297 resultados para humanização da assistência à saúde


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Descriptive exploratory study, prospective, with quantitative approach, performed on the Monsenhor Walfredo Gurgel Hospital Complex (MWGHC), in Natal/RN, aiming to identify injuries by body area and wound severity on drivers who suffered motorcycle accidents, evaluate the severity of injuries and trauma on these drivers and identify the existence of association between wound and trauma severity and some of the accident s characteristics. The population comprised 371 motorcycle drivers, with data collected between October and December 2007. We used as instruments the Abberviated Injury Scale (AIS), Injury Severity Score (ISS) and the Glasgow Coma Scale (GCE1). The results show that, concerning characterization, there was a predominance of the male gender (88.4%), aged between 18 and 24 years (39.90%), originating from the Natal metropolitan region (55.79%), with fundamental-level instruction (51.48%), catholic (75.78%), married (47.98%). 23.18% work on commerce-related activities and 75.20% have income of up to 2 minimum wages. As for the accident s characteristics, the predominant shift was the afternoon (46.36%), received up to one hour after the event (50.67%), transported by countryside ambulances colleagues and relatives (51.21%), 25.34% had the accident on Sunday; 53.91% suffered falls and vehicle rolls; among the collisions there was a predominance of the motorcycle-automoblie type (28.03%); 52,6% were licensed and among these 50.76% had up to one year of license; 65.50% declared not having suffered previous accidents; 65.77% declared waring helmets in the time of the accident; 57.41% said not to have used drugs, and among those who used, alcohol was the most consumed (98.10%). The lowest score evaluated by GCS1 (3 to 8) was linked to drivers who suffered accidents on Saturday (10.3%), those who were not wearing helmets (14.29%) and the victims of motorcycle-pedestrian/animal crashes (13.33%). The body areas most affected had AIS between 1 and 3 (95.76%) and were: external surface (39.90%) and head/neck (33.20%). As for trauma severity, the highest scores (ISS>25) belonged to those who consumed alcohol (30.73%), suffered falls or vehicle rolls (48.9%) and those attended to 3 hours or longer after the accident (50%). We conclude that for motorcycle drivers who suffered accidents, age, gender, weekday, type of accident, use of drugs and the absence of helmet use signal both to the risk of occurrence of these events, as well as for the greater severity of injuries and trauma.

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The pressure ulcers (PU), also known as decubitus ulcers, are defined as injuries caused by the constant pressure exerted on a particular point of the body, causing impairment of blood supply with a decrease or interruption of tissue irrigation, causing occlusion of blood vessels and capillaries, ischemia and cell death. This is a descriptive study with longitudinal design, and panel type, with quantitative approach that aimed to examine the association between predisposing conditions (PC), intrinsic factors (IF) and extrinsic factors (EF) with the occurrence of PU, in hospitalized patients in the Intensive Care Unit (ICU), pain clinical, surgical clinical and neurology wards of a university hospital. The study population was composed of all patients who were restricted to bed during the period from December 2007 to February 2008. The study was approved by the Ethics Committee of HUOL / UFRN (No 135/07). The data-collection took place through a structured formulary of observation, data from medical records and physical examination of patients skins. The results were organized in SPSS 15.0 software, tabulated, categorized and analyzed by descriptive and inferential statistics. Of the 30 patients studied, 43.3% had been hospitalized in the pain clinical and surgical clinic wards, 20.0% in the ICU, 20.0% in the ICU / ward and 16.7% in neurology, being the length of hospitalization in those units of 7 to 18 days (63.3%) and from 19 to 30 days (36.7%), predominantly female and aged ≥ 60 years (60.0%). 19 PU were diagnosed in 43.3% of patients monitored, being 38.5% with one PU between 7 to 18 days and 46.2% with two or more between 19 to 30 days of hospitalization, showing significant relationship (ρ-value = 0029) between length of hospital stay and the number of PU. Was found an association of 35.7% of the PC (cardio-respiratory, hematological, metabolic and psychogenic), IF (age group, oedema, skin changes in humidity and change of body temperature) and EF (type of mattress and strength of body pressure) for all patients studied, statistically significant (ρ-value = 0001), between the average scores in patients with and without PU, with reason chance to 12.0 for the development of PU and there was moderate correlation ( r = 0618) in the presence of this association. Results show the influence of the multiplicity of factors and conditions on the occurrence of PU, which brings us to reflect on the assistance focused on prevention and reduction of these injuries which will encourage the reduction of hospitalization length, physical and psychological suffering, and the possibility of improving the clinical condition of the patient.

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This work is an investigation related to issues of those who take home care of people who suffer from Alzheimer disease (AD). Thus, it is justified by the need to acknowledge how these relatives perform this task and in which ways they do this. The study has is analytical and qualitative methodology with the use of a thematic oral history approach. The subjects of the research were nine relatives of those who suffer from AD that participate in the home care group in the Candelária neighborhood in the city of Natal in Rio Grande do Norte-Brazil. The data was collected using a semi-structured questionnaire and interview that was booked in advance and had full support from the care takers. After information collection, three thematic axles were defined. After this procedure, three analisys subcategories were also defined. The first thematic axle emphasizes the so called movement of rite of passage, when the relative becomes a care taker of a person with AD. The second category deals with the care takers strategies, either related to their own behalf or on their relative. It is possible to infer that amongst other forms of help, the care taker needs to rely on a support network, such as health services, groups composed by multiprofessionals that enable better articulation between family and collaborators. The dimension related to faith and spirituality was also observed and pointed out as an important aspect in the emotional support process for these relatives. In the third axle the perspectives of struggle, conquests of the right to health and life quality of those who suffer from AD as well as their relatives was observed. These also deal with dreams and hope

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Hansen´s disease is considered a serious public health problem. In 2006, the Ministry of Health reported that worldwide, Brazil ranked 2nd in the number of cases of the disease, surpassed only by India. The North region is the geographical area in Brazil that presents the most cases. In the state of Rio Grande do Norte, the disease is considered to be eliminated because its prevalence has been identified as 1 per 10.000 inhabitants, criteria established by the State Elimination Letter of 2005. Training programs have been offered by the Coordination for the Control of Hansen´s Disease Program of Rio Grande do Norte, PCH-RN since 1997, with the support of the English governmental agency Leprosy Relief Association, LRA, with no evaluation having been conducted. The objective of this study was to evaluate the training programs in clinical diagnosis of Hansen´s disease and their contribution to the detection of the disease in the state of Rio Grande do Norte. The study was conducted in seven municipalities that are known as Regional Public Health Units (URSAPs): São José de Mipibu URSAP I, Mossoró URSAP II, João Câmara URSAP III, Caicó URSAP IV, Santa Cruz URSAP V, Pau dos Ferros URSAP VI and Natal, capital city of the State, in the Metropolitan Region. Physicians and nurses of the Family Health Program PSF were interviewed as to their perceptions of the implementation of the training program in clinica diagnosis of Hansen´s Disease conducted by the PCH-RN. They evaluated their own practice and the training program. These professionals presented a positive evaluation of the program and gave suggestions for future courses. The results of this study suggest the need for permanent education. Data of the disease obtained from the official records of the Secretariat of Health and from the interviews indicate that health education is the means to control Hansen´s disease effectively

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This study intended to evaluate the maze test accuracy in cognitive deficit screening in elderly with or without neuropsychological pathology. The sample included 40 healthy young (18-25 years old; mean- 21 ± 1.6), 40 healthy old (60-77 years old; mean- 67 ± 5.1) and 18 patients with probable diagnosis of Alzheimer s disease initial stage (52-90 years old; mean- 78 ± 9.2). Data analysis was made using Anova with Tukey s post hoc, multiple linear regression analysis and ROC curve analysis. According to Tukey s test Alzheimer patients spent more time (46843 ± 37926 ms) to execute the test than healthy young (5482 ± 2873 ms; p= 0.0001) and elderly (17978 ± 13700; p= 0.0001); healthy young executed test n lower time (p= 0.035). According to the regression analysis of age, education level and cognitive performance of the three groups, the cognitive performance was the predictor of the execution time. When analyzing young and elderly only age was the predictor and the cognitive performance was the only factor to influence the test of old aged healthy and patients. The ROC curve analysis indicated 72% accuracy for young and elderly and 36% for healthy and elderly patients. The maze execution time represented a better balance between sensibility (75%) and the specificity (61%) was near 13575 ms, indicating that those subjects that execute the maze in a time higher to this value may show cognitive deficit related to the executive function. According to the results it is suggested that the maze test used in this study shows a good accuracy in the cognitive deficit tracking and may discriminate age changes

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Descriptive exploratory study, with quantitative approach and prospective data performed on the Monsenhor Walfredo Gurgel Hospital Complex (MWGH), in Natal/RN, aiming to classify the type of motor vehicle involved in the accident, the public roadway s user quality and the more frequent injuries; to evaluate the severity of trauma in traffic accident victims; characterized the severity of the injuries and the trauma, and the type of motor vehicle involved. The population comprises 605 traffic accident victims, with data collected between October and December 2007. We used as a support for the evaluation of severity of injuries and trauma the Glasgow Coma Scale (GCSl), the Condensed Abbreviated Injury Scale (CAIS) and the Injury Severity Score (ISS). The results show that 82.8% of the victims were male; 78.4% were aged 18 to 38; the victims originating from the State s Countryside prevailed (43.1%); 24.3% of the population had completed middle-level instruction; 23.1% worked on commerce and auxiliary activities; most (79.4%) was catholic; 48.8% were married/consensual union; 76.2% earned up to two monthly minimum wages; Sunday was the day with the most accidents (25.1%); 47.4% were attended to in under an hour after the event; the motorcycle on its own was responsible for 53.2% of the accidents; 42.3% were attended to by the SAMU; 61.8% were victims of crashes; over half (53.4%) used individual protection equipment (IPE); 49.4% were helmets and 4.0% the seatbelt; 61.3% were motorcycle drivers; 43.3% of the accidents took place in the afternoon shift; from 395 drivers, 55.2% were licensed, and 50.7% among those had been licensed for 1 to 5 years; 90.7% of the victims had GCS1 between 13 and 15 points at the time of evaluation; the body area most affected was the external surface (35.9%); 38.8% of the injuries were light or moderate (AIS=1 and AIS=2); 83.2% had light trauma (ISS between 1 and 15 points). In face of the results, we can conclude that there is a risk for the elevation of injury severity and trauma resulting from traffic accidents, when these events are related to certain variables such as gender, age, weekday, the interval between the accident and the first care, ingestion of drugs, type of accident, the public roadway s user quality, the use of IPE, day shift, body regions and the type of motor vehicle involved in the accident

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This is an analytic research of a qualitative nature whose purpose is to examine the learning process involving students of the Nursing Program of the Universidade Federal do Rio Grande do Norte UFRN who are attending the Supervised Clerkship in Nursing (SCN) in Family Health Strategy (FHS), based on learning through daily living. In order to do this, a historical overview of this academic activity in the teaching of nursing was presented, and the importance of FHS as the scene where professional health education takes place was discussed. For the empirical investigation, ten eighth-semester students involved in clerkship activities at family health units in the Western Sanitary District of Natal, Rio Grande do Norte, were interviewed. The theoretical approach relied, as epistemological presupposition, on the ideas of educator Humberto Maturana who showed that learning, both in nature and among human beings, takes place within dialogic living relationships wherein acceptance of the other, affectivity (love) and dialoguing are essential stimuli to learning. Students discourses gradually became part of the analytic categories that had been established beforehand. There has been verified that the students went through meaningful learning encouraged by all who shared the living environment, that is: nurse/instructor, teacher/supervisor, family health staff, and the community. Several feelings were involved in the process, such as joy, satisfaction, self-reliance, affectivity and, in the opposite direction, sadness, indignation, a feeling of impotence, and fear. The learning of interpersonal relationship was describe as the most relevant of the academic experiences and, therefore, thus emphasizing the relevance of affectivity to the learning process as Maturana points out. It is suggested that the teaching of nursing keep on giving priority to family health units as the Basic Care educational scene, with attention to the importance of placing the students in welcoming environments, in such a way as to encourage learning

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This study aimed to seize the general social representations of doctors and nurses who work in ICUs on the process of death and dying. We also aimed to know the social representations of these professionals in relation to death and the process of dying of people who are under their care, identify factors that influence the construction of these representations and identify similarities and differences between the two professions. The study was conducted from the perspective of the Theory of Social Representations of Serge Moscovici and the Central Nucleus of Jean-Claude Abric. The study was conducted in the Intensive Care Unit of Natal Hospital Center, a private hospital of the city of Natal - Rio Grande do Norte. This is descriptive and exploratory research. Twenty-four (24) professionals were interviewed, twelve (12) nurses and twelve (12) doctors. Data were collected through two instruments: Test of Free Association of Words, semi-structured interview. Later, they were coded, categorized and analyzed according to Content Analysis of Bardin (1977). The words evoked after the use of inducing words - death and dying - and the interviews, led to three thematic categories: Death and dying as a biological event, death and dying as a psychosocial event, death and dying as a transcendental event. As final considerations, we believe that the social representations of the group are translated in death and dying as biological and psychosocial events and anchored in the transcendental aspects, we do not see obvious differences in the testimonies of doctors and nurses , and the factors that interfere the construction of these offices is the culture, including religion

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Prospective descriptive study with quantitative approach, which aimed to analyze the relationship of the knowledge of Nurses and conduct assistance during the process of transfusion, to patients in the ICU of a university hospital in Natal-RN. The sample consisted of 27 professionals from the nursing staff (5 nurses and 22 nursing technicians), climbing in the ICU during the period of data collection. Data collection was through a questionnaire and structured form of observation, in addition to consulting the diary. The results were organized in SPSS 15.0, tabulated, cathegorized and analyzed by descriptive and inferential statistics. The results show a young population, aged between 21 and 32 years (63.0%), female (85.2%). Among those surveyed were the main type of stock, mostly technical, nursing (ρ= 0006), which have little time to experience - up to 2 years (ρ= 0008), did not know the DRC in 153 (ρ= 0019), held greater number of pipelines care in blood (ρ= 0018), the non-participation in training and feel informed about the process of transfusion, showed no significant differences. As for officials, highlighted only the time to experience more than 2 years, carrying out fewer procedures and feel informed about the blood. As for the pipes during the transfusion process, I found that the majority of pipes observed in both the stock and the staff were inadequate, with predominance in the first, both in the pursuit of conduct regarding the shortfall. The averages of inappropriate conduct, predominantly developed by stock, were higher in all stages for appropriate conduct. Analyzing the knowledge about the disease process, the stock market were those who had lower scores of knowledge in three stages. As the relationship between the pipes care and knowledge, we see that at all stages of the process of transfusion inadequate knowledge of the averages were higher, taking a significant difference in the stages pre-transfusion (ρ= 0012). When analyzing the average of pipes behind, we see that in inappropriate conduct were significantly higher (ρ= 0031), who had searched in inadequate knowledge. As for the frequency of total procedures performed, we found a significant predominance (ρ= 0049) of inappropriate conduct (88.9%) of which 81.5% were developed by professionals who had inadequate knowledge, showing moderate correlation (r = 0,516) and odds ratio of 2,750 times the development of inappropriate conduct in trade with inadequate knowledge. We conclude that the professionals surveyed, especially the technicians of nursing stock, showed serious deficiencies with regard to the development of pipelines and knowledge of the transfusion process, showing the inadequacy to develop this therapy. Facing the foregoing, we accept the alternative hypothesis proposed in the study, because we show that the inadequacy of knowledge about the process of transfusion influence in inappropriate conduct implemented by the nursing staff in ICU.

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In tertiary care, the Intensive Care Unit (ICU) is nowadays one of the most complex settings in providing care to critically ill patients and could make the difference in favor of life. Nevertheless, the stigma of death which pervades the imagination when the ICU is mentioned and the excessive importance placed on machines rather than on the human being end up by causing distress to some extent. As the purpose of this investigation is to understand the distress caused to a patient in an ICU, it has been grounded on the following question: What kind of distress does a patient go through during his/her experience in an ICU? This study has, therefore, an analytical and reflexive character embedded in a qualitative dimension of a phenomenological approach based on narratives. To this purpose, five patients were interviewed from November to December 2008. Out of the empirical material gathered from these narratives we were able to identify several factors that cause distress to ICU patients. Among them were: the certainty that they are critically ill and fear death, a closed room, too much lighting, a typical loneliness arising from being isolated from family members and dear ones, lack of communication with the professional staff, and noise; besides having to undergo therapeutic procedures. In summary, although the ICU is seen as a place of distress, in many aspects and in accord with this research, such distress can and should be relieved. On the other hand, being near to death leads them to a redefinition of life, said the patients.

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A descriptive, quantitative approach and non-participant observation study, which was aimed at analyzing the association between knowledge and practice of inclusion and maintenance of urinary catheter by nursing professionals in the occurrence of urinary tract infection, performed in the ICU of Onofre Lopes University Hospital in Natal / RN. The original sample was composed of 42 nursing staff professional, five (5) nurses and 37 nursing technicians, 27 of them were outsourced (FUNPEC and IEL fellows) and 10 servers UFRN. Data collection was performed using two instruments, the first observation procedures used in the insertion and manipulation of indwelling urinary catheter (IUC) and the second with a questionnaire that addressed the characterization data of respondents, knowledge and conduct the insertion and manipulation of the IUC. The results were tabulated in Microsoft Excel and analyzed using SPSS software, version 15.0. We found the prevalence of institutional staff members on outsourcing - IEL and FUNPEC - (64.3%) were female (69.0%), aged 21 to 35 years (59.5%) and with mid-level education (88.1%). As to knowledge, we found that the nurses had levels of good to excellent and the nursing technicians, to regulate the poor. The nurses made a mistake when choosing IUC (40.0%) and washing hands (30.0%) and technicians on hand washing (74.4%) and the contents of the tray (34.7%). In relation to the conduct of insertion of IUC, the nurses made a mistake when choosing SVD (66.7%) and washing hands (57.1%). Regarding the handling of IUC/drainage system, the technicians were wrong more about washing their hands (56.0%). Analyzing the misconduct to the categorization of knowledge, we saw that the nursing staff who had missed more had inadequate knowledge (ρ = 0.001). At the end we found the risk of a patient to acquire UTI is higher in two and a half times when there is a large number of mismatches, patient spends more time using the IUC and hospitalized in the ICU. As regards the study hypotheses, we accept the alternative hypothesis and reject the null hypothesis proposed at the start of this research, where the number of gaps in knowledge and behavior increases the incidence of urinary tract infection.

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Understanding the meaning of death for student nurses is the subject of this research. The motivation for the meeting place of my difficulties as a person and especially as a teacher in the face of nursing students in dealing with death on a day-to-day hospital during the undergraduate course. Death became known that this evil looms before men and destabilizing, causing often irreversible mental disorders when faced with family loss. Therefore, it is appropriate to study it the possibility of making us reflect on our way of living life and dealing with human beings from the perspective of finitude. Aimed to understand the meaning of death for nursing students. For this purpose, it was based on the following guiding question: What is the meaning of death for you as a nursing student? From this perspective, the study was developed within a qualitative dimension of the phenomenological approach. To perform ten students were interviewed during the month of July 2009. Emerged from these interviews a variety of feelings such as fear, anxiety, insecurity, failure, sadness, as the sensory experience of each. To understand the meaning units that emerged from the empirical data which constitute the essence of this research were fundamental studies dealing with Heidegger about the death in a phenomenological perspective, as well as authors Bicudo, D'Assunção, Dastur, Morin, Boff, Kübler-Ross, Boemer, among others. From the understanding of the phenomenon, we can say that death produces mixed feelings in these students that lead to selfprotection, understood, often as a departure from the other, at the approach of death. However, it proved to be sensitive and receptive to the approach of death in other dimensions, beyond the highly technical aspects, pointing to a paradigm shift that has the yeast's own willingness to change. In addition, the research highlights the weaknesses in the education of nurses regarding the understanding of the whole human death and the need to overcome them.

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The ability to work, considered as resulting from a dynamic process between the individual resources in relation to their work, influenced from various factors such as sociodemographic, lifestyle, aging process and requirements of work. Aiming analyze the ability to work in a population of public servants, the study analyzed 132 public servants volunteers of the infrastructure sector, in a Federal Institution of Higher Education of the state of Rio Grande do Norte, Northeast, Brazil. Data were collected through a questionnaire called the Index of Capacity for Work - ICT. The variable analysis was done by using descriptive statistics of means, standard deviations, median minimum and maximum values of the scores of quantitative variables. The joint analysis of the variables was performed by multiple linear regression. The server had low capacity to work 11 (8.33%), moderate 31 (23.48%), good 54 (40.91), and Great 28 (21.21). Multiple regression analysis, adjusted for age, sex, education, age started to work, length of service, current capacity and full of disease, showed that best explained the variation of the CTI were age, current capacity and full of disease. The survey showed that 75% of the servers showed ICT below 43, so capacity low, moderate or good and only 25% of respondents had the CTI servers over 43 points, so great capacity for work. According to the recommendations of FIOH - Finnish Institute of Occupational Health, for servers that have these scores be implemented whose objective is to restore the ability to work which is low, improving the capacity for moderate work, support the capacity for the good work and maintain the ability to work great. Therefore, we recommend that the ICT is implemented in other units of the IFES survey in the perspective of achieving a real situation of all its servers, enabling the implementation of these measures as necessary to promote recovery and health of its employees.

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Descriptive study aimed to analyze the quality of life (QOL) of patients with venous ulcers (UV) outpatient clinic of a university hospital in Natal / RN. The aim of the study population was composed of 50 patients with UV treated at the cardiology clinic of a university teaching hospital at the tertiary level. The study was approved by the Ethics Committee of the Federal University of Rio Grande do Norte (Protocol 279/09). Data collection was performed over a period of two months by the very a masters degree and an academic nursing through the application of a form concerning the socio-demographic, clinical, and health care, and the instruments WHOQOL and WHOQOL - old. The data were analyzed with SPSS 15.0, using descriptive and inferential statistics presented in the form of tables, charts and graphs. Of the surveyed, female predominance, age range 59 years, Catholic, low education, married, with up to 03 children, not working, retired, or with occupations requiring long periods in one position, wage income of up to 02 minimum wages, inadequate sleep, patients with chronic venous insufficiency and other chronic diseases such as diabetes and hypertension, were taking medications for treatment, being a minority to IVC. In patients with predominant only one injury, time of injury up to five years, inadequate rest, pain, edema and lesions colonized. The assistance the UV patients began treatment of the injury until four months after the onset of the ulcer, and services primary health care most wanted, access to angiologist by reference form, commuted by public transportation, received support regarding the treatment of injuries. The topical product most used in the lesion was healing, and few were using compression therapy. respondents suffer discrimination in society, showed changes in quality of life after the occurrence of ulcer in relation to leisure, pain, restriction of social / school / transportation; barring employment / financial / social ladder; Physical appearance / discrimination and restriction of domestic activity. These changes were related to the time of injury and found that the more chronic injury is the most negative changes occur in their QV (ρ = 0.000). Analyzing the characteristics of QV measured by the WHOQOL-bref, we found for the two general questions they are dissatisfied with their health (ρ = 0.023) and all areas have significant difference compared with the worst QV have the injury of more than 5 years (ρ = 0.000). The QV measured by the WHOQOL-old, we found that these patients had no changes from the time of injury. We conclude that the QV of patients with UV was considered unsatisfactory when compared to the time of injury on more than 5 years which shows that the quality of life worsens with time the chronic UV.

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It is a descriptive study with a qualitative approach aimed at understanding the impact of the teaching / service between the Nursing College of University of Rio Grande do Norte (FAEN / UERN) and health services in the city of Mossoró / RN on student s learning process. Hence, it was inquired to rescue and over-elaborate the trajectories experienced by students who were graduating in the year of 2009 the Nursing graduation course. It was used, as guidance tool a questionary with both open and objective questions to support the data collection. The data analysis was accomplished based on the precepts proposed by Bardin. The research revealed a clear need of bond establishments with the involvement of the students on services as well as professionals inserted on Academy, in a way that knowledge can be built collectively and the difficulties can be eased.