Percepciones de los estudiantes sobre sus vivencias en las prácticas clínicas / Students' perceptions about their experiences in their clinical practices / Percepciones dos estudantes sobre suas vivências nas práticas clínicas

Resumen Introducción Los estudiantes de enfermería deben adquirir conocimientos, habilidades, actitudes y valores, para proporcionar cuidados de calidad. Las prácticas clínicas son el contexto ideal para lograr algunas de las competencias requeridas. Objetivo Explorar las percepciones de los estudiantes sobre sus vivencias durante sus prácticas clínicas. Método Abordaje metodológico descriptivo de tipo cualitativo y con un encuadre sociocrítico. Se analizaron los 45 portafolios de estudiantes de 4º curso de la Escuela Universitaria de Enfermería (EUE) Cruz Roja, donde explican sus vivencias en prácticas. Se optó por un portafolio semiestructurado en función de la competencia a demostrar definiendo previamente las tareas o evidencias Se realizó un análisis de contenido que comprendía las siguientes fases: reducción de los datos; categorización-codificación, presentación de datos y conclusiones/verificación de los datos. Se alcanzó saturación en la información sobre las categorías presentadas. Resultados Del análisis de los datos emergen distintas unidades de significado que se engloban en tres categorías: aprendizaje en prácticas, dificultades del entorno, crecimiento personal y profesional. Conclusiones El estudio evidencia la importancia de las prácticas clínicas para los estudiantes dentro del plan de estudios, ya que es donde aplican lo que han aprendido en el aula y son conscientes de la realidad a la que se enfrentan. El entorno clínico y la relación que se establezca entre este y el estudiante determina en muchas ocasiones el aprendizaje. Queda patente que los estudiantes durante sus prácticas clínicas toman conciencia de aquellos conocimientos del saber, saber hacer y saber estar.

Abstract Introduction Nursing students need specific knowledge, skills, attitudes and values in order to provide quality of care; and the clinical practices represent an ideal context to develop some of these required competences. Objective To explore the perceptions of nursing students about their own experiences in their clinical practices. Method This a qualitative descriptive study with social and critical focus. 45 practice-files from nursing students in the 4th course of a Mexico Red Cross School of Nursing were analyzed considering the following stages: data reduction, categorization-coding, data presentation, and data verification and conclusions. Data saturation was reached from the identified categories. Results From the data analysis, diverse units of meaning emerged within three main categories: learning in practices, difficulties in the environment, and personal and professional growth. Conclusions The study highlights the importance of clinical practices since it is there where students apply in real life what they learn in the classroom. The relationship between the student and the clinical environment greatly determines the quality of learning. So, it is suggested that students keep in mind reflecting on their to know, to know how, and to know how to be.

Resumo Introdução Os estudantes de enfermagem devem adquirir conhecimentos, habilidades, atitudes e valores, para proporcionar cuidados de qualidade. As práticas clínicas são o contexto ideal para atingir algumas das competências requeridas. Objetivo Explorar as percepções dos estudantes sobre suas vivências durante suas práticas clínicas. Método Abordagem metodológica descritiva de tipo qualitativo e com um enfoque sociocrítico. Analisaram-se os 45 portfolios de estudantes de 4º curso da Escuela Universitaria de Enfermería (EUE) Cruz Roja, onde explicam suas vivências em práticas. Optou-se por um portfólio semiestruturado em função da competência a demostrar definindo previamente as tarefas ou evidências. Realizou-se uma análise de conteúdo que compreendia as seguintes fases: redução dos dados; categorização-codificação, apresentação de dados e conclusões/verificação dos dados. Atingiu-se saturação na informação sobre as categorias apresentadas. Resultados Da análise dos dados emergem distintas unidades de significado que abrangem três categorias: aprendizagem em práticas, dificuldades do entorno, crescimento pessoal e profissional. Conclusões O estudo evidencia a importância das práticas clínicas para os estudantes dentro do plano de estudos, já que é onde aplicam o que aprenderam na aula e são conscientes da realidade à que se enfrentam. O entorno clínico e a relação que se estabeleça entre este e o estudante determina em muitas ocasiões a aprendizagem. É evidente que os estudantes durante suas práticas clínicas tomam consciência daqueles conhecimentos do saber, saber fazer e saber estar.

Poesía y cuidados: un instrumento para la gestión de emociones y sentimientos en enfermería / Poetry and care: an instrument to manage emotions and feelings in nursing / Esia e cuidados: um instrumento para o gerenciamento de emoções e sentimientos em enfermagem

Resumen: El objetivo de este estudio consiste en desarrollar una herramienta de reflexión emocional y de sentimientos que contribuyan a la gestión emocional y de los sentimientos de los alumnos de enfermería en sus prácticas clínicas. El método empleado ha consistido en utilizar un grupo de poemas derivados de experiencias clínicas como base para la identificación y análisis de emociones y sentimientos. Asimismo, se emplearon las orientaciones de Vigotsky y Heller para facilitar el análisis de las emociones y los sentimientos. Más allá de la concienciación de los futuros profesionales de la importancia de centrar el cuidado en el paciente, el gran reto consiste en dotar a los enfermeros de la capacidad cognitiva y las destrezas emocionales necesarias para gestionar el aluvión de sentimientos complejos e intensos que emergen durante la aplicación del proceso de enfermería con el fin de prepararlos para el trabajo emocional inherente a su trabajo y disminuir el riesgo de "burnout". Se concluye que los poemas inspirados en experiencias clínicas constituyen una herramienta pertinente para facilitar el trabajo emocional y de sentimientos generados durante las prácticas clínicas.

Abstract: The aim of this study is to develop a tool to think about emotions and feelings, in order to facilitate their management in nursing students in their clinical practices. The method used has been based on the orientations of Vigotsky and Heller to facilitate the classification and analysis of emotions and feelings. Likewise, a selection of poems derived from clinical experiences was used as a basis for the identification and analysis of emotions and feelings. Beyond the awareness of future professionals of the importance of focusing care practices on the patient, the great challenge is to provide nurses with the cognitive capacity and emotional skills necessary to manage the flood of complex and intense feelings that emerge during the application of the nursing process, in order to prepare them for the flow of emotions arising from their work and to decrease the risk of burnout. In conclusion, poems inspired by clinical experiences constitute a relevant tool to facilitate emotional work and feelings generated during clinical practices. The poetry of care contributes to the understanding and emotional regulation and it is a way of channeling the feelings that emerge in the students during their clinical practices.

Resumo: O objetivo deste estudo consiste em uma ferramenta de reflexão sobre as emoções e os sentimentos para facilitar a gestão emocional e de sentimentos dos alunos de enfermagem em sus práticas clínicas. O método empregado com base nas orientações de Vygotsky e Heller para facilitar a classificação e análise das emoções e os sentimentos. Além disso, utilizou-se uma escolha de poemas de saídas clínicas como base para a identificação e análise de emoções e sentimentos. Mais além da conceituação dos futuros profissionais da importância do atendimento no paciente, o gran reto consiste em dotar os enfermeiros da capacidade cognitiva e as emoções necessárias para gerenciar o aluvião de sentimentos complexos e intensos que emergem durante a aplicação do processo de enfermagem com o fim de preparação para o fluxo emocional inerente a seu trabalho e diminuir o risco de "queimar". Os poemas inspirados em experiências clínicas constituem uma ferramenta pertinente para facilitar o trabalho emocional e de sentimentos generados durante as práticas clínicas. A poesia de cuidados com a consciência e a regulação emocional e a constituição de canalizar os sentimentos que emergem nos alunos durante as práticas clínicas.

Practicantes de medicina militares del Ejército del Aire (1940-1941) / Air Force Military Medical Assistants

Antecedentes y objetivos: El Ejército del Aire (España) se creó en octubre de 1939 y su Cuerpo de Sanidad en febrero de 1940, donde se integraron los suboficiales practicantes de medicina como auxiliares. La actividad de los suboficiales practicantes de medicina del Ejército del Aire quedó suprimida en julio de 1941. Se pretende exponer el inicio de la enfermería militar profesional del Ejército del Aire, representada por los practicantes de medicina militares. Material y métodos: Se han utilizado técnicas cualitativas, centradas en la observación documental. Resultados: Se ha podido determinar el inicio y final de la única promoción de practicantes de medicina militares del Ejército del Aire. Conclusiones: Creado el Ejército del Aire, se decidió que fueran los practicantes de medicina, conforme a la titulación nacional en vigor, el personal auxiliar de la Sección de Medicina del Cuerpo de Sanidad. Es en el Ejército del Aire donde se concede la consideración plena de militar a los practicantes de medicina por primera vez; sin embargo, el Ministerio del Aire cambió, en menos de un año, la determinación de necesitar como personal auxiliar en el Cuerpo de Sanidad del Ejército del Aire a los practicantes de medicina, a considerar que eran totalmente prescindibles (AU)

Background and aims: The Air Force (Spain) was created in October 1939 and its Corps of Health in February 1940, in which medical assistant noncommissioned officers were integrated. The activies of Air Force medical assistant noncommissioned officers were suppressed in July 1941. The beginning of the professional military nursing of the Air Force will be explored with a focus on the military medicine assistants. Material and methods: Qualitative techniques have been used, with focus on documentary observation. Results: It was possible to determine the beginning and the end of the only promotion of military medicine assistants of the Air Force. Conclusions: When the Air Force was created, it was decided that the medical assistants were going to be part of the auxiliary staff of the Section of Medicine of Health Corps, in line with the national qualification in force. As a result, it was in the Air Force where the full consideration of military was firstly granted to medical assistants; however, the Ministry of the Air changed its previous determination to require medical assistants as auxiliary personnel in the Air Force's Health Corps to consider them totally dispensable, applying this change withinless than a year (AU)

Attitudes towards female genital mutilation: an integrative review.

BACKGROUND: Immigration and globalization processes have contributed to the international dissemination of practices such as female genital mutilation. Between 100 and 400 million girls and women have been genitally mutilated, and every year 3 million girls are at risk of being subjected to female genital mutilation. OBJECTIVES: The objective of this study was to describe the attitudes towards the practice of female genital mutilation in relation to different health systems and the factors that favour its discontinuation. METHODS: An integrative review was performed of publications from the period 2006 to 2013 included in the MedLine, PubMed, LILACS, SciELO, CINAHL and CUIDEN databases. RESULTS: We selected 16 studies focusing on diverse contexts that assessed the attitudes of both men and women regarding the perpetuation of this practice. Ten corresponded to studies conducted in countries of residence. Several areas of investigation were explored (factors contributing to the continuation of female genital mutilation, factors contributing to its discontinuation, feelings about the health system). LIMITATIONS: It is possible that the relevant studies may not have been included given the limitations of the literature review and the invisibility of the phenomenon studied. CONCLUSIONS: This review demonstrates the strong social pressure to which women are subjected as regards the practice of female genital mutilation. However, many other factors can contribute to eroding beliefs and arguments in favour of this practice, such as the globalization, culture and social environment of countries in the West. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Nurses occupy an essential position in detecting and combating these practices.

The convergence process in European Higher Education and its historical cultural impact on Spanish clinical nursing training.

UNLABELLED: The objective of this study was to promote student reflection on the historical and cultural impact of the implementation of the European Higher Education Area (EHEA) on the nursing practicum course in Spain. The objective was to demonstrate the relevance of a clinical practice diary as a facilitative tool for reflection, metacognition and self-evaluation during the practicum. The theoretical framework for this study was based on the socio-critical and critical thinking and comparative education paradigms. Methodologically, we used reflection and educational, ethnography-based resources. RESULTS: Theoretical and methodological competencies were perceived as requiring more time and effort (records, nursing process: 29%/35% respectively), whereas the technical skills that related to community work are perceived as involving the least amount of time and effort requiring (13%/10% respectively). The conclusion we have reached is that the primary difficulties in implementing the EHEA are in the cultural transformations that result from the new system of student-centred learning. A clinical practice diary is an effective tool with which to contextualise the nursing practicum and its impact on cultural characteristics, ways of thinking and the reflections of the students. This clinical practice diary facilitates the achievement of competences through the processes of reflection and metacognition.

[Nursing in the movies: its image during the Spanish Civil War]. / La enfermería en el cine. Imagen durante la Guerra Civil Española.

INTRODUCTION: The cinema had carried out a determining role in the development of stereotypes and in a wide gamut of models related to real life situations. The objective of this analysis is to determine the influence cinema had on the image of nurses during the Spanish Civil War from 1936-1939. These are the initial hypotheses: the role of Spanish nurses during the civil war was reflected by both sides in their respective movie productions; and the image of nurses shown in these films, on both sides, presents a conflicting role concept for women in society. METHODS AND MATERIALS: Following strategies developed by specialists in film analysis (Bondwell 1995, Uneso 1995, Carmona 1991) a total of 453 movie productions, 360 on the republican side and 93 on the national side, were reviewed. These films were listed in the Spanish National Films Library records. RESULTS: After analyzing the Spanish cinema productions during the Spanish Civil War, data relating to 453 films were identified. The genre included documents, news programs and fiction movies. 77 were produced in 1936, 235 in 1937, 102 in 1938 and 39 in 1939. A tremendous difference exists between the republican productions, 79% of the total, and the national productions. By genres, the types produced on the republican side were: in 1936, 53 documentals, 4 news programs and 9 fiction films; in 1937, 186 documentals, 5 news programs and 19 fiction films; in 1938, 72 documentals, 1 news programs and 2 fiction films; in 1939, 2 documentals and 2 fiction films. On the national side, their productions were: in 1936, 10 documentals and 1 fiction film; in 1937, 22 documentals, 2 news programs and 1 fiction film; in 1938, 19 documentals and 3 news programs; in 1939, 29 documentals and 6 fiction films. CONCLUSIONS: During the Spanish Civil War, movies produced by both sides made an effort to reflect their ideal woman as a stereotypical ideal nurse. This ideal nurse showed the values, ideas, aesthetics and prejudices each side held in the war.