The care giving production and management: cartographic notes on the nurses care giving practices in the hospital routine / A produção e a gestão do cuidado: notas cartográficas dos atos cuidadores do enfermeiro no cotidiano hospitalar

AUTOR(ES)
DATA DE PUBLICAÇÃO

2006

RESUMO

management. Questions about the nurses learning and duty in the context of health care were also included, having as scenary the principles of the Sistema Único de Saúde (SUS) ? the Brazilian public health care service. It was inquired if the nurses care giving practices were centered in the patientsneeds, if they were acting as articulators of both knowledge and practice, having in sight the integrality and humanization proposals. The design objective was: to cartografh the nurses care giving practices, in the hospital context, analizing the lines put into practice and the prevailing surfaces, with their power and resistence to produce life. Theoretical sustenance to inquietude was searched, drawing a conceptual map, broaching care menagement as well as the hospital implications towards the theme, keeping hand in a conceptual plot ? esquizoanalysis concepts and collective health mainly. At the second moment of drawing the map, denaturalization of care giving was carried out by using the Foucaultian Genealogy, creating four care-giving-practice configurations, aiming to unblock historical time for the redefinition of present time through what was considered evidence. The strategies for knowledge production were obtained in two parts: first, the utilization of the Foucaultian Genealogy to construct part of the conceptual map; second, a cartography of the nurses every day chores, in the hospital context, was outlined. A 62-hour observation was performed in a clinical surgical hospitalization unit which served beneficiaries of the SUS. The nurses work process, observed during the morning and afternoon shifts, was recorded in a Log Book. Fragments of the Log Book were placed next to theoretical texts, poems, memories, turning into a dialogue between these writings and the conceptual map. A type of craftsmanship work was done. In the practice territory, two micro territories were uncovered: that of Paranoia Machine and that of Desire Machine. The Paranoia Machine is characterized by instituted methods that had been captured by time, rules, routines with castrating and antiproductive tendencies, by fragmented work, and by the non-knowledge-power paranoia. The nurses care giving practices revealed a care production marked by hard and circular segmentarity lines, configured many times into careless acts, cooling the cared bodies, turning the patients into a ?burden?, not giving them chance, this way, to construct their autonomy. It was detected that the care management was focused on the procedure itself, with the beneficiary being not a care giving marker. The Desire Machine revealed a power for the care giving practices, permeated with listening and hospitality, managing as a strategy for care production traversed by escape lines. The nurses needs were considered; lecturers rethought concepts, searching for a more effective dialogue with the hospital practices for the strenghtening of the SUS. One of the visualized strategies was the possibility of creating collective spaces for the analysis of the work process on health care, and of the hospital managing pattern. The teaching must rethink of the utilization of tool/concepts that are able to produce an impact on the nurses work in face of the beneficiarys individual and/or collective needs, of the health staff, and of the health care service itself, becoming released from the bondaries that reinforce hegemony and subservience.

ASSUNTO(S)

gestão do cuidado cartografia care giving management processo de trabalho do enfermeiro the nurse s work process cartography.

ACESSO AO ARTIGO

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