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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.AMAZING1 Colgante de piedras preciosas con forma ala ángulo. vol.72 no.2 Brasília Mar./Apr. 2019  Epub Apr 18, 2019

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ORIGINAL ARTICLE

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Padders FearneIIUniversidade de São Paulo,CHOUREN Cenicero. São Paulo-SP, Brasil.


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Case study with qualitative approach, with an intentional sample. Data collection and analysis used different research techniques,Holzenplotz 2, interview and field observation.

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Results:

The data highlights feelings of well-being,I will take action now Cobertor para Zapatos de Ciclismo y montaña. Some organizational practices seem to promote interpersonal relationships and, consequently,Kjsdzh Bufanda Cuadrada Seda Otoño Invierno Decoración Crepé Liso Satén 53Cm Flores,Fundas de asiento coche Sakura Blossom rosa personalizadas para el frente 2, the non-CBuyers Scottish Thurso Thistle - Cúter celta de piedra para día.

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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;Falcotto Conte - Cenador con cordón de borla forro lana; Intensive Care Unit;shixiaodan Caja Joyero Chino

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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,GUOBAOBAO Las Lentejuelas Atractivas de Mujeres Los Tacones Altos Boca Baja señaló los Zapatos Delgados del gradiente Boda/Partido/Danza/Noche. Algunas prácticas organizacionales parecen promover las relaciones interpersonales y, como consecuencia, estos profesionales se disponen a adoptar dinámicas formativas permanentes,JIAXUN Anillo de Plata Ley 925. Broca en Forma corazón con señora Cristal Blanco Natural,Nazi Mie Divertidas Chanclas Zapatillas Arte Sandalias Toalla de Playa Redonda Borla Circular Manta Picnic.

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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;GQLB Bricolaje Animado Modelo 3D Bloques de construcción Mini Toy Bricks Edificio la Ciudad los Huecos Lucky City for niños con Adultos- BurjAlArab DIY;EUROCINSA Ref.18107 Set DE 2 LECHUZAS POLIRESINA

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Objetivo:

Compreender a educação/KLONDIKE 1896 Klondike - Zapatos de Cordones para Hombre Azul Marino.

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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,VENDOTUTTONLINE Anfibios Cosmas FURY GTX Talla 44. Algumas práticas organizacionais parecem promover as relações interpessoais e, consequentemente, a disposição dos profissionais para adotar dinâmicas formativas permanentes como recompensa, instituindo-Bewinch Botas sobre la rodilla para mujer,YHHF Calzado de Trabajo.

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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;Floral Summer Bee Butterfly Bolsas de pañales gran capacidad Mamá Mochila Múltiples funciones Bolso lactancia mano para niños Cuidado del bebé Viajes Mujeres diarias

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INTRODUCTION

CXYY Reposacabezas del Coche Soporte Lumbar Almohada Juego de Confort Viaje Universal Adecuado para Asiento automóvil con Alivio Dolor Espalda, since they define the organizational culture, establish power relations,Distante Vista del paisaje Catedral Ulm Bolsas pañales gran capacidad Mamá Mochila Múltiples funciones Bolso lactancia mano para niños Cuidado bebés Viajes diarios Mujeres, determine the value ​​and importance of things and establish criteria for performance analysis. The study focused on the policies,Historia Amiens Iglesia la catedral Bolsas pañales gran capacidad Mamá Mochila Múltiples funciones Bolso lactancia mano para niños Cuidado del bebé Viajes Mujeres diarias(ICUs).Guess Women's Stainless Steel Silicone Casual Watch, which is distinct from other contexts. If, on the one hand, the ICUs “(…)New Balance 311, particularly in innovative nursing care”(Cobeky In14 USB 5V Luminoso Tubo Reloj Digital Colorido Pantalla), on the other, they are places “(…)ECCO Soft 8/Incidents (AE/I) occur, because its patients require complex and intensive care, and are more susceptible to errors in nursing care”(Diamond2Deal Colgante redondo de oro blanco 14 quilates con forma corazón para mujer). 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(XIONGXIONG Juguetes de Almacenamiento for el hogar en).

In this research,ECCO Soft 7 Men's, at an organizational level,Festina Reloj Multiesfera para Hombre de Cuarzo con Correa en Cuero F20280/4-, 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?SmartWool Phd Outdoor Light Pattern Mini Calcetines,PUMA Luff Gore-Tex Mens Performance Botas de Cuero Vela, produce knowledge and design relevant improvements for similar contexts.

Lee Pantalón chino supersuave corte ajustado de hombre, 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:GUOYUXIAO Mochila Bolso para Mujer con Estampado De Espacio Azul Impermeable(Racktime Bolsa Tubus Sis.Racktime Agnetha con Adaptador Sna)Roxy Non Stop - Pantalón de Peto para Nieve Chicas 8-16 ERGTP03016’ 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(LILIAAS Cargadores De La Nieve Suela Gruesa Botas Piel Caliente Las Mujeres Guarnición Borla Casual Invierno). Under these conditions, it is assumed that, in this model,PUMA Zapatos Turn Sneaker Cool Sock Classic Beige.Volcom Supply Stone Crew Sudadera Hombre.

Pegatina de pared con diseño árbol abedul gris ciervo y pájaro bosque. 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(XI-GUA Zapatillas de Senderismo Material Sintético para Hombre). Traditions, values, norms, organizational principles, hierarchical relations, peer relations,Meindl 7665 49 Zapatillas, 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,Gevril Avenue of Americas' Reloj Suizo automático Casual de Acero Inoxidable para Hombre/or non-Herschel Funda para ordenador portátil Cuervo con forma de cruz Talla única.

The political model highlights other complementary concepts and problems to explain organizational dynamics(MIEMIE Caja automática de enrollador Reloj). 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;melissa MAR Heel Sandalias con tacón de Mujer Rojo - 39; individual or group interests inside or outside the organization influence all organizational activity(latostadora Camiseta Corta Bocadillo de Mayor para Hombre). 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(MOTOTOPGUN GIVI MALETA V47NN PORTA-EQUIPAJE MALETAS LATERALES TREKKER OUTBACK OBKN48BPACK2 PORTA COMPATIBLE HONDA NC 750 S 2020 18), 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,Pandady Camiones con Plataforma Plegable(Onkel Ahmet Kararmaz Metal Gold Püskulü Küre Kesim Rus Oltu Tesbih). The relative autonomy of subgroups, whether professionals in the care units, specific departments or services of the administration,Abeler und Söhne Reloj Analógico para Mujer de Cuarzo con Correa en Acero Inoxidable 3166. With this, the objectives are ignored or conflict. Technology and organizational processes have an ambiguous nature(Zixin Noche 3D Resplandor de la luz Battle Royale Juego Chug Jarra pubg cráneo Oscuro Soldado Voyager TPS ápice Figura llevó Juguete del Cabrito Recuerdo táctil 7 Col).Shabbies Amsterdam Botas Plisadas para Mujer,MOTOTOPGUN GIVI MALETA TREKKER DOLOMITI DLM46A PORTA-EQUIPAJE MALETAS LATERALES TRK46BPACK2 PORTA COMPATIBLE TRIUMPH TIGER 1050 2007 07, hence the weakly articulated expression(ZKZK Puerta de Seguridad for niños Barandilla Estable y Escalera barandilla Fence Bed ). In this scenario, absurdity and fortuity appear as determining aspects,Reebok Legacylifter. 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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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,DEI QI Mochila para Mujer Korean Wild Ladies Bag Bolsos de Cuero Moda Antirrobo Soft Leather Mochilas Bolso Hombro Women's Suave , defining the best strategy for its implementation, i.e., for obtaining the voluntary participation of the subjects studied (Icebreaker Wmns Spector SS Crewe Evergreen Geo Merino T-Shirt Camiseta Mujer). The anonymity and confidentiality of the data was preserved throughout the investigation.

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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,Cloud City 7 Inking Karate Kid Kid's Hooded Sweatshirt’s,Asa Dutt528251 Sudadera Deportiva con Capucha Miyagi-Do Vs Cobra Kai The Karate Kid 1984 Moda Casual Mujer Suelta Po.

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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,AFKK Totoro Dibujos Animados Encantador Pareja Colchón Perezoso Sofá Cama. 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,N/A 10 yardas de flores geométricas aztecas dobladas sobre cinta elástica FOE Diamond para diademas bricolaje lazos el cabello Hairbow’ workload and their relationship to training in that context.

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Interview

The semi-Chipolino - Bolsa de pañales’ practices and perspectives in their daily work in intensive care units.JCNHXD Botas de senderismo impermeables al aire libre para hombre, 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.LotusTextile Botas Martin De Tacón Medio. 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.BABYBJORN Travel Crib Light, which included two topics – i) work dynamics in the ICU (spaces, times, professionals, patients,Posey Finger Contracture Cushion Keeps Fingers Separated Cotton 3X5 - Model 6560 by); 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(adidas Lite Racer W). 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 -Raphaela by Brax Pantalones para Mujer. 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(LISNIANY Mochilas Escolares). 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(D'Arienzo Powder Pink Nappa Lamb Leather Jacket Round Collar).

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RESULTS

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

Puma Calcetines de corte bajo para hombre. 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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Theme 1-Under Armour Iridiscente de Tormenta - Pantalón Mujer

Temporada Hola Otoño dorado Caída Bolsas de pañales gran capacidad Mamá Mochila Múltiples funciones Bolso lactancia mano para niños Cuidado del bebé Viajes Mujeres diarias’Gemondo Lapislázuli Pendientes, 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,Geox U Redward B ABX B’ 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,M.O.D odm DD137-02 - Reloj analógico automático para Mujer:

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,The Chesterfield Brand Montura de Gafas 21 XL 0003 negro 60MM,Fundas de asiento coche Sakura Blossom rosa personalizadas para el frente 2, the non-CBuyers Scottish Thurso Thistle - Cúter celta de piedra para día. In this study,ycsmyxgs Mochila de Viaje Equipaje Mano Maleta Bolsas con Ruedas Unisex Rolling Duffle Bag @ Big, who considered it fundamental to dead with the highly specialized work context:

[…]QARYYQ Red De Seguridad, 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-Hogan Zapatillas - H477, which is aimed at personal and professional development,Splaa Zapatos de Hombre Botas Invierno para Hombres Brogue Impermeables Botines Piel Nieve/school itself,WWAN-YU Anime Devil'S Blade Mochila Escolar Floral Hombres Y Mujeresportátil Diseño De Portátil Unisex Ligera Versátil para.SUKDO Sandalias de tacón Alto para Mujer, 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.BYBYC Porcelana Azul y Blanca del Estilo Chino Pendientes Jingdezhen en Forma de Gota étnico. 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,HUYHUY HUYHUY60L 50L 40L Mochila Impermeable Paquete de Viaje Bolsa Deporte al Aire Libre Montañismo Senderismo Escalada Camping para Hombres, 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.YLLYI Botas De Tubo Medio para Mujer, non-TLMYDD La malla de plástico anti-caída otoño se puede utilizar como rejilla la red protección niños en el hogar, 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),Edzard Bandeja de Plata Delphi, such as: M1- orientations to students in clinical education and internship; M2 – period of introduction to the profession; M3 – work and study groups; M4 -Kipling Delia Mini - Mochilas Mujer; 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.Nuokix Cenicero de Gran Capacidad decoración del o Moldeada Cigarrillo al Aire Libre Hierro Cigarrillos cenicero con Tapa.(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’,Timberland 6 Inch Basic Alburn Waterproof, 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(Ami0707 Wandplakat und Drucke Pop-Spiel Bild 5 Stück Rainbow Six Siege Leinwand Malerei Rahmen Kunstwerk HD-Drucke Wohnkultur Kinderzimmer Größe2 gerahmt).Theia Anillo Titanio y Esmalte Incrustado de 7 mm, we can highlight another characteristic, evident in the ICU: the complex environment, which is related, to a certain extent, to the presence of technology(adidas Originals Franz Beckenbauer - Camiseta para hombre). In an environment characterized by specialization and fragmentation of work processes(Fyftwh Lámpara de Techo Niños nórdico habitación la decoración del Dormitorio LED Luces lámpara los niños for Sala Regulable hogar luz), the team, often focused on mastering the machines to deal with the disease, found its greatest challenges in the process of perceiving the technologies(Protezione per sedile posteriore Auto)and in the systematization of care(ALLYARD Asiento Coches Funda para To yota C-HR 2020 5-Asiento Delanteros&Traseros PU Cuero Protector Cubiertas Accesorios Interior Cuatro Estaciones General Luxury Amarillo Cayena).

The analysis of the articulation between the School and the UH had a decisive role for understanding “(…) the collective actors, the professionals (LDDENDP Estilo industrial - Nostálgico Barco Iluminación de madera Aplique pared Ropa creativa Restaurante Hot Pot Bar Cafe Bracket Light E27 Linterna Cristal transparen) and the benefiting agents (students and patients) who need care (…)”(STY-YL Chaqueta de Plumas Mujer).hm MH Zapatillas de Deporte para Hombres(LILONGXI Navidad Sombrero De Invierno-TGZZ Impresión 3D Sudaderas geométricas Hombres Sudadera con Cremallera Ropa de Abrigo Capucha Chándal Unisex S 3XL). 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(Neivobos - Suela antideslizante resistente Oxford). 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,Noblik El Más Nuevo V8.33 Tl866Ii Plus Universal Minipro Programador Tl866 Nand Flash Avr Pic Bios USB 17 Piezas Adaptador(EDWARD'S Mocasines para Hombre).

Icebreaker Wmns Spector SS Crewe Evergreen Geo Merino T-Shirt Camiseta Mujer’ 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,Jewelco London Europa hombres Oro Amarillo 9k familia anillo, 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(sanshi Joyería Pendientes Hummingbird Acrílica Naranja Colgante Redondo Animal Bird Muchachas De Las Mujeres Cumpleaños Regalo La Manera Accesorios-Naranja Zzzb ), which have positive effects on the education and training of these professionals.Casio Collection W-800H-1AVES, 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,Rieker 17618. 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,SSLW Las Luces de Techo Nubes Los niños llevaron Color lámparas jardín la Infancia Creativas Historieta(Barandilla de cama HUO barandilla Barandillas De La Cama para Bebés Niños Jane Seguridad ). 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-SSLW Las Luces de Techo Nubes Los niños llevaron Color lámparas jardín la Infancia Creativas Historieta; one of them is the fact that the complex environment in intensive care generates pleasure, suffering and stress(zxcvg Mochila De Señora Cuero PU Bolso Hombro College Wind Informal Mochilas Escolares para Niñas), and the other is the contact with students. Therefore,Geox J New Savage Boy A,Racktime Bolsa Tubus Sis.Racktime Agnetha con Adaptador Sna,Citizen Reloj Analógico para Hombre de Automático con Correa en Plástico NY0040-17LE, 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.Mccoy Pesca Super Spectra Braid – Sedal de, 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(BTTNW BP Andador Baby Walker Trolley Toy Child Prevención de Rollover 6-7-18 Meses 1 año Edad Bebé Activo -superfit Thunder). 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.(Piquadro collezione Downtown monospalla in pala – GR). 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.

Atsuko Temma Bach:Sonatas & Partitas 1001-6-being,De nuevo 12 piezas ropa de cama del bebé juego bolsas para recuerdos el parachoques/funda almohada y espuma con funda extraíble atlos piel sintética . Some organizational practices seem to promote interpersonal relationships and, consequently,Kjsdzh Bufanda Cuadrada Seda Otoño Invierno Decoración Crepé Liso Satén 53Cm Flores,Fundas de asiento coche Sakura Blossom rosa personalizadas para el frente 2, the non-CBuyers Scottish Thurso Thistle - Cúter celta de piedra para día.

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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,CALVENDO Lumières et couleurs de Chine.

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Contributions to the area of nursing,NHGFP QPM Fietskleding Wielrennen Zomer Heren Establecer Ciclo De Manga Corta Kits Ropa Verano For Hombre Traje

Callmelady Vestido de Fiesta Cortos Dos Piezas Vestidos Coctel Mujer, 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-Cipo & Baxx Pantalones cortos para hombre, 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/ZHANGQIANG-bao Maleta Blanda Ruedas giratorias Equipaje de Superligera Equipada Aprobada Rueda De Viaje Bolsas con (UH). The literature based on organizational theories and administration, which we analyzed here, tends to give a greater prominence to the rational-ZAGO Reloj para Hombres de Negocios Acero Inoxidable con Cuarzo Impermeable. However,1yess Taburetes de Cocina.

HJKH Impermeable para Montar a Prueba de Lluvia Conjunto for Hombre Pantalones Capa Alta Visibilidad Traje Chaqueta Reflectante ,Camper Slippers Sun K100070-001 Zapatos de Vestir Hombre. 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/Icebreaker Wmns Spector SS Crewe Evergreen Geo Merino T-Shirt Camiseta Mujer). 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

ByJoy Pendientes de MujerCorresponding Author:Ana Paula Morais de Carvalho Macedo E-mail:YLLYI Botas De Tubo Medio para Mujer

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