Aún lo social: crisis en la práctica clínica / [Still the social factor: crisis in the clinical practice].

Consultations in our hospital center are problematic, mainly due to the poor living situation which patients come from (the suburbs of Buenos Aires). The housing situation, the environment and the economic or political conditions of these patients frame "the social" emergency that sets the context and the impact in the different psychopathological symptoms that they present. These conditions should also be reviewed from our theoretical assessment together with the clinical approach that our assistance practice studies. From a perception viewpoint we observe that "self-perception is far from any ideals. The perception of their environment is threatening and has no future". We constantly note the loss of the value of words and speech, when we hear our patients, wo have turned language into just an abject joy, as in the word of the addict. These issues must be studied from a theoretical point of view to be applied clinically. Such analysis reveals that our practice takes place in a context of failure. However, we cannot move backwards in "potential treatment" as Lacan states in the ethics as regards psychosis.

El auxilio y el comprender del ser enfermo en el Servicio de Enfermería del Hospital Manuel Belgrano / The help and understanding of being sick in the Nursing Service of the Manuel Belgrano Hospital

Puede repensarse la figura del enfermero como aquel que solo recibe las indicaciones dadas por el médico tratante o los dispositivos hospitalarios, desconociéndose que el paciente emplaza su subjetividad en la relación de ayudas y solicitudes, cobijándose en la tarea asistencial del personal de enfermería como una suerte de garante y eficacia del tratamiento. Considerar en estos encuentros con el servicio de salud mental, las respuestas afectivas que implican a todo aquel que se ocupe del semejante, que se fundan en cualidades intrínsecas con disposiciones anímicas que la labor de asistencia pone en juego. Teniendo en cuenta la crisis social y poder revisar las condiciones laborales en la actividad de enfermería que da muestras de la exigencia y labor del enfermero en nuestro Hospital Manuel Belgrano

Nurse´s concept can be redefined as that who only receives the instructions of the doctor or the hospital devices not taking into account that the patient requires the nurse's subjectivity as regards assistance and requests. The patient usually looks for shelter in the assistance provided by the nursing staff as the guarantor of treatment efficiency. The affective responses of all those who follow a service career should be considered in these encounters with the mental health service since such responses are based on intrinsic qualities with the emotional disposition that the assistance work puts at stake. Taking into account the social crisis, we should review the working conditions of the nursing activity. Our hospital, Manuel Belgrano shows the high demands and the work performed by the nurses

É possível repensar o papel do enfermeiro como aquele que só recebe as indicações dadas pelo médico tratante ou os dispositivos hospitalares, desconhecendo que o paciente localiza sua subjetividade na relação de ajudas e requerimentos, amparando-se na tarefa assistencial do pessoal de enfermaria como um modo de garantir a eficiência do tratamento. Considerar nesses encontros com o serviço de saúde mental, as respostas afetivas que implicam a todo aquele que se ocupe do semelhante, que se funda em qualidades intrínsecas com disposições anímicas que a tarefa de assistência coloca em jogo. Levando em consideração a crise social e poder revisar as condições de trabalho na atividade de enfermaria que oferece mostras da exigência e trabalho do enfermeiro em nosso Hospital Manuel Belgrano