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Introdução: Um estágio constitui um elemento fundamental no desenvolvimento de competências especializadas, permitindo a articulação entre conhecimento teórico e prática profissional em contextos de elevada complexidade, como o Serviço de Urgência e a Medicina Intensiva. Nestes contextos, a abordagem à pessoa em situação crítica evidencia a importância de intervenções atempadas e baseadas na evidência.
Objetivos: Refletir sobre o percurso formativo desenvolvido nos contextos de estágio, descrevendo e evidenciando o processo de aquisição, desenvolvimento e consolidação das competências do enfermeiro especialista, bem como a sua articulação com a prática baseada na evidência.
Métodos: Foi adotada uma abordagem descritiva e reflexiva, baseada nas experiências vivenciadas durante os ensinos clínicos em contexto de Serviço de Urgência e de Medicina Intensiva. A reflexão foi estruturada de acordo com os domínios das competências comuns e específicas definidos pela Ordem dos Enfermeiros, integrando enquadramento teórico com situações clínicas observadas.
Resultados: A experiência clínica permitiu desenvolver competências ao nível da responsabilidade profissional, ética e legal, da melhoria contínua da qualidade, da gestão dos cuidados e do desenvolvimento das aprendizagens profissionais. Verificou-se uma evolução progressiva na tomada de decisão, priorização e gestão de situações críticas. A vivência de situações clínicas complexas, incluindo doentes com sépsis e choque séptico, reforçou a necessidade de fundamentar a prática na evidência científica, particularmente no que diz respeito à administração precoce de antibioterapia.
Conclusão: O percurso formativo contribuiu para a consolidação de uma prática profissional mais autónoma, crítica e fundamentada, orientada para a qualidade e segurança dos cuidados. A experiência clínica evidenciou a importância da prática baseada na evidência na abordagem à pessoa em situação crítica, constituindo o ponto de partida para o desenvolvimento da componente de investigação apresentada na Parte II, centrada na influência do tempo porta-antibiótico nos desfechos clínicos em doentes com sépsis/choque séptico.
Palavras-chave: Pessoa em situação crítica; Competências do enfermeiro especialista; Prática baseada na evidência
Abstract Introduction: An internship is a fundamental element in the development of specialized competencies, enabling the integration of theoretical knowledge with professional practice in highly complex settings, such as the Emergency Department and Intensive Care Unit. In these contexts, the approach to the critically ill patient highlights the importance of timely and evidence-based interventions. Objective: To reflect on the learning process developed during clinical placements, describing and demonstrating the acquisition, development, and consolidation of specialist nurse competencies, as well as their articulation with evidence-based practice. Methods: A descriptive and reflective approach was adopted, based on the experiences lived during clinical placements in the Emergency Department and Intensive Care Unit. The reflection was structured according to the domains of common and specific competencies defined by the Order of Nurses, integrating theoretical framework with observed clinical situations. Results: The clinical experience enabled the development of competencies in professional, ethical, and legal responsibility, continuous quality improvement, care management, and professional learning development. A progressive evolution was observed in decision-making, prioritization, and management of critical situations. The experience of complex clinical situations, including patients with sepsis and septic shock, reinforced the need to base practice on scientific evidence, particularly regarding the early administration of antibiotic therapy. Conclusion: The learning process contributed to the consolidation of a more autonomous, critical, and evidence-based professional practice, focused on the quality and safety of care. Clinical experience highlighted the importance of evidence-based practice in the management of critically ill patients, serving as the starting point for the research component presented in Part II, focused on the influence of door-to-antibiotic time on clinical outcomes in patients with sepsis/septic shock. Keywords: Critically ill patient; Specialist nurse competencies; Evidence-based practice
Abstract Introduction: An internship is a fundamental element in the development of specialized competencies, enabling the integration of theoretical knowledge with professional practice in highly complex settings, such as the Emergency Department and Intensive Care Unit. In these contexts, the approach to the critically ill patient highlights the importance of timely and evidence-based interventions. Objective: To reflect on the learning process developed during clinical placements, describing and demonstrating the acquisition, development, and consolidation of specialist nurse competencies, as well as their articulation with evidence-based practice. Methods: A descriptive and reflective approach was adopted, based on the experiences lived during clinical placements in the Emergency Department and Intensive Care Unit. The reflection was structured according to the domains of common and specific competencies defined by the Order of Nurses, integrating theoretical framework with observed clinical situations. Results: The clinical experience enabled the development of competencies in professional, ethical, and legal responsibility, continuous quality improvement, care management, and professional learning development. A progressive evolution was observed in decision-making, prioritization, and management of critical situations. The experience of complex clinical situations, including patients with sepsis and septic shock, reinforced the need to base practice on scientific evidence, particularly regarding the early administration of antibiotic therapy. Conclusion: The learning process contributed to the consolidation of a more autonomous, critical, and evidence-based professional practice, focused on the quality and safety of care. Clinical experience highlighted the importance of evidence-based practice in the management of critically ill patients, serving as the starting point for the research component presented in Part II, focused on the influence of door-to-antibiotic time on clinical outcomes in patients with sepsis/septic shock. Keywords: Critically ill patient; Specialist nurse competencies; Evidence-based practice
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Antibióticos Competência profissional Cuidados críticos Doença crítica Enfermagem médico cirúrgica Fatores de tempo Revisão scoping Sépsis Antibacterial agents Critical care Critical illness Medical surgical nursing Professional competence Scoping review Sepsis Time factors