The medical praxis in the emergency care in the presence of the patient with chronic sequelae: guilt, fear and compassion

• Autor(a) principal: Aredes , Janaína de Souza
• Data de Publicação: 2022
• Outros Autores: Giacomin , Karla Cristina, Firmo , Josélia Oliveira Araújo
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Trabalho, Educação e Saúde (Online)
• Texto Completo: https://www.tes.epsjv.fiocruz.br/index.php/tes/article/view/987
• topic: cuidados de saúde; quadro crônico; incapacidade; pronto socorro; health care chronic clinical picture; disability; emergency care; cuidados de la salud; cuadro crónico; discapacidad; urgencia

What is the relationship between urgencies and chronic care? This question, which is appa-rently paradoxical, was approached in an ethnography conducted at the largest emergency care hospital of a Brazilian metropolis; the ethnography investigated medical care from admission to the confirmation of the clinical and functional condition of the patient with severe sequelae. Between December 2012 and August 2013, we conducted interviews and participant observation with 43 physicians: 25 men and 18 women, aged between 28 and 69 years. The analysis, which was guided by the signs, meanings and actions model, led to the realization that the care varies according to the context: at the ‘gateway’ and at the ‘intensive therapy center’, the struggle to maintain life is intense; at the “chronic patient” sector, care is provided to people who survive, but who have a high degree of dependence. For the physician, ‘life’ means regaining previous function, while survival with dependence would mean a ‘living death.’ The physician refrains from dealing with a highly-limited human being, for he/she feels somehow guilty of the clinical picture, even though he/she feels compassion towards the patient who requires chronic care. The insufficiency of a long-term care network and the lack of palliative training on the part of the physicians cause suffering in those who care and in those who are cared for.