Processo de trabalho do enfermeiro na estratégia saúde da família: Dimensão Educar

Abstract

The nurses' work process consists of the dimensions of educating, assisting, administering, researching and participating politically. From this perspective, the analysis of the educational dimension in the Family Health Strategy in Manaus-AM was chosen as the object of study. The dimension to participate politically has been understood as transversal the dimensions to educate, watch and administer. The educational dimension should include both the population and health professionals, using the terminology education in health and permanent education respectively. Health education has in the Family Health Strategy a privileged space for its development. The Family Health Strategy was conceived by the Ministry of Health in 1994 and was implemented in Manaus in 1999. The main objective of this study was to analyze the educational dimension of the nurses' work process in the Family Health Strategy in Manaus / AM and how Specific objectives: to describe the development of the educational practice of the nurse in the FHT; To examine how nurses analyze their educational practices and to investigate the educational practices of nurses, the transversality of political participation. For the development of the study we opted for the qualitative research, of descriptive and exploratory character. The study was carried out in Basic Health Units of Manaus, in the five Health Districts, having as subjects five nurses who worked at the FHS. As data collection technique, interview and participant observation were used. The data collection instruments were a questionnaire to characterize the nurses' profile, a semi structured interview script, an observation script and a field diary. The field work was carried out from January to March 2016. For the analysis of the data, the Content Analysis technique was used. The analysis of the data indicates that the UBS does not have an adequate internal space for the practice of health education for the community. They show that the nurses in the study have between 2 and 27 years of professional training. Two nurses were considered to be new, up to five years of service, between six and fourteen years of service. Experienced, over fifteen years. The working day indicates 30h and 40h weekly. The development of educational practices takes place both in the internal space of the health unit and in alternative spaces such as social centers, community spaces, schools, churches and companies. The organization of the work process was done through planning in collective meetings, with absence of the educational project, but it was verified the action plan and schedules of the health education practices. Not all nurses have complementary training for the development of educational practices, and those who have acquired them in specialized courses that focus on the subject. The educational practice in nurses 'perception is considered as fundamental within the nurses' work process, however little reference was made to political participation. The performance of the nurse as educator, driver and facilitator of the teaching process was valued. However, the content of health education practices are mostly demanded by a national agenda, and in the background, the demands of the territorial population are met. The teaching materials used are produced and made available by the Ministry of Health, and in some situations made by the nurses themselves. In the development of educational practices the pedagogical proposal was based on the Traditional Methodology of Education and Dialogical Methodology of Education. The teaching strategies adopted were dramatizations, songs, thematic environment, theatrical presentations, jokes and walks. We also used a raffle of gifts and snacks to obtain public adhesion. The nurses cite as difficulties for the development of educational practices the physical space of the units, the great extension of the area of comprehensiveness, the workload of the nurse, the inadequate profile of the professional for the activity and the cultural diversity of the population. As something desired, the nurses cited: increase the available time in the area of coverage, optimize working conditions and promote the permanent education of professionals on the instruments that enable dialogic education. The nurses analyzed their educational practices, such as successful, unsatisfactory and difficult. Political participation was investigated as transversal to the educative dimension of the nurses' work process, and emerged from the construction of the nurse profile, when they mentioned their participation in the Municipal Health Council, Local Health Council, Brazilian Nursing Association, Council Of District Ethics and churches. Political participation took place at the individual, collective and organized level, and eventual participation was absent. A timid posture regarding the nurse's political participation was highlighted, highlighting the intersectoriality, established partnerships, as a way to improve the autonomy of individuals and to establish citizenship.