Nurse’s role in psychiatry

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The history of nursing intertwines with the history of psychiatric care. In the construction of the clinic, nursing professionals were important in the elaboration of care actions, since the patients’ observations generated the first classifications of mental illnesses. In Brazil, the Alfredo Pinto Nursing School (EEAP) started a process of preparing nurses responsible for patient observation, known as observer nurses. These professionals, in addition to being closer to the patients, participated in a training process, in addition to participating in meetings with the medical team.

Read too: Nursing care for people with panic disorder [Setembro Amarelo]

By being in this place of observation and information, nursing starts to have a hierarchical space. In addition, these professionals were responsible for various care, such as those related to food, body care, bringing them closer to family members, among other functions that generated dignity for the person with psychological distress. But they were still seen as those who held the keys, switches the freedom process and were responsible for the violent action present in the model of the time.

At the beginning of the last century, there was the beginning of a nursing training process in the country. In psychiatry there were two types of professionals: those who did not have any training to work in nursing and others who did it with a vocation of caring, which provoked an interest in training in capitals, especially in the Southeast region. The schools in Rio de Janeiro Alfredo Pinto and Ana Nery were the first to build a training process.

In São Paulo, Minas Gerais, Bahia and other regions of Brazil, a training process linked to hospitals linked to public universities also begins, where reflection on the model of discussion of care practices begins. However, the training was linked to the institutionalized asylum model, which caused a limited performance, until we had the beginning of the anti-asylum struggle in Brazil.

Some distinguished nurses began to discuss the practice, in a theoretical way, in the 1960s, enabling reflections on know-how, such as Tereza Sena from the Federal University of Rio de Janeiro (UFRJ) and Maria Aparecida Minzoni from the School of Nursing at the University of Rio de Janeiro. Sao Paulo (USP). Other nurses from Public Universities also made their contributions with the central objective of giving new contours to the professional identity until then based on an alienist vision.

Nurse's role in psychiatry

Transition from the asylum model

The metamorphosis from the asylum model to the deinstitutionalized model took a few decades. Even with advanced discussions in Italy, influenced by the Italian Franco Baságlia, a psychiatrist who revolutionized the ideal of care at the time. In Brazil, we had great resistance to the adoption of the deinstitutionalized model, which only gained strength after the mental health conferences in 1987; creation of the 1988 Constitution, which protected human dignity and promoted health as a right for all; Creation of the Unified Health System; creation of Law 10,216/2001 and other laws that relate to the service structures that build the Psychosocial Care Network.

With the modification of the model, the work of nurses had its biggest changes. Before, care took place in an institutionalized environment and the rules and routine were stipulated by nursing professionals. Now the person in psychic suffering has a voice and is free to choose the treatment and actively participates in the therapeutic process. A very big literary-academic advance was necessary for nursing professionals. The appropriation of knowledge in psychology, sociology, philosophy, legal sciences, administration, pharmacology, art therapy, nutrition and other knowledge are necessary for professional practice.

They became part of the multidisciplinary team with a voice and had to adapt to an interdisciplinary practice, not seen in the care models of the past. Sometimes, nursing professionals were seen as those necessary for care and to promote physical and drug restraints, at a time when the person with psychological distress was seen only as violent and distant from resocialization. However, something that happened in the past is still happening today. The nursing professional remains the closest to the patient and everything that involves madness.

to take home

Nursing care continues to be fundamental and the most important among all care practices, as they are those that give dignity to the human person and are the strong basis of the resocialization movement for those who have moved away from their lives because of the disease. The future does not cause the decrease in the importance of these professionals. On the contrary, there is a greater appreciation of the knowledge of those who are closer to madness. The most important professional in the perception of human behavior, now gains possibilities to expand his performance in offices, in the clinic itself, in management, education and in other diverse areas.

Caring for people with severe psychological distress necessarily requires study, sensitivity that can be learned, humanization and dedication. Training is the instrument through which the professional can reflect, learn and develop these premises. The future of psychiatric nursing lies in the development of nurses’ specific knowledge regarding the practice of care, valuing knowledge from different areas of knowledge. So we can take a leap in terms of a care proposal, based on institutionalized practices still today. And so we will have the constant edification of psychiatric nursing.

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# Silva, Teresa Cristina da, & Kirschbaum, Débora Isane Ratner.. The construction of knowledge in psychiatric nursing: A historical-critical approach. SMAD Electronic journal mental health alcohol and drugs, 2010; 6(spe):409-438. # Maftum MA Alencastre MB Nursing practice and teaching in mental and psychiatric health in Brazil: questions for reflection. Cogitare Enferm., Curitiba, 2002 7;(1):61-67. # Pereira MA, Labate RC. Reflecting the historical evolution of psychiatric nursing. Minutes Paul Enferm. 1998;11(3):52-59. Available at: https://acta-ape.org/article/reflecting-a-evolucao-historica-da-enfermagem-psiquiatrica

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