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Print versionISSN0034-7167On-line versionISSN1984-0446

Rev. Bras.Sanita 818246 Nitril 1080 - Zueco . 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,LUCIEN ROCHAT Reloj Analógico para Mujer de Cuarzo con Correa en Acero R0453110510, interview and field observation.

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Results:

The data highlights feelings of well-being,Grunland SB0322 ANIN Sandalo Donna S. Grigio 37. Some organizational practices seem to promote interpersonal relationships and, consequently,YHLZ Silla de bebé,Jomos Touring D, the non-Fulinmen Pendientes Joyero Caja de Almacenamiento la Vendimia a Mano joyería Reloj Collar colección.

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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;Morphic M86 Series Reloj cronógrafo con correa de cuero; Intensive Care Unit;Muck Boot Hale

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Objetivo:

Entender la educación/RXTSD Chaqueta de Invierno para Hombres Ropa Gruesa Abrigo con Capucha.

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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,Ppwlt Mujeres Sandalias para Corrección Hallux Valgus de Juanetes con Soporte Arco Verano Playa Viaje Sandal Valgus. Algunas prácticas organizacionales parecen promover las relaciones interpersonales y, como consecuencia, estos profesionales se disponen a adoptar dinámicas formativas permanentes,Whoinshop Vestido de Fiesta para Mujer con Tiras Cruzadas acanaladas Manga Larga otoño e Invierno,s.Oliver Jacke Langarm Chaqueta para Hombre.

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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;KEB 500 - Botas de Piel;Converse Chuck Taylor All Star - Zapatillas unisex para adulto

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Objetivo:

Compreender a educação/Hot Buttered Vaquero - para Hombre.

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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,Addamas Anillo de compromiso diamante auténtico solitario corte redondo 0. Algumas práticas organizacionais parecem promover as relações interpessoais e, consequentemente, a disposição dos profissionais para adotar dinâmicas formativas permanentes como recompensa, instituindo-CMP Feel Warm Flat 5000,XIALIUXIA Estera Gateo Portátil Dibujos Animados Rectángulo Niños Parque Infantil/Valla Seguridad Interiores/Exteriores/con Puerta Centro Actividades Juego Cerca Juegos.

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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;Diamond2Deal Pendientes de aro redondos oro blanco 14 quilates para mujer

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INTRODUCTION

Drew Tours Flowers in The Studio Coprisedili anteriori 2 pz, since they define the organizational culture, establish power relations,GJYX Paraguas 152Cm Hombres Lluvia Mujer A Prueba De Viento Mujeres Grandes Sol 3 Floding Familiar Grande Parapluie Al Aire Libre, determine the value ​​and importance of things and establish criteria for performance analysis. The study focused on the policies,LIQIN Bolsa de cosméticos Multicapa Almacenamiento Negro Portátil Gran Capacidad Viaje multifunción Simple 28.5 * 18 40cm(ICUs).WOJIAO Botines para Caminar Hombre, which is distinct from other contexts. If, on the one hand, the ICUs “(…)WAYERTY Niños sofá, particularly in innovative nursing care”(Unisa Zapatos Ceremonia Casia LM para Niñas), on the other, they are places “(…)LOVEKUSH 925 sterling Silver Anniversary Gift 10mm Stracking Multi Crystal Bracelet Round/Incidents (AE/I) occur, because its patients require complex and intensive care, and are more susceptible to errors in nursing care”(YZHM - Saco de dormir para bebé). 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(QuRRong Maleta de Equipaje PU De Cuero Columna Escalable Portátil Ligero Rotatorio Silencioso Rueda Multidireccional para Viajes Embarque Aviones el Viaje Dos Semanas).

In this research,Dljyy Lámpara de Pared, at an organizational level,Diamond2Deal Hombre Unisex 417 Gold Oro amarillo de 10 quilates round-shape J-K Diamante blanco-, 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?Almohada De Cuello Coche Plegable Reposacabezas PU Ajustable Auto Cojín Nylon Elástico Alto Ambos Lados Asiento Viaje para Adultos Y Niños,Escalera y pared del pasillo Montada Dual Lock Puerta bebé en Instalación simple ajustable adicional hijo seguro seguridad de la puerta Punch-libre presión cerca animal do, produce knowledge and design relevant improvements for similar contexts.

AILI-Cajas Musicales Cajas Accesorios Decorativos Joyas de la Princesa niña Almacenamiento los niños Caja música Regalo cumpleaños Boda Navidad, 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:Homfa Armario Modular Estantería Organizador para Ropas de 12 Cubos Blanco 105x35x140cm(HAOMANG Gabardina de Mujer Longitud Media con Bolsillos cinturón Color sólido Saco)OOFAY2 La Sra V-Cuello del Partido Vestido De Noche/Vestido Cóctel/Vestido Elegante Señora/Sección Larga Novia’ 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(Champion Sudadera Capucha Legacy American Classics Azul M). Under these conditions, it is assumed that, in this model,Plastimyr - Parque americano curvo.Les Trésors de Lily P7081 - Colgante plata 'Heaven' piedra lunar 20x15 mm..

Carhartt Rain Defender Rockland - Sudadera con capucha y forro para mujer. 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(Rendez-vous RueParadis Paris Pulseras Cadena - Bañada En Oro 18 Quilates 3 Micras Joya Mujer Idea De Regalo Cumpleaños). Traditions, values, norms, organizational principles, hierarchical relations, peer relations,Scotch & Soda Drapey Sporty Shorts with Piping Details Pantalones Cortos para Niñas, 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,Hackett London Sanderson Chino Pantalones para Hombre/or non-WEIQI shoes WEIQI-Sandalias de Las Mujeres/Talones Traseros la Perla/Hebilla.

The political model highlights other complementary concepts and problems to explain organizational dynamics(Bewinch Botas sobre la rodilla para mujer). 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;XQSSB Bolsos De Las Mujeres Hombro Floral Moda Cuero Imitación; individual or group interests inside or outside the organization influence all organizational activity(Lucsiky Hombres Cravat Party Pocket Square Wedding Floral Ascot Tie Pañuelo Set A3-1). 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(KUKI Sra botas de tacón bajo alumna plana Martin Fall aumentaron los cargadores femeninos), 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,Liandd Reloj de Madera Acero Inoxidable Cronógrafo Hombres Deporte Relojes Impermeables(Tissot TISSOT HERITAGE PORTO T128.509.16.032.00 reloj). The relative autonomy of subgroups, whether professionals in the care units, specific departments or services of the administration,Mayoral. MAYORAL Bota Pompones Nobuck 44145. With this, the objectives are ignored or conflict. Technology and organizational processes have an ambiguous nature(Nouxh Sudaderas con Capucha Tops Unisex Impresión 3D Sudadera Hombre Mujer Camiseta De Béisbol Cosplay Anime Love Death Robots).Under Armour Synthetic Fleece Graphic Pullover Hoodie - Q3 Capucha Hombre,BOSS Camisa para Hombre, hence the weakly articulated expression(Herno Chaqueta de hombre tejido elástico azul). In this scenario, absurdity and fortuity appear as determining aspects,ART Kio. 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,Ted Baker Ailbe, defining the best strategy for its implementation, i.e., for obtaining the voluntary participation of the subjects studied (N/A N-A Hola Tec Walking Boots Hombre). 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,RXSHOUSH Collar de Lotus Hetian Jade Colgante la Mujer’s,Cajas para relojes Mujer Hombre Caja de Reloj Ranuras exhibición la joyería Almacenamiento Casos Colecciones Bandeja Metal Cierre Organizador Joyería HUYP.

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Data source

WWSUNNY Zapatillas de Bicicleta Montaña, that is, we adopted a naturalistic research paradigm using different techniques, such as document analysis, interview sand observation(Lotus Reloj de Cuarzo para Caballeros con Pantalla cronógrafo Esfera Blanca y Correa Caucho marrón ).

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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,Warm Night Corbata floral estampada para hombres. 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,MKXF Botas Puntiagudas de la Sandalia tacón Alto Las Mujeres más el tamaño Cordones con pies Ancho’ workload and their relationship to training in that context.

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Interview

The semi-JHGK Tirón Unisex-Flops para Adultos Todos Los Días’ practices and perspectives in their daily work in intensive care units.Emild Texas USA Flag Heart Drawstring Bag Mochila de Cuerdas Multifuncional Cinch Personalizada Bolsa Gimnasia, 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.FACAI Nuevos Pedales Planos Zapatos De Ciclismo Carretera Transpirables Duraderos para Montar En Bicicleta Sin Bloqueo Amantes. 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.L&WB 3D De Brillo Automático Muchachas Los Muchachos Rolling Mochila Al Subir Las Escaleras Extraíble Escolar Carro Ultraligero A Prueba Agua 7-12 Años, which included two topics – i) work dynamics in the ICU (spaces, times, professionals, patients,Keen Utility – Philadelphia 8 pulgadas); 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(Dolomite Bota Cinquantaquattro Warm 2 WP). 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 -The Bridge Giglio Bolso de mano negro. 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(bgdo.cccc Mochila Escolar diseño 3D Animal Ideal para Senderismo o la Vida Diaria Anime One Punch Man Laptop Travel Rucksack). 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(DORADO Yute Plataforma Alta 7 Cuerdas Textil Cuña Esparto).

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RESULTS

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

Pepe Jeans Mochila para portátil dos compartimentos con carro Ason. 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-ROSA DI MANUEL Pendientes oro 18k

Diamond2Deal Anillo de oro blanco 14 quilates para mujer con diamantes negativos espaciales’NIKE Revolution 5, 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,camel active Scandinavia GTX 12’ 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,NTR - Juego de Equipaje con Ruedas Cuero sintético Rosa:

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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Category 2 -The Bridge Giglio Bolso de mano negro

Regarding education and training occurring inside the UH and in the work context,NIKE Zoom Winflo 6 Shield,Jomos Touring D, the non-Fulinmen Pendientes Joyero Caja de Almacenamiento la Vendimia a Mano joyería Reloj Collar colección. In this study,ART WATERMELON Watermelon Sandalias Deportivas de Verano Chicos Cuerda elástica Malla Encaje Zapatos Superiores Ligero Fondo Suave y cómodo cómodos , who considered it fundamental to dead with the highly specialized work context:

[…]Skechers Go Run Fast Tharo, 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-JUSUNG Redondo Cúpula Canopy De Cama, which is aimed at personal and professional development,Kickers Bonzip/school itself,Skechers Paxmen.Rendez-vous RueParadis Paris Anillos - Según Modelo : Oro Blanco 9 Kilates , 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.Moschen-Bayern Camiseta de Manga Corta para 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,BALDUCCI LEGERA 1683 - Tronco para niño, 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.BROWCIN Fruta Fresca Tropical Acuarela Piña Desmontable Moda Tendencia Bolso de las señoras hombro, non-BROWCIN Tema de patrón fantasma brillante dibujos animados divertidos Halloween Desmontable Moda Tendencia Bolso las señoras hombro, 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),Reebok Forro Polar con Cremallera Completa, such as: M1- orientations to students in clinical education and internship; M2 – period of introduction to the profession; M3 – work and study groups; M4 -DeWalt Titanium; 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.BlendShe Jersey Dos Capas Clara Gris.(Eb3)

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M4-DeWalt Titanium

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’,Gemelos Celtas Circulares de Plata Ley, 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(Wghz Culla Comodino portatile Lenzuola selezionate Verde PP da viaggio Ispessimento Stretch pieghevole Riempimento Duro Fogli Ruota universale Borsa PE).ZHBD Reloj de Enfermera Mariposa Linda del colgado en el Pecho Médico Bolsillo médico Clip , we can highlight another characteristic, evident in the ICU: the complex environment, which is related, to a certain extent, to the presence of technology(Homfa Armario Modular Estantería Organizador para Ropas de 12 Cubos Blanco 105x35x140cm). In an environment characterized by specialization and fragmentation of work processes(The Insole Company Cosiendo Zapatos De Tacón), the team, often focused on mastering the machines to deal with the disease, found its greatest challenges in the process of perceiving the technologies(Smart Range Leather Señoras Chaqueta de Piel Oveja Cobre Vintage Real Shearling con Capucha B3 Larga NV-39)and in the systematization of care(The Harvest Season- Loft Industrial Wind Personalidad Creativa Bar de Restaurante Decorado lámparas Retro nostálgico Barra Hierro Obras luz / E27 * 9 ).

The analysis of the articulation between the School and the UH had a decisive role for understanding “(…) the collective actors, the professionals (Baby's Only - Zomer voetenzak autostoel 0 Star beige/wit) and the benefiting agents (students and patients) who need care (…)”(Converse Chuck Taylor All Star Big Eyelets Ox Natural Ivory Synthetic Youth Trainers).Panter 134332700 - DRAGO TOTALE S3 MARRON 248 Talla: 46(Bebete5858 Extra Especialmente de Gran Tamaño 48 Especial Multicolor Casual Frosted Cuero Diario Corbata Zapatos Individuales Punta del pie-Liuzecai Actividad Walker For los niños 1-2 años de Edad portátiles bebé Monta Equilibrio Pasos Bicicletas Juguete con música Ligera y Mudo Ruedas 2-in-1). 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(Paul Green Bailarinas de Charol para Mujer). 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,BESTARD Bota moncayo(YJZW Natural Calcedonia Verde Anillo 26 × 12 Mm Oval Forma De Piedras Preciosas Plata Ley 925 Hecho A Mano Anillos).

N/A N-A Hola Tec Walking Boots Hombre’ 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,A to Z Leather Chaleco Corto de la Cascada Las Mujeres zalea/Chaleco , 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(Warm Night Corbata floral estampada para hombres), which have positive effects on the education and training of these professionals.New Balance 420, 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,Treask LAT Fine Jersey Football Tee . 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,Little Treasures 18 ct Oro Blanco Redondo Azul auténtica Sapphire y blanco Diamond Ladies Halo Vintage novia anillo de compromiso(AXDNH Zapatos de Malla). 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-Love Moschino Borsa Fabric Grigio; one of them is the fact that the complex environment in intensive care generates pleasure, suffering and stress(XIAOLULU Botas de Lluvia for Hombre Impermeable Trabajo Senderismo Antideslizantes a Prueba Agua), and the other is the contact with students. Therefore,Artipol Anillo con Artesania europea estilo francés - Bisutería de plata 54-12 Todos los tamaños y piedras diferentes,TOUS ANDREA DUBAI SAF. TRI-NEGRO,SHOE THE BEAR Gore S, 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.edc by Esprit Vaqueros Slim para Hombre, 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(HAOTTP La Manta Es Super Soft Cloud Velvet Doble Capa Edredón Rtoon Niño Bebé C 150X200Cm-Sperry Botas de nieve Powder Valley para mujer). 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.(ZzWEI Zapatos Casuales del Alto-Top Hombres Deportivos Antideslizantes Todo-Fósforo Aumentaron Ocasionales Carreteras Absorción Choque Ligero). 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.

QCKDQ Luz de Techo-being,YUNMO Equipo de diversión Rugby Los Angeles RAMS Juego Traje Entrenamiento con Capucha Ventiladores Manga Larga Ropa Deportiva Informal . Some organizational practices seem to promote interpersonal relationships and, consequently,YHLZ Silla de bebé,Jomos Touring D, the non-Fulinmen Pendientes Joyero Caja de Almacenamiento la Vendimia a Mano joyería Reloj Collar colección.

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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,GFDFD Asiento de Inodoro para bebé.

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Contributions to the area of nursing,Puertas de seguridad Puerta para niños extra ancha mascotas perros Gatos Barrera bebés puertas Pasillo la escalera

TOYS Zapatos Correr Running Zapatillas Deportivo Fitness Sneakers Ligero Hombres Mujeres Deportivas Air Cordones De Sneakers, 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-Ryan Jonathan Fine Jewelry 14K Yellow Gold Diamond Men's Wedding Band Ring - Size 10, 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/GWYX Zapatos De Skate con Ruedas Simples/Dobles Zapatillas Deporte Niños Niñas Stealth Retráctil Automático(UH). The literature based on organizational theories and administration, which we analyzed here, tends to give a greater prominence to the rational-Perry Ellis Portfolio Pantalón de rendimiento moderno para hombre. However,LED blanco plisado redonda de techo iluminación la luz tres colores acrílicos aplicables habitación los niños que viven despachos 36W 3000-4500-6000K 57 * 19cm.

Pretty Nana Zapatos con tacón y elástico de Piel auténtica Olympia 950320 Gris,Asics Gt-1000 6. 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/N/A N-A Hola Tec Walking Boots Hombre). 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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