Análise do trabalho no setor de emergência de uma maternidade pública

Abstract

The health of health workers has increasingly been at the center of studies and humanization policies of the SUS, considering its interface with improving the quality of health care for the population. Care in maternity wards occurs based on practices that differ from scientific evidence for safe pregnancy in the world, and are associated with precarious work. The dynamics of work in urgent and emergency services has been conditioned by constant overcrowding, imposing a fast pace and overload on workers. The task of providing direct and uninterrupted care exposes nursing professionals to serious occupational risks and accidents. It aimed to analyze the work in the emergency sector of a public maternity hospital. The first article analyzed the organization and functioning of the admission sector of the public maternity emergency, its management aspects, characteristics of the demand for work in the admission sector and relationships with the health risks of these workers.The second described the conflicts and strategies of nurses and nursing technicians in the emergency admission sector of a public maternity hospital and analyzed the characteristics of the work activity and identified aspects associated with risks to their health. This is qualitative research carried out in a public maternity hospital located on the outskirts of Salvador during 2012. For this, the Ergonomic Work Analysis (AET) was used, focused on the analysis of real work situations. An ergonomic study was carried out with analysis of documentary sources, open observations of tasks, semi-structured and situated interviews. Contradictions, restrictions and pressures experienced by workers and managers were identified related to the excessive increase in demand and insufficient resources available for the work and operation of the institution. It was found that the demand disconnected from the guarantee of an effective model of reference and counter-reference of prenatal care for childbirth in the SUS has repercussions on the precariousness of work contexts in the maternity ward and makes it difficult to guarantee quality of care. Nurses' workload is related to their work in multiple sectors with diverse demands. For nursing technicians, overload is related to the excess of procedures and tasks included in the actual work beyond what was planned. Inadequacies in protocols, standards and prescribed routines contributed to increasing conflicts with users and other workers. It showed the importance of adequate sizing and occupancy of jobs, taking into account the real demand for services and the importance of prescriptions for work.