Processo de supervisão do enfermeiro: contributos para o desenvolvimento da autonomia no ambiente hospitalar

Abstract

The process of supervising nurses in the hospital environment undergoes changes, thus passing from the character of control and supervision, elements of its essence, through transformations that come to meet the current contexts of each reality of health/nursing organizations. The object of this research is seen from the perspective of more modern conceptions of Social Supervision and under Paulo Freire's constructs. To formulate the guiding question, the acronym PCC (Population, Concept and Context) was used, (P): nurses (C): Supervision process and the development of professional autonomy; and (C): hospital environment. Having as a guiding question: “How does the nursing supervision process constitute a contribution to the development of professional autonomy in a hospital environment in three Ibero-American countries?. The central objective of this investigation is analisis to process of supervision of the nursing as a contribution to development of professional autonomy in a hospital environment in three Ibero-American countries. This is qualitative research, which is part of a multicenter study of University Hospitals in three countries, Portugal, Spain and Brazil. The research had as participants the assistant nurses and heads of the inpatient units, nursing coordination, managers and supervisors. Semistructured interviews and systematic observation were used. This data collection took place from 2019 to 2020. For the systematization of the data, webQDA® and NVivo® software were used, for the analysis method, Minayo's content analysis was used. This study analyzed the nursing supervision process in hospital organizations in three countries. Five articles, a bibliometrics and a scope review study on hospital supervision were built, carried out with the objective of mapping the evidence on the subject. Field research data are presented in three articles, one that addresses the characterization of the nurses' supervision process in the three investigated scenarios; another on the interface of supervision and the development of autonomy in the three countries and the last on the use of quality tools in a hospital in Brazil. The study points to the movements of breaking paradigms related to the adopted management model and to the weaknesses, such as insufficient dimensioning of nursing workers and fragile understanding of the supervision process. The rethinking of managerial practices in the sense of basing the process of supervision of nurses in the hospital environment for the perspective of Social Supervision, in which there is an understanding of the need to break paradigms and to get rid of a model focused on control, identification of failures and increased productivity under the influence of Administrative Theories in Nursing. The nursing supervision process constitutes a contribution to the development of the construction/strengthening of professional autonomy, as it is a powerful space for professional and knowledge development, in the construction of political action aligned with the production of care, which seeks to guarantee safety. patient and worker satisfaction