PRÁTICAS DE ENFERMEIROS (AS) NA ESTRATÉGIA SAÚDE DA FAMÍLIA DO CEARÁ: UM ESTUDO QUALITATIVO

Abstract

The family health strategy has been considered since 1994 as a preferential model attention to prior attention for the Brazilian health. Considering that Ceara was the pioneer state in the process of reaching Primary Attention to Health guarantee , through the Family Health Strategy and the nurses were part of the Health Family Team and develop a set of health practices, since the beginning of the Family Health Strategy, this study brings the following question: How can the nurses and the health municipality managers notice the nurses’ professional practices in the Family Health Strategy in municipalities from Ceará? The aim is to analyse the nurses’ professional practices that work in the in municipalities from Ceará. It is about a qualitative approach, made from October 2017 to January 2018 in four municipalities from Ceará: Cruz, Eusébio, Fortaleza and Tauá. The participants totalise 17, being eight nurses, two from each municipality, and nine managers (health municipality secretary and basic attention coordinators from the respective municipalities). A semi structured interview was used and a thematic analysis was adopted. The discussion was made starting from the categories : Family Health Strategy nurses’ work process, challenges related to users’ welcoming, service organization and municipality management: nurses’ life experience in the : Family Health Strategy from the sense of work to the worker’s health and Family Health Strategy work process on dimension of attention, promotion and management: a scenario of changes. The results pointed that these professional practices are guided by administrative, management, assistance and relational premises. From the attention activities that appear as a scope of the Family Health Strategy nurses practices, it is highlighted the prior attention for the primary groups such as: children, elderly, pregnant, people with chronicle diseases among others. The nurse appointment appeared in the interviewed reports and the medical prescription was presented as an activity that still brings questions by other professional groups and among the nurses themselves. It was noticed that the nurse performs health education activities such as: School Health Program , Lectures, Groups, waiting room, and national campaigns with predetermined themes. . About the group work, the nurses and the Health Communitarian Agent approach the inter professionality activity. The innovative practices in the vision of the interviewed were: shared appointment, technological advance, use of creativity and social network, the support to management activities. : impotency for not responding the users expectations, work overload, dissatisfaction, as a consequence for not being recognized for their work, showing that these factors influence negatively on their health. The nurse practices performed, give support to the group work, and respond to the user’s several necessities, without, however being consolidated. It is concluded that the fragmented care practice persists in the Family Health Strategy in several knowns, less flexible agendas and bureaucratic al attendance for standards. There is the necessity to demonstrate the importance of the social and technical capacity that the nurse has in the Primary Attentio to Health, as well as the Family Health Strategy work process qualification, related to multiple possibilities of functions developed by the nurses.