterized outpatient oncology as high complexity. 60% of the outpatient clinics are located in the metropolitan region of Belo Horizonte, being 40% in oncology clinics. 55% of the services do not have a certificate/accreditation. The median number of nursing professionals is 5.5, and of technicians is 3. Regarding the structural profile, the number of beds/seats for chemotherapy infusion was concentrated in units ranging from 10 to 30, while the number of patients/days attended by the outpatient clinics was 10 up to 100. 50% work from Monday to Friday from 07:00 to 19:00. All participants know Resolutions ANVISA No. 220/2004 and Cofen No. 569/2018, while 90% know Cofen No. 543/2017 and 55% said they know the Functional Site method. However, only 10% reported receiving training on team sizing. 55% of nurses reported not using any instrument to size a team. 65% of the nurses do not use any tool to monitor workload. It is noteworthy that 66.7% considered the staff adequate, and 65% felt safe to size. Conclusion: The organization of nursing work and the operational reality outpatient clinics studied are heterogeneous but demonstrate weaknesses in the nurses' domain regarding workload monitoring and staff requirements. The study results constitute an important alert to the need for improvements of this skill in these nurse groups to establish enhancements in organising the work and monitoring workload staff requirements to guarantee the quality and safety of nursing care.

A importância dos registros de enfermagem no contexto avaliativo da auditoria / The importance of nursing records within the audit assessment context

Objetivo: Analisar a importância dos registros de enfermagem no contexto avaliativo da auditoria. Método: Trata-se de uma revisão integrativa da literatura realizada nas bases de dados LILACS, MEDLINE e BDENF, por meio dos descritores Auditoria de Enfermagem; Auditoria Clínica; Registros de Enfermagem; Anotações de Enfermagem e Enfermagem. A busca foi realizada de 12 de janeiro a 26 de fevereiro de 2018 e selecionados 17 artigos que compõem o estudo. Resultados: a importância dos registros de enfermagem no contexto avaliativo da auditoria se dá pela investigação da qualidade do cuidado prestado por meio das evidências proporcionadas nos registro/anotações de enfermagem no portuário do paciente, evitar prejuízos na continuação do cuidado, intensificar sugestões de implantações de valores educacionais por meio da educação continuada e permanente, resgatar os valores econômicos perdidos por glosas em contas hospitalares e promover a melhoria da qualidade da assistência. Conclusão: foi possível verificar que, mesmo sendo uma prática que deva ser realizada com qualidade, o processo de auditora ainda encontra muita fragilidade nas informações encontradas nos diversos registros do profissional de enfermagem, o que acarreta grandes prejuízos.

Objective: To analyze the importance of nursing records in the evaluative context of the audit. Method: This is an integrative literature review performed in the LILACS, MEDLINE and BDENF databases using the descriptors Nursing Audit; Clinical audit; Nursing records; Nursing and Nursing Notes. The search was performed from January 12 to February 26, 2018, selecting a total of 17 articles. Results: the importance of nursing records in the evaluative context of the audit is due to the investigation of the quality of care provided through the evidence provided in the nursing records/annotations in the patient's chart, avoiding losses in the continuation of care, intensifying suggestions for implantation of nursing care, educational values through continuing and continuing education, recovering the economic values lost by disallowances in hospital bills and promoting the improvement of the quality of care. Conclusion: it was possible to verify that, even though it is a practice that should be performed with quality, the audit process still finds a lot of fragility in the information found in the various records of the nursing professional, which causes great losses.

Pivoting During a Pandemic.

When the coronavirus hit the United States earlier this year, hospitals across the country were forced to quickly convert to crisis mode. Overnight, health systems transformed clinical and administrative operations to care for rising numbers of COVID-19 patients. Now, as the country slowly reopens and we move back to "normal," hospitals again face a major reboot to regroup and recover. Those that meet this challenge successfully will survive. Many others will not. This month's Magnet Perspectives column examines how Magnet hospitals are uniquely positioned to ride the waves and manage the chaos. What are the components that helped them adapt and adjust when COVID-19 struck, and how are those elements facilitating response and recovery? The column also looks at how the Magnet Recognition Program itself responded to challenges posed by the coronavirus and altered some of its long-standing processes to meet customer needs.

[Mix, career paths and gendered division of work in nursing teams]. / Mixité, trajectoires professionnelles et division sexuée du travail dans les équipes infirmières.

Nursing is a highly feminised profession, yet includes a certain proportion of men. What this does fairly low mix mean, and what are its effects on the way teams work and on career paths?

Building a Research Team in Adolescent/Young Adult Oncology Nursing.

Introduction: Participation on a collaborative team is an attractive option for conducting research, especially in pediatric hematology/oncology nursing, where the patient population is small. The Consortium to Study Symptoms in Adolescents and Young Adults with Cancer (CS2AYAC) is a nursing research team that has been in existence for over a decade. Purpose: The authors share the process by which CS2AYAC formed and describe key features that contribute to its sustainability. Results: While the team developed organically rather than via the tenets of team science, key aspects of success include principles related to mentorship, communication, building trust, establishing shared goals, and managing conflict. Conclusions: This description of one team's experience may help other nurses build their own teams for research. Strong, collaborative research teams will advance pediatric hematology/oncology nursing science and scholarship and can be an important source of collegiality and support.

A preceptorship toolkit for nurse managers, teams and healthcare organisations.

The transition from student to newly qualified nurse can be challenging. A period of preceptorship is recommended to support newly qualified nurses in their new work environment, and to give them time to adapt and gain confidence. Researchers have developed a toolkit based on previous research that contains several resources that nurse managers, teams and organisations can use to develop and improve preceptorship for newly qualified nurses. The toolkit includes an organisational support tool, a managerial support framework, a supernumerary time tool and a local culture of support tool. This article describes these resources and gives an example of how the toolkit can be adapted locally.

Gestión de los equipos de enfermería de uci durante la pandemia covid-19 / Management of icu nursing teams during the covid-19 pandemic

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Nurses and midwives from around the world tell us what it’s like to fight COVID-19

On World Health Day, nurses and midwives from around the world tell us what it’s like to fight COVID-19 7 April 2020 is the day to celebrate the work of nurses and midwives and remind world leaders of the critical role they play in keeping the world healthy. Nurses and other health workers are at the forefront of COVID-19 response - providing high quality, respectful treatment and care, leading community dialogue to address fears and questions and, in some instances, collecting data for clinical studies. Quite simply, without nurses, there would be no response. In this International Year of the Nurse and the Midwife, World Health Day will highlight the current status of nursing and around the world. WHO and its partners will make a series of recommendations to strengthen of the nursing and midwifery workforce. This will be vital if we are to achieve national and global targets related to universal health coverage, maternal and child health, infectious and non-communicable diseases including mental health, emergency preparedness and response, patient safety and the delivery of integrated, people-centered care, amongst others. We are calling for your support on World Health Day to ensure that the nursing and midwifery workforces are strong enough to ensure that everyone, everywhere gets the healthcare they need.