A recusa do cuidado em situações de emergência: uma abordagem fundamentada na teoria Human Becoming

Abstract

The emergency unit is intended to receive and best serve all patients who require emergency or urgent care. However, despite the patient s need for care, nurses have noticed refusal of care by some of them. In this sense, this study questions: what are the feelings and positions that emerge from the nursing team when receiving the refusal of care by the patient in need of care? Thus, the phenomenon of this study is the refusal of care in emergency situations, with an approach based on the Human Becoming theory. Therefore, the following general objective was constructed: To analyze the feelings and positions expressed by the nursing team, in face of the refusal of care in emergency situations, from a perspective based on the Human Becoming theory. And the specific objectives: To know the feelings and the positioning that emerge from the nursing team, in the face of the patient's refusal in an emergency and urgent situation, in the context of the nurse-person relationship based on the Human Becoming theory; To discuss what are the feelings and positions of nursing professionals related to the ethical dimension of care and the Human Becoming theory. It is a qualitative, participatory approach. Approved by the Ethics Committee of UERJ under Protocol No. 52543815.9.0000.5259. The scenario for the development of the study was an emergency unit of a municipal hospital in Rio de Janeiro. Participants were the nurses and nursing technicians of the emergency unit. The data were collected in 2016 through interview, talking-map and World Café, and the data treatment followed the orientation of the Bardin Content Analysis, emerging three categories and a subcategory, entitled: Emotions and feelings arising from the refusal; and its subcategory: Motives and motivations for the refusal of care, according to nursing professionals; Meaning, rhythmicity and transcendence in the nurse-person relationship; And Positions after the refusal and relevance of the study. It is concluded that various feelings emerge from these professionals at the time of refusal, such as frustration, anger, impotence, empathy, indifference. It was also possible to analyze that many principles of Parse s theory are applied in the routine of the nurse-patient relationship in the emergency unit. However, there is still a long way to go in this direction. It was possible to verify that the professionals seek to orient and elucidate the patients, with respect to their autonomy.