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Experiências dos enfermeiros-bombeiros no atendimento extra-hospitalar a vítimas politraumatizadas
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| Projeto de graduação_43164 | 1.43 MB | Adobe PDF |
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O trauma mantém-se como uma das principais causas de morte e incapacidade em todo o mundo, afetando sobretudo pessoas entre os cinco e os vinte e nove anos (WHO, 2024). Em Portugal, em dois mil e vinte e um, registaram-se quinhentas e sessenta e uma vítimas mortais e mais de dois mil feridos graves em acidentes rodoviários, o que demonstra a dimensão e gravidade deste problema de saúde pública (European Commission, 2023). Neste cenário, o SIEM assume um papel fundamental, garantindo a resposta coordenada a situações críticas, onde os bombeiros surgem frequentemente como a primeira linha de atuação (INEM, 2023). Entre estes profissionais, destaca-se o enfermeiro-bombeiro, cuja intervenção alia competências clínicas e operacionais essenciais à estabilização e à sobrevivência das vítimas politraumatizadas (Mota, Cunha & Santos, 2021).
O estudo teve como objetivo compreender as experiências vividas pelos enfermeiros-bombeiros no atendimento extra-hospitalar a vítimas politraumatizadas, partindo da questão de investigação: “Quais as experiências vividas pelos enfermeiros-bombeiros no atendimento extra-hospitalar a vítimas politraumatizadas?”. Foram definidos objetivos específicos que procuraram compreender o significado atribuído à experiência profissional, explorar os sentimentos e emoções associados, identificar fatores que facilitam e dificultam a intervenção, reconhecer implicações pessoais e profissionais e recolher sugestões para melhorar a resposta prestada, todos esses pontos em contexto extra-hospitalar a vítimas politraumatizadas.
Foi realizada uma investigação qualitativa, de caráter exploratório e descritivo simples, através da realização de entrevistas semiestruturadas a oito enfermeiros-bombeiros. As entrevistas foram transcritas integralmente e analisadas segundo a técnica de análise de conteúdo proposta por Bardin (2020).
Da análise resultaram seis áreas temáticas. A primeira abordou o significado atribuído à experiência profissional, evidenciando que os participantes veem a sua atuação como exigente, intensa e emocionalmente desafiante, mas profundamente gratificante, reforçando o sentido de missão e a identidade enquanto enfermeiros-bombeiros. A segunda temática centrou-se nos sentimentos e emoções vivenciados, revelando uma mistura de ansiedade, stress e angústia com satisfação, orgulho e motivação. A terceira destacou os fatores facilitadores, como a experiência profissional acumulada, a boa comunicação entre equipas e a existência de protocolos claros. A quarta análise analisou os fatores dificultadores, entre os quais se encontram a falta de liderança, a escassez de recursos humanos e materiais, as condições ambientais adversas e a pressão exercida por populares. A quinta temática abordou as implicações pessoais e profissionais, mostrando que o desenvolvimento técnico e a autoconfiança coexistem com fadiga física, perturbações do sono e desgaste emocional. Por fim, a sexta temática reuniu sugestões para a melhoria da intervenção, salientando a importância da formação contínua, da realização de debriefings após ocorrências críticas, do acompanhamento psicológico e do reforço dos recursos humanos e materiais.
Conclui-se que o enfermeiro-bombeiro desempenha um papel essencial no atendimento a vítimas politraumatizadas em contexto extra-hospitalar. Apesar das dificuldades e das exigências emocionais associadas à função, estes profissionais demonstram resiliência, compromisso ético e profundo sentido de serviço à comunidade. O estudo evidencia a necessidade de um maior reconhecimento institucional, da valorização da formação permanente e da implementação de mecanismos de apoio psicossocial, para fortalecer e dignificar o papel do enfermeiro-bombeiro no sistema de emergência médica português.
Trauma remains one of the main causes of death and disability worldwide, particularly affecting people between the ages of five and twenty-nine (WHO, 2024). In Portugal, in 2021, there were five hundred and sixty-one fatalities and more than two thousand serious injuries resulting from road accidents, highlighting the scale and severity of this public health problem (European Commission, 2023). In this context, the Integrated Medical Emergency System (SIEM) plays a fundamental role by ensuring a coordinated response to critical situations, where firefighters often represent the first line of action (INEM, 2023). Among these professionals, the nurse-firefighter stands out, combining clinical and operational skills that are essential to the stabilisation and survival of polytraumatised victims (Mota, Cunha & Santos, 2021). The study aimed to understand the lived experiences of nurse-firefighters in the pre-hospital care of polytraumatised victims, based on the research question: “What are the experiences of nurse-firefighters in the pre-hospital care of polytraumatised victims?”. Specific objectives were defined to understand the meaning attributed to their professional experience, explore the associated feelings and emotions, identify factors that facilitate or hinder their intervention, recognise personal and professional implications, and gather suggestions to improve the response provided — all within the pre-hospital context of polytraumatised victims. A qualitative, exploratory, and descriptive study was conducted through semi-structured interviews with eight nurse-firefighters. The interviews were fully transcribed and analysed according to the content analysis technique proposed by Bardin (2020). The analysis resulted in six thematic areas. The first addressed the meaning attributed to the professional experience, showing that participants view their role as demanding, intense, and emotionally challenging, yet deeply rewarding, reinforcing their sense of mission and professional identity as nurse-firefighters. The second theme focused on the feelings and emotions experienced, revealing a mixture of anxiety, stress, and anguish alongside satisfaction, pride, and motivation. The third theme highlighted facilitating factors such as accumulated professional experience, good communication between teams, and the existence of clear protocols. The fourth examined hindering factors, including lack of leadership, shortage of human and material resources, adverse environmental conditions, and pressure from bystanders. The fifth theme dealt with personal and professional implications, demonstrating that technical development and self-confidence coexist with physical fatigue, sleep disturbances, and emotional exhaustion. Finally, the sixth theme gathered suggestions for improving intervention, emphasising the importance of continuous training, post-incident debriefings, psychological support, and strengthening of human and material resources. It is concluded that the nurse-firefighter plays an essential role in caring for polytraumatised victims in the pre-hospital setting. Despite the difficulties and emotional demands associated with the role, these professionals show resilience, ethical commitment, and a deep sense of service to the community. The study highlights the need for greater institutional recognition, the enhancement of continuing education, and the implementation of psychosocial support mechanisms to strengthen and dignify the role of the nurse-firefighter within the Portuguese medical emergency system.
Trauma remains one of the main causes of death and disability worldwide, particularly affecting people between the ages of five and twenty-nine (WHO, 2024). In Portugal, in 2021, there were five hundred and sixty-one fatalities and more than two thousand serious injuries resulting from road accidents, highlighting the scale and severity of this public health problem (European Commission, 2023). In this context, the Integrated Medical Emergency System (SIEM) plays a fundamental role by ensuring a coordinated response to critical situations, where firefighters often represent the first line of action (INEM, 2023). Among these professionals, the nurse-firefighter stands out, combining clinical and operational skills that are essential to the stabilisation and survival of polytraumatised victims (Mota, Cunha & Santos, 2021). The study aimed to understand the lived experiences of nurse-firefighters in the pre-hospital care of polytraumatised victims, based on the research question: “What are the experiences of nurse-firefighters in the pre-hospital care of polytraumatised victims?”. Specific objectives were defined to understand the meaning attributed to their professional experience, explore the associated feelings and emotions, identify factors that facilitate or hinder their intervention, recognise personal and professional implications, and gather suggestions to improve the response provided — all within the pre-hospital context of polytraumatised victims. A qualitative, exploratory, and descriptive study was conducted through semi-structured interviews with eight nurse-firefighters. The interviews were fully transcribed and analysed according to the content analysis technique proposed by Bardin (2020). The analysis resulted in six thematic areas. The first addressed the meaning attributed to the professional experience, showing that participants view their role as demanding, intense, and emotionally challenging, yet deeply rewarding, reinforcing their sense of mission and professional identity as nurse-firefighters. The second theme focused on the feelings and emotions experienced, revealing a mixture of anxiety, stress, and anguish alongside satisfaction, pride, and motivation. The third theme highlighted facilitating factors such as accumulated professional experience, good communication between teams, and the existence of clear protocols. The fourth examined hindering factors, including lack of leadership, shortage of human and material resources, adverse environmental conditions, and pressure from bystanders. The fifth theme dealt with personal and professional implications, demonstrating that technical development and self-confidence coexist with physical fatigue, sleep disturbances, and emotional exhaustion. Finally, the sixth theme gathered suggestions for improving intervention, emphasising the importance of continuous training, post-incident debriefings, psychological support, and strengthening of human and material resources. It is concluded that the nurse-firefighter plays an essential role in caring for polytraumatised victims in the pre-hospital setting. Despite the difficulties and emotional demands associated with the role, these professionals show resilience, ethical commitment, and a deep sense of service to the community. The study highlights the need for greater institutional recognition, the enhancement of continuing education, and the implementation of psychosocial support mechanisms to strengthen and dignify the role of the nurse-firefighter within the Portuguese medical emergency system.
Descrição
Projeto de Graduação apresentado à Universidade Fernando Pessoa para obtenção do grau de Licenciada em Enfermagem.
Palavras-chave
Enfermagem em emergência Assistência pré-hospitalar Suporte básico de vida Traumatismo múltiplo Emergency nursing Pre-hospital care Multiple trauma