Representação social da consulta de enfermagem e registros da assistência pré-natal por enfermeiros da atenção primária à saúde

Abstract

Objective: Understanding the representational contents and their origins about the prenatal nursing consultation and records of prenatal care performed by primary health care nurses (PHC). Method: Qualitative approach based on the Theory of Social Representations, according to Abric and Moscivici. Research carried out with nurses who work in the Family Health Strategy in Minas Gerais, Brazil. The interview was carried out in depth, guided by guiding questions with audio recording and applied free evocation technique triggered by inductive terms (nursing consultation and register, Ministry of Health protocol for low-risk prenatal care, electronic medical record and Sisprenatal). Text data treated in program NVivo Pro 11, according to content analysis whose theoretical densification was performed by Pearson values ≥0.7. Evoked cognates treated by the dictionary technique of equivalent terms and prototypical analysis. Results were triangulated in light of the Neuman System Theory. Meeting all ethical and legal research questions. Results and discussions: Participated 81 nurses: women (98.3%) with a job (87.7%); training time of 10-20 years (42%); all with at least one specialization and ten years of service in the APS of 10 to 20 years (48.1%). The nursing consultation was objectified by the care/assistance, obtaining information, and anchored in daily life, interprofessional relations, coexistence with users/companions and in the MS protocol, being considered a complex technical practice that values the autonomy of the work exercise to the nurse to conciliate the praxis with the philosophical ideology. The health protocol of the Ministry of Health for the usual prenatal risk was based on a biologicist, hospitalocentric and multiprofessional model that predicts the responsibility of nurses to build and establish links without explicitly compromising other professional categories. It is anchored in the backing and safety attributed to work performance and valued for a thorough and detailed yet extensive professional performance. The nursing record was objectified by the normative character established by the regulatory agencies and was linked to a value judgment that covers veiled criticism. If prescriptive character is not sufficient to ensure its execution in clinical practice. The electronic medical record was objectified by the documentation, technology, time of feasibility and support that attributes to the therapeutic conduct. Its anchorage was concealed by the (in) ability to handle it, by the scarcity of infrastructure to enable it or by the resistance to achieve it although considered relevant. Sisprenatal was aimed at collecting data, care-assistance and the creation and maintenance of links with the pregnant/fetus with the team and unit, being anchored in the systematization of nursing care and in the use of technologies. Final considerations: The symbolic contents about nursing consultation and registry, protocol of the Ministry of Health, electronic medical record and Sisprenatal allowed to understand that, although they are contextualized in the professional practice of nurses, they are not always able to apply it in professional practice. It is recommended the structuring of the unit and the local computerization in order to make it possible to resize the professional time and the qualification of the records made.