Medicina e Enfermagem saberes e práticas incomensuráveis? Uma abordagem à luz da hermenêutica e dos science studies

Abstract

This present dissertation is the product of a research made in female infirmary of a healthcare center on a public university hospital from Rio de Janeiro. My goal in this research was to understand the relationships and the pathways of the medical and nursing work. From the hermeneutic perspective, I have established conversations with and also among - research subjects, professional groups, the hospital institution itself, the biomedicine its facts and artefacts. Moreover, the science studies and its examples about how to follow and interpretate specialists in their practice field were inspiring. The research was specifically built and developed with qualitative methods, such as the ethnographic observation and semi-structured interviews, being the first one the foundation of the second. The interpretive exercise set in motion since the research projection was not depleted by its end: it kept on going afterwards and it made itself present in this dissertation output, idealized in the form of a narrative. In order to substantiate the choice for the narrative discourse, I took it on as a risk report , the way Latour suggests when describing the networks and its actors. Thereby, I intent to include in the content the intense movement and all kinds of events that were put as challenge to the practices of such professionals; and also to provide action to subjects and things. According to this approach, the narrative presents a prologue in which states opinion on the work of Saúde Coletiva (Collective Health); the introduction has an extended survey on its construction. On chapter one, talks about how the researcher negotiated with the hospital institution the possibility of the research; it is also about one of its fundaments: the philosophical hermeneutic on conversations with Rorty and Ayres. On the second one, it is presented a report on Fleck s social constitution of doctors and nurses. Still, it invites one of the research subjects to provide a concept that enlights the strains of the everyday relationship between nurses and doctors; from the existing concept, it presents some portraits of such relationships. On the third chapter, the case of a user who had the maintenance of her life decided in a meeting and on a phone call, the concept of Kuhn s "paradigm" in is used to talk about the worldviews of doctors and nurses. On the forth, it tries to make dynamic the social constitution between doctors and nurses when relating it to their worldviews to the "enculturation" process of the two professional groups; to achieve it, the chapter refers to the concept of " tacit knowledge " and to the different categories of expertise such as those developed by Collins and Evans. It mentions what the doctors and nurse "know what they're talking about/doing." Finally, it suggests two possible outcomes for the dissertation: first, that the doctors and nurses practices are incommensurable among each other; second, that doctors and nurses share a "forced trading zone." There is a foreclosure yet: through the description of a "virtuous" doctor, the invitation for the readers to a conversation about contemporary subjects and the "world " which we live in.