Representações sociais dos profissionais de saúde das unidades de pronto atendimento sobre o serviço de atendimento móvel de urgência

Abstract

There have been significant changes to emergency care in Brazil since the 1990s,mainly by increased demand generated by rising rates of violent crime and caraccidents that were treated as public health problems. Regulation of attention toemergency rooms across the country has been addressed in various Ordinances ofthe Ministry of Health among them the 1864 Ordinance of 2003, created thecomponent Pre-Hospital Mobile, through the deployment of Mobile Service ofemergency (SAMU). The implementation of the SAMU allowed adequate relief tovictims, helping to minimize the increase in sequelae and favorable prognosis. Butthe SAMU also fit the service demands of users with clinical, obstetric and psychiatricemergency, with the rear Emergency Care Units (APU) and Emergency hospitals. InBelo Horizonte - MG, the UPA working with the spontaneous demand and alsoreceiving patients referred by the SAMU, find themselves "forced" to serve them. Thissituation often creates tension between the professionals of the SAMU and the UPA.Thus, whereas social representations are made within the phenomena ofcommunication and impact on the interactions and social change means that in themicro area of the UPA, health workers from different professional groups may havedifferent social representations of SAMU. This study was to analyze the socialrepresentations of health professionals in Emergency Care Units on the SAMU. Thestudy was based on social representations theory proposed by Moscovici (1978) andthe Central Nucleus Theory developed by Abric (1998),using the EVOC 2003. Hehas created scenery of the study 04 (four) UPA Belo Horizonte, with two receiving alot of users served by the SAMU and two receiving less. The subjects were 274health professionals of the UPA, ie doctors, nurses, nursing assistants and nursingtechnicians. Data collection was conducted through a questionnaire with items thatidentified the profile of respondents and request free recall on the term inducerSAMU. The results show that 31.1% of the respondents were male and 67.8%female. Most professionals are married (45.6%) followed by 37.6% to 11.3% singleand divorced. Regarding the professional categories were 56.2% and auxiliarynursing staff, 32.5% doctors, 11.3% of nurses. Regarding working time in UPA 39.2%are over 05 (five) years and 36.3% less than 01 (one). In relation to the corpusformed by free evocations were discussed in 1338 words, 108 different words. In thefour general homes built from the end of evocations inducer SAMU, one can observethe contents of its social representation and the structure and hierarchy of elementsof their cognitive systems. In the upper left are the possible elements of the corerepresentation of this study, ie, correspond to the most important elements in thedesign of the structure of social representations thought by these healthprofessionals. In this core are the following words: emergence, alcoholic, speed,recovery, transportation and emergency, which reflect the image represented by thesubjects of SAMU, the image mostly positive recognition of their work. The elementsidentified have character, especially functional SAMU, referring to the descriptivecharacteristics of the object and the inscription in the social practices of theseindividuals. In this case the SAMU be one of the types of pre-hospital mobileresponsible for fast response, rescue or transport of patients with recurrent urgent oremergency declared. Appearing also as a factor contradictory and unexpectedelement drinker, social pent up demand so that is gaining ground in health careemergency. In the upper right, first periphery, is the words-serious cases and traumathat reaffirm and strengthen the role of the SAMU emergency care and emergencyand trauma cases, and serious. The words located in the lower right, secondperiphery, are ability, humanization, and poor regulation. In that space ofrepresentation of SAMU, there are positive attitudes toward the SAMU, recognizing itas having skills and capable of being a tool of humanization of care, but at the sametime, reveals that this service is perceived as poor in its structure, relationships andcalls that place. Also in this area we discuss the regulation as a necessary process,but at the moment flawed and far from the reality of professionals who are on theedge. The words agility, service, conflict, team-unprepared, pre-hospital care andsave lives are in the quadrant of the contrasting elements or intermediaries, ie, theybring to discussions about what is at the core and at the same time some representelements of tension in relations between the sectors studied. These elementsinfluence the core and are points that should be addressed to interference inbehaviors and perceptions about the SAMU. Thus, it is considered that the SAMU isan area of decision-making and inter-relationships of emergency, influenced byeconomic factors, political and symbolic alter the development of their role andrecognition of their work. It was possible to see that the SAMU is representedpositively in most cases, is often criticized for problems present in the work units.Understanding the SAMU is a new strategy and that can be improved consider itimportant to discuss the operation of networks of reference and cross-references andyour organization to improve relations between the two professional services.