Work process in mental health and the psychosocial area

We present a theoretical reflection about determinants and constitutive elements of the nursing work process in the psychiatric and psychosocial areas, in the context of the Brazilian Psychiatric Reform. The aim is to offer theoretical and conceptual guidance with a view to mental health workers' reflexive action, particularly in nursing. The purpose of this article is to preserve the memory of nursing practice in psychiatry and to go beyond, with a view to constructing the psychosocial area, supporting teaching in all fields of health knowledge.     

Psychiatric nursing and modern nursing in Rio de Janeiro: a history lesson

The present study is the result of an essay written for the discipline Research Laboratory of Nursing History. It refers to the interest and struggle of the Brazilian Association of Nursing (ABEN), in the 1940s, in Rio de Janeiro, to make professionals of this area aware of the need of the inclusion of nursing in the psychiatric field in Rio de Janeiro. Our objective is to present the difficulties of this insertion, although the beginnings and the regulation of the nursing profession in Brazil started in a school of nursing, in the Psychiatric Hospital of Rio de Janeiro. In order to present the difficulties for this inclusion, we analyzed the documents that prescribed the regulation of the nursing profession, in the psychiatric area of the hospital mentioned above. Results indicate that standards established by Anna Nery Nursing School were broken, since psychiatric assistance was denied by this school until 1949, while the Nursing School Alfredo Pinto provided this kind of care since 1890. It is important to point out the strategic and historical role of ABEn as the coordinator and motivator of discussions regarding the course of the nursing profession.     

Building a new form for professional organization--a challeng for the "Political-Professional Project of Brazilian Nursing"

This article is a reflection about the form of Brazilian nursing professional organization, highlighting the limits of the current model and the challenges for the future. It is based on the authors' analysis of an important social movement of Brazilian Nursing, the "Participation Movement" that took place from 1980 to 1990. This Movement has promoted a reflection about nursing work and organization and about nursing participation in the country's re-democratization, as well as defending the right to health. This article summarizes some gains obtained by the movement, especially in the Brazilian Nursing Association-ABEn, and limits in the discussion about the professional organization. It highlights the need to establish agreements and to include in the "Nursing Political-Professional Project" the importance of building a unifying organization originating from ABEn.     

Psychiatric nursing production in Brazil, 1932-1993

The present research aims at studying the psychiatric nursing bibliographical production in Brazil, from 1932 to 1993. Therefore, the authors searched national journals, annals of the Brazilian Nursing Congresses, Annals of the National Seminars on Nursing Research and Catalogues of the Brazilian Nursing Association--Center of Nursing Studies and Research. In addition, the authors selected publications of the following events: III Meeting of Researchs on Mental Health, II Meeting of Specialists on Psychiatric Nursing, Nursing Undergraduation Golden Jubilee and National Meeting of University Hospitals. After the conclusion of this study, discussions were based on the central themes of the texts as well as on historical development of Psychiatric Nursing in Brazil.     

Psychiatric nursing work and workers' health problems

This study, based on social determination and the systematization by Laurell and Noriega, aims to understand the health-disease process experienced by nursing workers at a psychiatric hospital, with a view to identifying the burdens nursing workers at a psychiatric hospital are exposed to; understanding the exhaustive processes they experience and analyzing the coping strategies indicated as processes that increase quality of life at work. Data were collected through a focal group with 6 participants. Results showed that the object of work, i.e. the psychiatric patient, is seen as socially excluded. With regard to the work load, workers are exposed to all kinds of burdens, but the work load is intensified by the mental burden. Exhaustion is present in physical as well as mental terms. Workers present great mental exhaustion, due to the work conditions experienced or not, specifically because of living with the object of work.     

A gender reading about the (re)inauguration of a female practice: from England to Brazil

It is a gender reading of Florence Nightingale's main work, "Notes on Nursing: what is and what isn't", a book which brings together the principles and essential elements of modern nursing, professionalized in England in the second half of the XIX century and the way the profession was constituted in Brazil, as explicited in the work of Glete de Alcantara: "Modern nursing as a professional category: obstacles to its expansion in Brazilian society", the first nursing dissertation produced in the country, in 1963. It verified that in both situations the specificities of the nursing profession intermixes with that of the female working world.     

Worker's health: conditions of work of the nursing staff in psychiatric hospitals

This study deals with the concern shown by health care professionals, especially by those working in the psychiatric nursing area, with the stress they experience due to particular characteristics of their work activity. We tried to learn about the relationship between work conditions in nursing, an anxiety-builder environment, and physical and psychological exhaustion. We found the need to implement programs aimed at reducing professional risks ran by psychiatric nursing staff.     

Chancers, pests and poor wee souls: problems of legitimation in psychiatric nursing

This paper explores the relationship between psychiatric nurses and 'problem' patients as a means of commenting on the occupation of psychiatric nursing. Proceeding from a detailed examination of the case of one particularly problematic female patient, and drawing on a body of observational and interview data relating mainly, though not exclusively, to nursing activity on two very different psychiatric wards, we argue that what is critical in determining nurses' categorization of some patients as 'problems' is not so much the level or nature of patients' demands, as much previous work has suggested, but rather the patient's willingness to legitimate the nurses' therapeutic aspirations. Possessing neither readily identifiable technical skills nor unambiguous authority, the psychiatric nurse must look to her dealings with patients to sustain a viable professional identity. 'Problem' patients are those who call attention to the fragility of nursing authority by rejecting, implicitly or explicitly, the special services that the psychiatric nurse stands ready to provide.     

Nursing work force and its insertion in the rooming-in system

A theoretical reflection is developed, featuring the characteristics of the Nursing work force in the rooming-in units. A focus is given, along a leading line, to the importance those workers have in caring for the families of newborn children in hospital facilities. The reference basis, adopted as the argumentative development of the text, centers on previous studies and authors covering the work process in Nursing, as well as on the understanding of nursing as a social and historical practice. Reflection is initially developed along considerations of the organization and division of work in health and in nursing. This study also points out the formal and legal origin of Brazilian nursing workers, in order to characterize this work force specifically in the work process carried out by nursing agents of different levels in rooming-in systems at the maternity facilities. The conclusion reached, showed that the work developed in these units requires from the nursing professionals proper qualification to assist the newborn, the puerpera and also the family. They must also demonstrate theoretical/technical command to operate those instruments (means) which are not usually available in the majority of health services.     

“5S”管理模式对精神科安全护理的效果探讨

目的探讨在精神科安全护理中实施"5S"管理模式的效果。方法以2018年1月-2019年1月我院精神科病房的精神疾病患者共340例为对象开展研究,在病房安全护理工作中实施"5S"管理模式,分析实施前后在护理质量变化情况。结果实施后,病房护理管理质量合格率、基础护理质量合格率、不良事件发生率、综合满意度分别达到了97.35%、98.53%、0.59%、99.41%,较实施前均有显著改善,P<0.05;护理后患者PANSS评分、PSP评分较实施前均有显著改善,P<0.05。结论在精神科安全护理中实施"5S"管理模式能够提高护理工作质量,增强护理人员安全意识,有利于改善患者症状及功能表现状况。     

Psychosocial care Center for Alcohol and Drugs (CAPS ad): nursing insertion and practices in São Paulo City, Brazil

This exploratory study with a qualitative approach aimed to identify nurses' insertion and practices at Psychosocial Care Centers for alcohol and drugs in S?o Paulo City, Brazil. Sixteen nurses participated in the study. Data were recorded and were analyzed by dialectic hermeneutics and guided by Brazilian psychiatric reform premises. The results evidenced nurses' difficulties to take part in the care recommended at these services, as their practices are more linked up with the traditional mental health care model. Causes of this phenomenon include nurses' lack of preparation to act in psychoactive substance-related issues and lack of knowledge on specific contents that would favor their insertion into care practice in these scenarios. It is concluded that more attention should be paid to these contents in nursing education, as the legal requirement of nursing presence at these services is insufficient as a strategy to guarantee their actual insertion.     

品管圈在提升精神科临床护理路径有效执行率中的应用效果

目的探讨品管圈活动在提升精神科临床护理路径有效执行率的应用效果。方法在病区建立品管圈小组,运用头脑风暴、特性要因图、柏拉图等质量管理工具对该病区的临床护理路径有效执行的现状和患者满意度进行统计分析,根据分析出的要因有针对性地对护理人员进行培训和改进工作流程;对患者进行安全健康宣教、疾病知识宣教,最终提升精神科临床护理路径有效执行率、患者满意度。结果临床护理路径有效执行率由51.53%提升到78.86%,差异有统计学意义(P<0.05);患者满意度提高,差异有统计学意义(P<0.05)。结论借助于该次病区开展的品管圈活动,降低了精神科临床护理路径中的缺陷项目发生比例,提升了精神科临床护理路径有效执行率和患者满意度,同时还增强护士发现问题、沟通解决问题、团结协作的能力。     

The professionalization of Brazilian nursing in the written media of the end of the nineteenth century: a gender analysis

The object is the relationship between the professionalization of Brazilian nursing and women, in the broadcasting of news about the creation of the Professional School of Nurses, in the light of gender. Aims: to discuss the linkage of women to the beginning of the professionalization of Brazilian nursing following the circumstances and evidence of the creation of the Professional School of Nurses analyzed from the perspective of gender. The news articles were analyzed from the viewpoint of Cultural History, founded in the gender concept of Joan Scott and in the History of Women. The creation of the School and the priority given in the media to women consolidate the vocational ideal of the woman for nursing in a profession subjugated to the physician but also representing the conquest of a space in the world of education and work, reconfiguring the social position of nursing and of woman in Brazil.     

Nursing classification in collective health--the International Classification of Nursing Practice in Collective Health project

Words used by Brazilian nurses in their practice in collective health were identified in the project CIPESC developed in Brazil. The project represented the Brazilian contribution to the international project of ICN and it was developed by managers and 115 researchers in the health basic units of 15 research sites selected all over the country. It was applied 10 research tools and 49 focal groups were performed with the participation of 720 individuals of the nursing staff. The information contained in the focal groups were transcribed and it was submitted to processual and semantic analysis in order to characterize the work process and to contribute for a standardized language used by the nursing staff in collective health field. The results showed what the nurses do and the reasons for their nursing actions.     

The health labor market in the South-East of Brazil: the insertion of the nursing team

The study points out the main characteristics of the nursing labor market in the Brazilian South-East, using Medical-Sanitary Assistance-AMS research data as a reference base, which were recently published by the Brazilian Institute of National Statistics and Geography-IBGE. With 272398 jobs in this region, the nursing team mainly works in the public health system and hospital institutions. In coherence with the Brazilian health system decentralization policies, the municipalization of nursing jobs and signs of labor market flexibility were observed in 1999. In view of this national and regional context, a research should be carried to obtain a quantitative and qualitative analysis of the current labor market for the nursing team.     

Clinical nurses working in psychiatric institutions in Ribeirao Preto: characterization,education, and performance

This is a quanti-qualitative study that had the purpose to characterize nurses who work in psychiatric institutions at the city of Ribeir?o Preto, focussing on their education, identifying nursing actions that those professionals perform daily and finding out about practice and knowledge that they consider specific to their area. The discussions on the results were based on authors who study psychiatric nursing teaching and research. Data evidenced a sample mainly formed by adult women, with a reasonable period of service in the area. The majority of the professionals did not search for specialization or continuing education courses and did not participate in training courses and scientific events. Among the actions that nurses perform daily, the bureaucratic-administrative ones are emphasized. They mentioned some themes such as specific knowledge on psychiatric nursing, especially therapeutic relationship. They also pointed out some difficulties and facilities they found regarding their professional education and knowledge updating.     

Nursing actions in the daily scenario of a psychiatric institution

This qualitative study had the purpose to observe and describe nursing actions performed by nurses at a state psychiatric institution. Eight nurses who work in the institution participated in the study. In order to collect data, authors used participant observation and registration in a field record book. The discussions regarding the results were based on research about nursing practice in psychiatric institutions. Data evidenced that nursing actions were predominantly bureaucratic and administrative and that the professionals studied did not have a defined position about the need to perform interventions in the nursing care provided in this institution.     

护理质量缺陷登记本在精神科病房的应用体会

目的调动病区全体护士参与护理质量管理,减少护理缺陷的发生,提高临床护理质量。方法护士将工作中发现的缺陷及时做好登记工作,上班时及时翻阅,护士长及时总结。结果护士责任心加强,护理质量缺陷明显减少。结论在精神科病房使用护理质量缺陷登记本能显著提高护理质量,减少护理质量缺陷的发生。     

Pediatric nursing and the family approach: contribution to undergraduate teaching

This work aims at presenting the instruments used in the family nursing approach as depicted in the international literature as well as at providing subsidies for their utilization by Brazilian nursing professionals in family health approaches to child care. The authors present the experience of introducing a methodology for systematized care in Pediatric Nursing programs using instruments for data collection such as the family APGAR, Genogram and Ecomap. They argue that these instruments do not replace the theoretical basis of care or the reason and discernment in order to provide data with meaning and find better solutions to care for children and their family.