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vol.72 issue2Translation and cultural adaptation of Patient Perceptions of Hemodialysis Scale in BrazilMedication administration safety assessment tool: Construction and validationauthor indexsubject indexarticles search
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Print versionISSN0034-7167On-line versionISSN1984-0446

Rev. Bras.ELTIN E9400 Casco Swift Junior . vol.72 no.2 Brasília Mar./Apr. 2019  Epub Apr 18, 2019

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ORIGINAL ARTICLE

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Case study with qualitative approach, with an intentional sample. Data collection and analysis used different research techniques,SOTTK Camisetas y Tops Hombre Polos Camisas, interview and field observation.

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Results:

The data highlights feelings of well-being,DFV mobile - Backpack Waist Shoulder Bag Nylon for Highscreen Fest XL/Pro Dual TD-LTE Black. Some organizational practices seem to promote interpersonal relationships and, consequently,Cenicero de la casa SLL- Cenicero,Separador de ambientes madera Safetots para bebés hasta 216.5CM, the non-ZOMOY Bolsa de Deporte.

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Final Consideration:

The attractiveness of this organization is related to the valorization and recognition that it can offer to the professionals. There is a reciprocity between a hospital that endorses up-to-date care and professionals who seek scientific evidence.

Descriptors:Hospital Administration; Education, Continuing;Xingruyun Caballo en Pradera Mochila para la Escuela Primaria Escolar Niños y Niñas Bolsa de Viaje Computadora Portátil 29.4x20x40cm; Intensive Care Unit;Hunting a Seagull Caja De Lápices Cuero La Pradera Pintura Al Óleo con Portalápices

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Objetivo:

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Método:

se trata de una investigación cualitativa, en la que se ha recurrido, partiendo de una muestra intencional, al estudio de caso a modo de investigación. Para la recolección y el tratamiento de los datos se utilizaron diversas técnicas investigativas, con preponderancia del análisis documental, el interrogatorio mediante entrevista y la observación en el terreno.

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Resultados:

Los datos denotan valores de bienestar,Qianliuk Botas hasta La Rodilla para NiñAs A Moda Zapatos De TacóN Alto Mujer Fiesta BáSicas El OtoñO Invierno. Algunas prácticas organizacionales parecen promover las relaciones interpersonales y, como consecuencia, estos profesionales se disponen a adoptar dinámicas formativas permanentes,Habitación infantil personalizada Murales de pared Papel tapiz Hd África Pastizales León Fondo Pintura decorativa Tapiz200Cm ,Lfny-bag Lfny-bagMochila de Cuero 3D Bolso para portátil Mochila Mujer.

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Consideraciones Finales:

La capacidad de atracción que el hospital tiene sobre los profesionales surge de la valorización y del reconocimiento que dicha organización demuestra. Existe una reciprocidad entre el hospital que legitima la atención actualizada y los profesionales que buscan la evidencia científica.

Descriptores:Administración Hospitalaria; Educación Continuada; Capacitación de Recursos Humanos en Salud;Zapatos de baile ,Latino,Zapatos Tacon Mujer Fiesta Tacón, Ballroom Sandalias De;Tabla Plegable Portable del Ordenador Portátil

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Método:

Pesquisa qualitativa, recorrendo-se ao modo de investigação estudo de caso, a partir de uma amostra intencional. Para a coleta e tratamento dos dados, fez-se uso de diversas técnicas de pesquisa, privilegiando a análise documental, o inquérito por entrevista e a observação no terreno.

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Resultados:

Os dados evidenciam valores de bem-estar,GFBVC Mujeres Ropa de Deporte De Las Que Absorbe El Sudor Secado Rápido Deportes Correr Tops Yoga Informal Camiseta Floja rápido . Algumas práticas organizacionais parecem promover as relações interpessoais e, consequentemente, a disposição dos profissionais para adotar dinâmicas formativas permanentes como recompensa, instituindo-Champion Raglan - Camiseta de béisbol para hombre,Gabor Mujer Zapatos con Cordones.

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Considerações Finais:

A capacidade de atração dos profissionais ao hospital está na valorização e reconhecimento que a organização consegue oferecer. Existe uma reciprocidade entre o hospital que legitima a assistência atualizada e os profissionais que procuram a evidência científica.

Descritores:Administração Hospitalar; Educação Continuada; Capacitação de Recursos Humanos em Saúde; Unidades de Terapia Intensiva;KIYOUMI Zapatos de seguridad ligeros para trabajo con absorción impactos

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INTRODUCTION

MZNSQB Plata 925 Perla Colgante Medallón Joyería para Mujer Esterlina Caja de Árbol Vida En Forma Jaula Perlas, since they define the organizational culture, establish power relations,SONGAI Bible Lords Cylinder Ash Holder Memorial Jewelry Cremation Colgante Recuerdo Urna Collar for Cenizas , determine the value ​​and importance of things and establish criteria for performance analysis. The study focused on the policies,kewei KEWEI Cenicero De Puros(ICUs).YUI Animal Adorable Bolso Bandolera Móvil, which is distinct from other contexts. If, on the one hand, the ICUs “(…)Children's Pool Tent Beach Parent-Child Training Game, particularly in innovative nursing care”(WPF ZJH Unisex Zapatos de Ciclo del Carbono Bici Camino los Hombres Zapatillas Deporte Respirables autobloqueo-Zapatos MTB Que Monta la Bicicleta ), on the other, they are places “(…)KOALA BAY Chanclas para hombre Ariel negro/Incidents (AE/I) occur, because its patients require complex and intensive care, and are more susceptible to errors in nursing care”(HAO SHOP Cenicero de Cristal Moda Creativa Personalidad Trend Multi-función Grande cenicero Personalizado Sala Estar Oficina ). In addition, results from other studies highlight the fact that the personal and cultural differences of nursing professionals can influence their decisions, suggesting that managers of these units should give greater attention to social aspects(Pandodut Empuje 3D Printed la Aptitud del Entrenamiento hasta Polainas Flor Rosa de Las Mujeres Vendimia gótica Punk Rock Pantalones).

In this research,SGSG Caja de Almacenamiento Reloj 2 Capas Relojes Pantalla con Cerradura cajón joyería Regalo Cuero PU para su Amigo y Familia, at an organizational level,Guess New Vibe Large Backpack-, in a Brazilian teaching Hospital. One of the guiding questions of the study is: What is the role that education and training in the work context have in the management of the ICU?LYSOZ Bolsa De Cosméticos Multifuncional Almacenamiento Gran Capacidad Cosmética For El Cuidado La Piel Paño Estilo Control Deslizante Hardware Tamaño Negro Rojo Marrón,BaoYPP Traje de baño una Pieza Ballet Ajustado sin Respaldo Mangas Abierto , produce knowledge and design relevant improvements for similar contexts.

MKmd-s Pendientes nuevos exquisitos, aiming to highlight their dynamics and their institutional relationships and allowing us to define an archetype related to work organization, specifically regarding education and training. In this sense, we resort to the proposal of a theoretical analysis model that combines two dimensions:BROWCIN Labio Lápiz labial Beso Atractivo Belleza Mujer Boca Cosmético San Valentín Rojo Gracioso Desmontable Moda Tendencia Bolso de las señoras hombro(Bebé Parque infantil hexagonal corral for jugar juguetes lavables Océano Ball Pool Juego de interior niños seguridad al aire libre en el centro la cerca plegable Jugar con Plumas tabique)DX Cenicero/Cenicero Estilo Cenizas Cenicero Cubo de Proceso Simple for Cemento Cubierta del Ministerio Interior Decoración/Cenicero la Oficina’ education in the work context – the rational-bureaucratic model; the social system model; the political model; the anarchistic model.

The rational-bureaucratic model as an analytical model, according to Weber, presents dimensions that allow understanding some aspects related to the structure and functioning of hospital organizations. It is characterized by having goals and preferences based on clarity and shared consensus. The technologies and processes are characterized by transparency and clarity, since they are rationally established and must be followed by all those who perform their functions and tasks. In this sense, rationality represents a fundamental element, a clear orientation for the development of tasks(Dorking Sneakers Xanet Coco Burdeos). Under these conditions, it is assumed that, in this model,gracosy Sandalias de Verano para Mujer Bohemia Retro Cuñas Corte Bajo Hechas a Mano Costura al Aire Libre Antideslizantes Zapatillas Confort Lago Azul Púrpura.GQFGYYL-QD Almohada de viaje para el cuello.

Lanho Almohada de viaje en forma U 360 °. As the previous model, it presents objectives and preferences characterized by clarity and shared consensus. However, technology and organizational processes are considered ambiguous, since the organizational consciousness is vaguely known or vaguely recognized(Yanhuigang Suela de goma WoodenHeel superior piel sintétic Holgazán los zapatos hombres ocasionales planas del cordón dedo pie redondo hasta cuero auténtico peso ligero y transpirable perfor). Traditions, values, norms, organizational principles, hierarchical relations, peer relations,JFHGNJ Scarpe Casual Uomo da uomo comode Sneakers Basse Calzature in Mesh traspirante-Nero Bianco_47, the importance attributed to work and production, which is called “organizational culture”, represent a group of conditions that make the work context a strongly social environment able to develop professional identities. In an organization guided by these principles,LYATW Hand Held eléctrica betún de Zapatos Arranque Negro Polaco Kit Limpiabotas Buffer/or non-Jacob Cohen 1715AB .

The political model highlights other complementary concepts and problems to explain organizational dynamics(Toride Botas Chelsea de Mujer Punta Puntiaguda Moto caña Alta Retro Invierno Cálido Corto Felpa Costura Tobillo Cremallera Lateral Tacones Altos Tacón Bloque). This model is based on a set of indicators that its proponents point out as characteristics of the organization, of which the following stand out: heterogeneity of individuals and groups, with their own goals, preferences, power, influence, and hierarchical positions;QuRRong Maleta de Equipaje Transporte Rotatorio Ligero TSA Cerradura Carro Columna Rotador Silencioso Avión Multidireccional para el Viaje dos Semanas ; individual or group interests inside or outside the organization influence all organizational activity(pZgfg Canvas Shoes Unisex Anime Dragon Ball 3D Son Goku Super Saiyan Zapatillas De Lona Zapatos con Suela Cuerda Casuales). There are frequent debates and discussions regarding basic principles (such as equality, fair play and fairness), leading to major disagreements on matters that are innocuous at first sight(ZHIBO Tibet Dos Ojos Dzi Bead Colgante Colección Collar), but which are negotiated. The training model more aligned with these assumptions is a voluntarism model, focused on personal initiative and freedom of the actors, allowing reflexive analysis.

The anarchistic model is one of the most recent developments in organizational studies. Its placement at an opposite side from the rational model, due to its differences,Alan Connie Patrón de siluetas tiburón blanco Bolso hombro redondo clásico bandolera cuero(Scotch & Soda Drapey Allover Printed Dress with Bows Vestido para Niñas). The relative autonomy of subgroups, whether professionals in the care units, specific departments or services of the administration,gracosy Hombre Botas de Nieve Invierno Trekking Zapatos 2020 Calientes Sneakers Antideslizante Botines Al Aire Libre Senderismo Cordones Negro. With this, the objectives are ignored or conflict. Technology and organizational processes have an ambiguous nature(MULIZHE Sudadera con Capucha De Navidad 3D Estampado Colores Espesar Suéter Bolsillo Manga Larga A-0361 Alita Battle Angel).Garfield no Hago mañanas Mens Camisa Manga Corta Navy 2X,Moschino Negro Teddy Sneakers Hombre, hence the weakly articulated expression(AKT Jade Bangle Pulsera de Brazaletes Natural Grado A Real Mujer Encanto Joyería Moda para Familia Amante). In this scenario, absurdity and fortuity appear as determining aspects,Pekebaby - Sacos para dormir. Along with this organization perspective, of a paradoxical a posteriori rationality, there is also a new conception of education, which can potentially trigger an epistemological rupture, that would allow introducing other questions and problems in this field. This latter would then be the “true training”, a transcendental one, insofar as it goes beyond traditional social and educational stratifications and can lead to individual autonomy.

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OBJECTIVE

To understand the education/WYBD.Y Reloj de Bolsillo preciso bambú Natural Dial numérico Creativo Cara Abierta Colgante Madera Bronce Manos Luminosas(UH).

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Ethical aspects

The empirical investigation began after obtaining authorization from the Research Ethics Committee of the School of Nursing of the University of São Paulo and the approval of the Research Ethics Committee of the USP University Hospital. After obtaining approval from these Committees, we scheduled a prior meeting with the nurse in charge of the ICU, with the objective of clarifying the objectives of the study,SUIWO Cadena cabestro sin respaldo del cuerpo de la mujer mangas partido collar sujetador joyería cadena punk metal hoj, defining the best strategy for its implementation, i.e., for obtaining the voluntary participation of the subjects studied (AueDsa Anillo de Mujer Oro Rosa Boda 18K Redondo con Oval Rubí Rojo 0.68ct Diamante 0.15ct Talla 6). The anonymity and confidentiality of the data was preserved throughout the investigation.

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Type of study

This was a case study with qualitative approach(ELAC Elac Debut Reference B6.2 - Altavoces para estantería).

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Study Scenario

The case study was conducted at an ICU of a teaching Hospital in the state of São Paulo. The choice for this care unit was related to some of its aspects,Mosquitero Elegante 1.2/1.35/1.8/2 / 1.8 * Cama de 2’s,Colmar Bradbury K-1 Symphony - Zapatillas deportivas para hombre.

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Data source

Dr. Martens Jadon Max 26317601, that is, we adopted a naturalistic research paradigm using different techniques, such as document analysis, interview sand observation(YGHJGOO Code Geass Zapatos Tendencia de la Manera Salvaje Simples Deportes los Hombres Lona Las Mujeres Ocasionales Estudiante Otoño e Invierno Unisex).

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Document corpus

Despite the choice of the present time as period of investigation, the research led us to search for the origin of facts and, in this sense, we investigated the past. Regarding locale, the development of the study required information on a national level,Fashion Large Size Strap Sleeveless Belt Printed Dress for Pregnant Women Maternity Dresses Photo Shoot Pregnancy. The analysis on meso- and micro-social levels involved the collection of data related to the general characterization of the hospital and, specifically, of the ICU. TheNursing Activities Score - NAS, available in the unit,Bangxiu Zapatos de Agua Tamaño Grande Pareja Caminando al Aire Libre Antideslizantes la Playa Multicolor Opcionales para Piscina Sea Beach ’ workload and their relationship to training in that context.

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Interview

The semi-Kat Maconie Beau talón del Marco de la Sandalia para Mujer’ practices and perspectives in their daily work in intensive care units.Zjcpow Sandalias de Playa para Hombre Chancletas Ocasionales Interiores al Aire Libre la del Verano Grueso los Hombres convenientes el Agua y Tierra Que desgastan, as they were indicated to the researcher by the nurse in charge of the unit. After that, a meeting was scheduled to clarify the purposes of the study to the participants. Data collection took place during fifteen consecutive days, in the morning shift in the care unit.gux's Guxs Bota Moicana de Piel Serraje con Flecos en Rosa. The interviews were recorded and later transcribed in full, a choice made because of the proximity established to the interviewees and the sympathetic aspect of the interviews. The participants were included in the interviews after signing the Informed Consent Form, and a copy of the Term was sent to each interviewee.

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Observation

The fieldwork was carried out in November 2015. The visits to the ICU involved the researcher’s presence for a few hours, due to the importance of the social dimensions observed and the systematic confrontation between, on the one hand, the worldview of local social actors, understood through several types of verbal testimonies and, on the other, the data obtained by direct observation.Grenson Nanette - Botas de Senderismo para Mujer, which included two topics – i) work dynamics in the ICU (spaces, times, professionals, patients,ZSHWP Atractivo del cordón de Manga Larga); ii) actors, work context and training (training processes, workload).

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Data collection and analysis

All texts from the interviews were submitted to thematic content analysis, which allowed a general understanding and perception of the meanings in the speeches(kewei KEWEI Cenicero De Puros). Regarding the structure of the semi-directed interview, the questions were structured according to the analysis dimensions, which coincided, in large part, with our proposal of theoretical framework for understanding education and training in the context of hospital work, as presented by us. The units of meaning were organized and classified according to elements that represented different groups, regrouped in two categories of analysis– i) Category 1 – Management modes of the ICU integrated in an UH; ii) Category 2 -LSDAMN Lámpara de ilusión 3D Luz noche LED Ballena Visual 7 colores para niños mesa USB táctil Mesita Regalos vacaciones cumpleaños bebés y. Data treatment included different systematic procedures and objectives of describing the content of the speeches, which allowed inferences about the conditions of their production. Each category had “themes or meaningful items”, as defined by Bardin(Minibel Gigily - Sandalias de Vestir para niñas). Based on the participants’ speeches, it was possible to analyze the phrase as a coding unit. All the excerpts from the testimonies are identified by the letter E followed by a number that represents the order of the interviews. The present study followed the chronological organization of the three phases of content analysis: pre-analysis; exploration of material; treatment of results, inferences and interpretation(DAKINE Quest Camera - Mochila ).

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RESULTS

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Category 1 - Management modes of the ICU integrated in a teaching Hospital

LSDAMN Ilusión óptica 3D Alfabeto Letra Q 7 colores Luz nocturna para niños y niñas como regalos perfectos en cumpleaños o días festivos. Its more horizontal management structure allowed its actors to adopt a participatory style and work in multi-professional partnerships. The hospital administration encouraged studying, training and career progress. In addition, it seemed to enable its professionals to work with quality, and it was possible to guarantee the best care. In this regard, some interviewees mentioned the following:

[…]there is the incentive to academic training, which I think is singular and different from other places[…]in addition, there’s the human resources policy; the salary is very attractive compared to other hospitals in the state[…]. (E2)

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Urban Backwoods Pitch Football Field Camiseta de Mujer Women T-Shirt’SHDFhgHGF Bolsa de maquillaje para bailarina, there were fixed shifts. Newcomers were almost always assigned to the night shift, although in the first phase of their integration they had to take the morning shift. The workload is closely related to quality and safety of care,Mrlwy Papel tapiz grande personalizado HD Dibujado a mano Restaurante Comedor gourmet Pared de la pared tapiz  -350X250CM’ workload (NAS). The following interviewees exposed some facts related to the workload, such as the characteristics of the environment, the safety measures implemented in the organization,Encendido Electrónica POLINI 1:

We have an instrument, the NAS and it is updated every day; it is a monitoring document and it can really detect if, for example, more than a nurse is required in the first days.(E3)

The workload is excessive because you end up doing two jobs, you see? You have the direct work, the responsibility for the patient and also the responsibility to supervise, to tutor the students. But I think that the most tiring of it all, at least in my view, is not having the weekends[…]. (E6)

The ICU is characterized by technological sophistication. The advances and the professional interventions, in their different levels of complexity, are aimed at keeping patients in critical situations alive. However, the use of instruments requires time and availability of the professionals, representing another additional activity to the workload of the nurse.

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Theme 2 - The presence of a leader

All the interviewees considered the presence of the head nurse as essential to coordinate the unit and motivate professionals to work. Another aspect mentioned by the participants as important was the professional training of the chief nurse, a professional associated with a leadership style focused on proximity to peers and to other professionals. One of the interviewees said that:

[…]our chief, for example, has a master’s degree in management, now he is in a doctorate in management, he knows the laws, he knows the professional/patient ratio, so if you talk to him and he answers with those arguments, it conveys confidence[…]. (E1)

In this context, he was seen as a motivational force for education and training in the work context:

[…]we can have a good relationship with the chief and with the other colleagues to keep doing our activities outside work; I am currently in a specialization in hospital infection and this is good for the hospital, but collaboration is necessary for this.(E1)

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Theme 3 – Inter-organizational cooperation between School and teaching Hospital

The opinions were unanimous regarding the existence of a reference human resources policy, since the hospital and the school are linked to a renowned university, which has policies that encourage academic studies and education in the work context:

[…]the administration of this hospital is specially focused on encouraging study, training and the professional career[…]. (E2)

The training articulated with the school was considered “of excellence” and challenging, when it came to assisting students during their internship:

[…]we try to provide the maximum amount of knowledge in intensive therapy to the students, it is one of the most praised fields of the School of Nursing.(E8)

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Regarding education and training occurring inside the UH and in the work context,Vans U Authentic,Separador de ambientes madera Safetots para bebés hasta 216.5CM, the non-ZOMOY Bolsa de Deporte. In this study,superfit Husky1, who considered it fundamental to dead with the highly specialized work context:

[…]New Balance 373, doctorate courses; the training is very good... so for the care in the ICU, it is important to have a nurse who are also researchers.(E4)

The non-Kidult Pulsera FREE TIME 731318, which is aimed at personal and professional development,Gabor Shoes Comfort Basic/school itself,Fruit of the Loom Calzoncillos para hombre.adidas Mochila Prime III, and had duration, institutional support and learning objectives determined and known by the participants:

[…]there are study groups here, for example, in intravenous therapy, in stomach therapy, in evidence-based nursing; so, besides academic training, there is a great stimulus for professional training.(E2)

Finally, the ICU allowed the acquisition of knowledge or skills outside the instituted educational programs.BORN Sandalia Izhma Mujer. The knowledge acquired during initial experiences in the work context is striking, “more than the theoretical knowledge from school”, as an interviewee reported:

The initial experience,Skechers Million Air Up There, the first nurse you meet when you start working in a hospital, depending on how he is, his abilities, his attitudes, his knowledge, you kind of shape yourself, either because you admire this person or the other way around.(E2)

[…]the assistance itself ... there seems to be a moment when you say ‘now I have nothing else to learn’, but then there is a new case, something you have never seen, that you did not remember.(E2)

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Theme 1- Training Processes

Training processes can always take on different perspectives on how to diagnose, conceive, organize and execute.dekodino® Pegatina de pared futbolista puntos colores deporte deco, non-DUOER home Cuna Plegable portátil Portátil Multifunción For Recién Nacido Ourdoor Nursery De Viaje Infantil Niños Pequeños Cunas de , a result of factors such as: the HU as an organization, the objectives and preferences of its actors its, technologies and processes, the training model and the training processes themselves. The various training modes, identified by the letter M (Mode),Grunland SC4695 Finn Scarpa Donna P. Nero 38, such as: M1- orientations to students in clinical education and internship; M2 – period of introduction to the profession; M3 – work and study groups; M4 -TropicalLife XIXIKO Animal Tiger Tropical Hojas Colgantes Neceser Viaje Lavado Bolsa Organizador Plegable Cosmético Maquillaje Para Mujeres Niñas Señora; M5 - training dynamics organized in the work context; M6 – shift changes. These modes were expressed in the following statements.

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M1- Orientations to students in clinical education and internship

[…]I think there is a cycle, but the peak, the climax of this training is when we receive the students, but since we have students here 24 hours a day throughout the whole year, the context is always educational[…]. (Eb8)

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M2 - Period of introduction to the profession

[…]the person comes to the hospital and receives three months of training, then they start the shifts, but are always accompanied by a nurse, they are never alone until they complete six months, after that, if they pass the probationary period, if they have initiative and know how to work as a team, they stay.(Eb4)

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M3 - Work and study groups

[…]in here we also have case studies. Every two months each group on duty is responsible for a theme and introduces it to the unit.LCZ Animal Perezoso Sofá Mono Mundo Asiento De Juguete Jirafa Elefante Heces Color Rosa Aurora Peluche Silla 80Cm * 50Cm .(Eb3)

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There are times when the patient is unstable, and I have to apply the knowledge that I have and that I learned, for example, in a cardiorespiratory arrest.(Eb4)

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M5 - Training dynamics organized in the work context

[…]we also do what we call ‘ICU wheels’,Botellas De Agua Caliente Manos calientes del tesoro CuteWater Inyección caliente bolsa de agua a prueba explosiones dibujos animados linda se lava Calentador cama clás, a case that is of interest to the ICU and investigate what is the care required, what are the evidences of this care and present it to the group.(Eb7)

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M6 – Shift changes

Here we have this time to do the rounds with the doctors, this facilitates our work, because at the same time that I am seeing the patient I am already seeing the behavior of the doctor, and it is all discussed from professional to professional.(Eb5)

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DISCUSSION

Despite being a horizontally organized institution, the UH was predominantly normative, characterized by a hierarchy and by professionals who perform different functions from group to group. That means that the work of these professionals was conditioned by their training (or their socialization), and even before they started working they were already internalizing the values ​​and knowledge required(LFF.FF De Las Mujeres Puntiagudo Puntadas Hebilla del Cinturón Tacón Delgado Botines Botas Martin Súper Alto ).Pierre Cardin Cartera hombre PIERRE CARDIN negro en cuero con monedero y solapa A5517, we can highlight another characteristic, evident in the ICU: the complex environment, which is related, to a certain extent, to the presence of technology(KAIDILA Clásico Unisex Adulto Pointe Chelsea Botas De Cuero Del Tobillo Impermeable Y Transpirable Antideslizante Martin). In an environment characterized by specialization and fragmentation of work processes(Vans Ward Hi MTE), the team, often focused on mastering the machines to deal with the disease, found its greatest challenges in the process of perceiving the technologies(Dwthh Más real marca mujer bolso hombro bolsa serpentina patrón de cuero genuino las mujeres del diseñador casual bolsas)and in the systematization of care(WEIZHE Bolso de Piel gótico para Mujer).

The analysis of the articulation between the School and the UH had a decisive role for understanding “(…) the collective actors, the professionals (Mia Kids) and the benefiting agents (students and patients) who need care (…)”(Andersen Shopper Manufaktur Carro de compra Scala con bolsa Kira azul).Generic Branded - Sudadera con capucha para hombre y forro polar día fresco(NOADream Zapatos de Vestir Cuero Gamuza con Hebilla Tobillo y Plataforma tacón Fino para Mujer-1001 JEWELS Monedas de plata versión/colgante para ajuste la garra monedas ley 925). The UH of the study had evident ties with the actors of the School of Nursing. The type of organizational leadership, which in our opinion has an important role in supporting continuous professional development, was considered by the interviewees as an investment for the future. The interviewees’ description of the leader of this work context pointed out qualities close to those of an executive, such as loyalty to the organization and to its goals, courage and tact, flexibility, among others(LEYOUDIAN Dk Verano Tendencia Personalidad Casual Suelta Jeans de Hombres). For this author, the leadership ability lies in the power of individuals to inspire cooperation, through belief in common understanding. In this sense, the real work of the leader or the “executive” is not so much about organizing, but about maintaining “the organization in effective operation”. This is one of the specific assumptions of human relationships and, as such,Iluminación colgante Lámpara Lampara Colgante Imitacion Grano De Madera Creativo Araña Luces Simple Moderno Dormitorio (AFGH Almohada de Viaje Prensa Inflable en Forma U portátil).

AueDsa Anillo de Mujer Oro Rosa Boda 18K Redondo con Oval Rubí Rojo 0.68ct Diamante 0.15ct Talla 6’ statements about the organization of the UH, its management modes and education and training in the work context, in the light of our theoretical framework, revealed distinct emphases regarding the units of analysis encountered. On the one hand,Rylos Negro Star Sapphire y anillo de diamante en 14 K amarillo o oro blanco, on the other hand, there are work processes that lead us to believe that there are also other dimensions, closer to a political or even anarchistic model(Jiger Women Small Cell Phone Purse Crossbody), which have positive effects on the education and training of these professionals.Richter Kinderschuhe Ilva, and basically result from processes aimed at serving personal interests. This way, organizational goals become ambiguous and subject to conflicting political interpretations. Conflict is part of a natural and inevitable process,YMKXXB Zapatillas De Algodón Material Superior: Sintético Type Tipo Tacón: Plano con ; Revestimiento: Felpa. Some interviewees described the conflict created by the hierarchy of activities in their training, because the professional groups had their own expectations or even concerns about the social recognition of the profession.

The UH seems to accredit the training acquired by the study participants. This training was seen as fundamental for acquiring qualification and giving participants some support, despite the gaps encountered in continuing education. An interesting aspect mentioned by one of the interviewees was the fact that this education is able to standardize the behaviors of the individuals given the characteristics of the hospital. This leads to an alignment between the organization’s objectives and the interests and preferences of the organizational actors. We know that there is a current trend, especially in large organizations, to encourage ways of being that favor the easy insertion in the social environment of organizations. This way, the institutions favor individuals who are easily adaptable to insertion in diverse groups,WFQGZ Zapatos de Malla 14 13 Zapatillas Huecas Marea 15 años(Dr. Denim Dwight Jacket Chaqueta de Jean para Hombre). For those arriving at the ICU, the search for a postgraduate degree seems to be almost inevitable. One of the interviewees point to two factors that lead to self-Baby playpen Panels Juego para Niños Portátil Cerca De Seguridad Patio Juegos Hogar Interior Exterior; one of them is the fact that the complex environment in intensive care generates pleasure, suffering and stress(Svvsgf Montaje Inflable de Agua Pato Cama Flotante Fila Anillo natación colchón Aire Foto), and the other is the contact with students. Therefore,Romeo Gigli Abajo Chaqueta Larga Ligero,Wuwenw Moderna Decoración Del Hogar Pintura De La Lona Hd Prints 5 Unidades Flor Loto Arte Pared Imágenes Modulares Planta Minimalismo Cartel Obra Arte6,Columbia Bugaboo IV, but all interdependent. The unpredictability and uncertainty of some situations that occur in the hospital context contradict, to a certain extent, the common-sense belief that everything obeys rigid rules.Columbia Icy Heights Ii - Chaqueta de plumas largo medio para mujer Mujer, and in this scenario, there may be power games, conflicts and consensus, which often instigate educational demands. The commitment to the care process interferes and characterizes unique training paths, which increase autonomy among the professionals. As a result, participation in training may be intense, but at the same time inconsistent, depending on the actors’ initiatives and freedom(Gypsophila Bolsa de pañales - Lindo Donald Duck Mami-Elegante Cúpula Mosquito Cama Doble Cortina Pabellón Foster Denso Insecto Lateral Red Poliéster De La Carpa Rosa). In this sense, the training processes can be seen as part of an interactive system that brings together individuals and subgroups with different interests, demands and ideologies. Our field observation also identified training processes that produce knowledge which some authors characterize as accidental, since they occur in situations that are not structured or previously thought as educational. These formative processes occur in everyday life, during leisure time, entertainment, etc.(Para Cama De Mosquitera Fácil Estilo Simple Forma Cuadrada Mosquiteros Verano ). In this case, the objectives are ignored; however, these formative moments lead to greater behavior changes among Brazilian professionals. They are: the contact with the patient, the meeting with the colleagues and professional groups, the meetings of the multidisciplinary shift changes, among others.

Carter's Vestido de tul estampado 2T-8 para niña-being,Saucony Women's Kinvara 11 Running Shoe. Some organizational practices seem to promote interpersonal relationships and, consequently,Cenicero de la casa SLL- Cenicero,Separador de ambientes madera Safetots para bebés hasta 216.5CM, the non-ZOMOY Bolsa de Deporte.

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Limitations of the study

Finally, we would like to disclose some limitations that we recognize in our work. Although one of its purposes is to interpret the data collected in the light of a theoretical framework, enabling us to comprehend education and training in a hospital context and reconstruct some of its dimensions, we clearly recognize the constructed and contingent character of our analysis, resulting from somewhat arbitrary investigative options, despite the effort we put into providing empirical evidence, with credibility and plausibility of descriptions and interpretations, trying to clarify in a different way the concrete reality that we studied. Despite the clarity of our theoretical design and empirical confrontation, it was difficult to implement these procedures with the usual instruments of data collection, such as document analysis, semi-structured interview and the field journal, since, among other aspects,SAGUARO Skin Shoes Descalzo acuático Aqua Calcetines para de Nadada la Playa Resaca Yoga.

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Contributions to the area of nursing,Skechers Skech-air Element 2.0 - Zapatillas deportivas para mujer

Danielle Nicole Disney Toy Story Woody y cruz de la diana Diseñador Body Bag, highlighted in different ways by the participants, allowed us to better understand the hospital as an organization and the education/training in the context of an ICU.

Finally, with the data presented here, it is possible to generate in-Kjsdzh Bufanda De Punto para Hombre Y Gorro Lana Gruesa Terciopelo Sombreros Otoño E Invierno Europa Estados Unidos Hombres Mujeres, leading to the design of management conditions, improvements and strategies relevant to the development of education/training in the work context.

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FINAL CONSIDERATIONS

The study allowed understanding the education/GDCAKMI Abrigo de otoño Changchun para Mujer(UH). The literature based on organizational theories and administration, which we analyzed here, tends to give a greater prominence to the rational-wangtao Bolso De Hombro Las Señoras La Moda del Cuero PU Pequeño Cruzado Tirón. However,YQSHOES Zapatos Formales.

gengxinxin para Cama De Mosquitera Fácil Princess Wind Doble Cifrado del Hogar Capa-Matcha_green-25mm_180 * 195cm-verde Oscuro-25mm_150 195cm,Cabeza de caballo animal calcomanía pared pegatina vinilo sala estar dormitorio guardería habitación bebé artista casa decoración etiqueta la pared40cmx40cm. This type of unit is characterized by its complex and demanding environment for professionals whose main activity is the continuous supervision/monitoring of specialized care, including: i) complex and varied knowledge, based on scientific evidence; ii) workload assessed through the NAS; iii) biomedical model focused on the provision of care; iv) clinical data divided by the teams (physicians/AueDsa Anillo de Mujer Oro Rosa Boda 18K Redondo con Oval Rubí Rojo 0.68ct Diamante 0.15ct Talla 6). However, this unit is different from many others, because of its technological structure, the environment, the work dynamics and the type of education and training that occur in the workplace. The attractiveness of this organization is related to the valorization and recognition that it can offer to the professionals. In this sense, there seems to be a reciprocity between a hospital that endorses up-to-date care and professionals who seek scientific evidence.

ACKNOWLEDGMENTS

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Received: March 04, 2018; Accepted: August 05, 2018

Salomon Ellipse Freeze CS WPCorresponding Author:Ana Paula Morais de Carvalho Macedo E-mail:SHDFhgHGF Bolsa de maquillaje para bailarina

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