Exercício da autonomia profissional de enfermeiras e enfermeiros no ambiente hospitalar

Abstract

Specific and precise knowledge in the competence of nurses is essential to the independence of care and interprofessional sharing in healthcare. This research presented as object the exercise of professional autonomy of nurses in the hospital environment. A qualitative research, with a descriptive approach, which aimed to analyze the practice of nurses in the context of hospital care practice. The research selected three scenarios: Hospital Universitário Professor Alberto Antunes (HUPAA), Hospital Geral do Estado Professor Osvaldo Brandão Vilela (HGE). Nurses who work in the General Intensive Care Units of each hospital participated in this research. For the purpose of constituting a sufficient information bank in quantity and with elements which support the analysis and discussion of the results anchored in the chosen theoretical framework, 19 participants were listened to. Information was produced from October 2020 to January 2021, through semi-structured online interviews, using the Zoom® and Google Meet® platforms. Na exhaustive reading of the narratives was carried out, interpreted in the light of Eliot Lazarus Freidson's Sociology of Professions. The analysis of the information showed that there are several challenges and difficulties faced by nurses who seek to assert their professional autonomy in the hospital environment, whether in the process of care, team leadership, servisse management or the interprofessional relationships that are established in the daily work. There were multiple meanings attributed to the issue of professional autonomy which revealed a lot about the way each nurse positions themselves to deal with different situations that motivate or discourage the development of an autonomous practice in hospital institutions. Among the various factors identified in this research that enhance the exercise of professional autonomy, expertise was listed as the central and decisive element during the nurses’ work. And Other elements that weakened this exercise were the power relations with doctors and members of the nursing team itself. The research concluded that the autonomous exercise in the hospital environment is a complex process which goes beyond formal regulation, and which is constructed and legitimized in the daily work.