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Revisiting health care practice: subjectivity as material for the reorganization of the nursing process

Nursing practice in the Home Care Service (SAD - Serviço de Assistência Domiciliar) of the Municipal Healthcare Department of the city of Ribeirão Preto in the state of São Paulo, Brazil, is the object of this investigation, whose purpose is to analyze the process of home care, pointing out the production of subjectivities and of possibilities concerning healthcare work. This study was empirical and qualitative, relying on concepts derived from the institutionalist movement. The subjects were nurses working in the SAD (Home Care Service). The technique used to collect empirical data was the focus group. The ordering of data was carried out based on the Discourse of the Collective Subject (DCS) method. Results confirmed SAD (Home Care Service) potential as an agent for the transformation of healthcare/nursing practice and the possibility of its gradual incorporation into the practice of the nurses that do this type of work. SAD (Home Care Service) experience has enabled self-questioning, reflection and a review of conduct. The authors stress the importance ascribed to light technologies for healthcare work and, primarily, for home care, incorporating the subjective dimension inherent to all production. It was also possible to show that this type of work carries with it limitations and frustrations, but that involvement, creativity, responsibleness and satisfaction are also attached to it. The process of change is recognized as being slow, requiring that the worker be willing to constantly accept being overseen and to review the work process.

Home-based healthcare; Nursing; private Nursing practice


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