Participação do enfermeiro na gestão de recursos hospitalares

Abstract

Hospitals are complex structures that promote health recovery while consuming physical, human, material and financial resources, so it is necessary to properly allocate those through planning, distribution and control. As science advances and the complexity of care grows, health costs considerably increased throughout the years, as resources became increasingly limited and budgets restrict. We highlight that the human, materials and financial resources in adequate quantity and quality are essential assets for health care, frequently causing conflicts in the management process, being object of interest and dispute amongst the different professionals and care units. Nurses deal routinely with resource allocation within hospitals, fulfilling the needs of patients, identifying others by professional experience, making requests and justifications, but only to receive them below expectations under the guise of cost reduction. The present study aims to analyze the role of nurses in the management of resources in everyday nursing in a private hospital in Belo Horizonte. We have done a descriptive, qualitative, case study. We have interviewed 16 assistential nurses, one sectorial coordinator, a pharmacist, one patrimonial manager, and 4 members of the directing board, totalizing 23 subjects. The data was collected through a semi-structured interview, which afterwards were subject to content analysis. Results showed that nurses participate in operational level of management, such as planning, control and distribution. They engage in everyday human resource management, like hiring, firing and personnel size adjustments. They also offer training and adaptation to the new nursing staff. Nurses also take part in management of material resources, using and making them available to the staff. They participate in the standardization committee, signaling inadequateness to the pharmacist, although they do not define quantity or quality of materials. Concerning physical resources, nurses provide information on assistance flow and care dynamics, showing the directing board the needs for restructuration of space, but they always receive the final project and notices of future modifications. Financial resources are managed by the directors board and administrative sectors, nurses only justify the consumption of assets, medical record adequation to lessen financial losses from gloss. Nurses take part in everyday resource management, in operational level, providing information for decision making, although they do not participate in strategic planning, action or priority allocation of resources. The limits of their participation in institutional resource management are not well defined and vary according to institutional philosophy, where they work, their placement on hierarchic tree and even to the characteristics of the professionals that require their resources.