Da prescrição à construção de competências profissionais: o trabalho invisível dos enfermeiros do centro cirúrgico de um hospital do interior de Minas Gerais

Abstract

The nursing activity in the Surgical Center has become increasingly governed by norms and routines, in an attempt to guarantee the best care for patients. The fact of working is linked to the possibility of man appropriating already established prescriptions, modifying them, managing variability, as well as transferring personal values and life experiences in his "use of self". The invisibility of work is inherent to nursing activity, during human action at work, in its permanent quest to appropriate the environment, manage malfunctions and the possibilities of maintaining one's own health, the quality of care, productivity and the safety of the process. Being and acting competently are established from these constant arbitrations between the use of oneself by oneself and the use of oneself by others, in a heterodetermination. The question that guided this study was: What are the renormalizations used by Surgical Centre nurses to manage antecedent norms in an attempt to ensure control of the variability and malfunctions that arise during the work process? The methodology used was Ergonomic Work Analysis (EWA) through observations (general and systematized) and interviews (semi-structured and self-confrontation) and ergology, with the intention of demonstrating the dynamism and unpredictability inherent in real working conditions. Using the qualitative-descriptive method of ergonomics and ergology, the main technical and organizational factors inherent in health work management were identified. The results observed were: (1) the uniqueness of 5 Surgical Center nurses, how they accessed the values, knowledge and skills originating in the dynamics of work and the productivity system, (2) the constant dispute between alienation and de-alienation in everyday life to ensure a living work, (3) the risks and difficulties experienced in providing care to fulfill the tasks assigned and (4) the gaps in standards and their skills for managing patient care based on the surgical agenda. In this way, it was possible to conclude that the methodological approach proved adequate to achieve the objectives of this study. By bringing out the activity, the work was made visible, the results of which revealed the individual and collective strategies established in care, in the daily procedures of care, as well as a better understanding of the complexity and demands that characterize nursing care in the Surgical Centre.