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Compromissos do sistema cardiovascular na pessoa em situação crítica: da conceção à prestação de cuidados de enfermagem - Projeto de desenvolvimento de competências clínicas especializadas na área de Enfermagem à Pessoa em Situação Crítica
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Abstract(s)
Este relatório constitui uma peça crucial do percurso que realizei no âmbito do Mestrado em
Enfermagem Médico-Cirúrgica, na área da Enfermagem à Pessoa em Situação Crítica
(MEMCPSCT), da Escola Superior de Enfermagem do Porto (ESEP).
O relatório de estágio, agregando o que resulta das Unidades Curriculares “Estágio de natureza
Profissional com relatório” (Módulo I – 15 ECTS e Módulo II – 30 ECTS), visa constituir-se como
documento que reporta o processo de desenvolvimento de competências, para posterior
apresentação e discussão pública. A elaboração deste relatório foi sustentada na plataforma
pedagógica da ESEP "e4nursing".
As competências a que aludo referem-se às competências comuns e específicas ao Enfermeiro
Especialista (EE) na área de Enfermagem à pessoa em situação crítica (PSCT), tal como
preconizado nos Regulamentos nº140/2019 e nº429/2018. Reconheço que o mestrado
frequentado, naquilo que diz respeito ao desenvolvimento de competências, representa
(apenas) uma etapa, ainda que relevante, no meu percurso profissional e académico.
O desenvolvimento de competências é um processo dinâmico e contínuo, que exige
investimento e capitalização das oportunidades de aprendizagem; neste caso aquelas que me
foram proporcionadas no contexto do estágio, em três contextos clínicos distintos – um Serviço
de Urgência (SU), uma Unidade de Cuidados Intensivos Coronários (UCIC) e uma Unidade de
Cuidados Intensivos Polivalente (UCIP). O estágio visou o desenvolvimento de “todas as
competências” do EE na área de Enfermagem à PSCT. Contudo, enquanto estratégia de
condução das aprendizagens, nos termos da lógica de organização e funcionamento do curso,
estive particularmente focada nos compromissos ao nível do processo do sistema
cardiovascular, considerando aquilo que antecipo para o meu futuro profissional. As afeções e
compromissos do sistema cardiovascular assumem, neste contexto, uma relevância primordial,
representando um dos eixos definidores das situações críticas (Baid, Creed & Hargreaves, 2016)
e um dos aspetos mais relevantes para a abordagem terapêutica à PSCT.
Com efeito, a instabilidade que caracteriza a PSCT exige um controlo e vigilância apertados do
sistema cardiovascular, com vista a assegurar débitos cardíacos adequados, valores de pressão
sanguíneas corretos e ritmos cardíacos efetivos. Neste enquadramento, são regularmente
utilizadas estratégias de monitorização das funções do sistema cardiovascular (Urden & Lough,
2013), assim como terapêuticas avançadas de suporte; aspeto absolutamente relevante para a
prática de enfermagem no contexto da assistência a este tipo de utentes.
Neste documento são descritos os contextos clínicos onde tive oportunidade de realizar o estágio, são apresentados três “estudos de caso” que ilustram o processo de conceção e
prestação de cuidados a utentes em situação crítica e ainda, um exercício de reflexão sobre os
contributos dos factos vivenciados em estágio, para efeitos do desenvolvimento de
competências.
This report is a crucial part of the path I took within the scope of the Master's Degree in Medical- Surgical Nursing, in the area of Nursing to the Critical Person (MEMCPSCT), of the Higher School of Nursing of Porto (ESEP). The internship report, adding what results from the Curricular Units "Internship of a Professional nature with report" (Module I - 15 ECTS and Module II - 30 ECTS), aims to constitute itself as a document that reports the process of development of skills, for subsequent presentation and public discussion. The preparation of this report was supported by ESEP's pedagogical platform "e4nursing". The competencies to which I refer refer to the common and specific competencies of the Specialist Nurse in the area of Nursing to the person in a critical situation, as recommended in Regulations nº140/2019 and nº429/2018. I recognize that the master's degree attended, with regard to the development of skills, represents (only) a stage, even if relevant, in my professional and academic career. The development of skills is a dynamic and continuous process, which requires investment and capitalization of learning opportunities; in this case those that were provided to me in the context of the internship, in three distinct clinical contexts - an Emergency Service (SU), a Coronary Intensive Care Unit (UCIC) and a Multipurpose Intensive Care Unit (CIPP). The internship aimed at the development of "all the skills" of the Specialist Nurse in the area of Nursing to the person in a critical situation. However, as a strategy for conducting learning, in terms of the logic of organization and functioning of the course, I was particularly focused on the commitments at the level of the process of the cardiovascular system, considering what I anticipate for my professional future. The affections and commitments of the cardiovascular system assume, in this context, a primary relevance, representing one of the defining axes of critical situations (Baid, Creed & Hargreaves, 2016) and one of the most relevant aspects for the therapeutic approach to PSCT. In fact, the instability that characterizes PSCT requires tight control and surveillance of the cardiovascular system, in order to ensure adequate cardiac output, correct blood pressure values and effective heart rhythms. In this context, strategies for monitoring the functions of the cardiovascular system are regularly used (Urden & Lough, 2013), as well as advanced supportive therapies; an aspect absolutely relevant to nursing practice in the context of assistance to this type of clients This document describes the clinical contexts where I had the opportunity to carry out the internship, three "case studies" are presented that illustrate the process of designing and providing care to clients in a critical situation and also an exercise in reflection on the contributions of the facts experienced in the internship, for the purposes of developing skills.
This report is a crucial part of the path I took within the scope of the Master's Degree in Medical- Surgical Nursing, in the area of Nursing to the Critical Person (MEMCPSCT), of the Higher School of Nursing of Porto (ESEP). The internship report, adding what results from the Curricular Units "Internship of a Professional nature with report" (Module I - 15 ECTS and Module II - 30 ECTS), aims to constitute itself as a document that reports the process of development of skills, for subsequent presentation and public discussion. The preparation of this report was supported by ESEP's pedagogical platform "e4nursing". The competencies to which I refer refer to the common and specific competencies of the Specialist Nurse in the area of Nursing to the person in a critical situation, as recommended in Regulations nº140/2019 and nº429/2018. I recognize that the master's degree attended, with regard to the development of skills, represents (only) a stage, even if relevant, in my professional and academic career. The development of skills is a dynamic and continuous process, which requires investment and capitalization of learning opportunities; in this case those that were provided to me in the context of the internship, in three distinct clinical contexts - an Emergency Service (SU), a Coronary Intensive Care Unit (UCIC) and a Multipurpose Intensive Care Unit (CIPP). The internship aimed at the development of "all the skills" of the Specialist Nurse in the area of Nursing to the person in a critical situation. However, as a strategy for conducting learning, in terms of the logic of organization and functioning of the course, I was particularly focused on the commitments at the level of the process of the cardiovascular system, considering what I anticipate for my professional future. The affections and commitments of the cardiovascular system assume, in this context, a primary relevance, representing one of the defining axes of critical situations (Baid, Creed & Hargreaves, 2016) and one of the most relevant aspects for the therapeutic approach to PSCT. In fact, the instability that characterizes PSCT requires tight control and surveillance of the cardiovascular system, in order to ensure adequate cardiac output, correct blood pressure values and effective heart rhythms. In this context, strategies for monitoring the functions of the cardiovascular system are regularly used (Urden & Lough, 2013), as well as advanced supportive therapies; an aspect absolutely relevant to nursing practice in the context of assistance to this type of clients This document describes the clinical contexts where I had the opportunity to carry out the internship, three "case studies" are presented that illustrate the process of designing and providing care to clients in a critical situation and also an exercise in reflection on the contributions of the facts experienced in the internship, for the purposes of developing skills.
Description
Keywords
Enfermagem Médico-Cirúrgica Pessoa em Situação Crítica Estágio clínico Competências Clínicas Afeções cardíacas Relatório de estágio