Conquistas e desafios do processo de trabalho de enfermagem: o caso dos CAPS em Natal/RN

The Brazilian Psychiatric Reform proposes creating linkages / interactions of the mentally ill with civil society , through promoting citizenship and assistance to the mentally ill. The deinstitutionalization of mental health advocates from the guidelines decreased supply of hospital beds and consequently the creation of substitute services for psychosocial care, especially with regard to therapeutic practices emancipatory. From this scenario, the present study aims to investigate the relevance and challenges of the process of nursing work in CAPS III in Natal / RN. It is descriptive research with a qualitative and exploratory. The subjects are employees of the nursing team in CAPS III East of Natal / RN. This service has actions for the psychosocial care of the subjects treated with daily multidisciplinary care by behaving the length of treatment and follow-up activities, industrial and cultural activities. Employ the semi-structured interview as a tool for data collection. The data analysis was done by means of thematic analysis proposed by Bardin. Thus, this sought to bring to the discussion of how this process is consolidated in the daily service. Thus, purposed to contribute to the debate on deinstitutionalization in psychosocial care as a guideline in the process of mental health nursing work in a CAPSIII, Natal / RN

A formação de conceitos no ensino de graduação em enfermagem à luz da teoria da aprendizagem significativa

The Theory of Meaningful Learning (TML) described by David Paul Ausubel offers a proposal for the teaching strategies to provide a more active and effective student learning. The projection of the TML practice is demonstrated through the development of concept maps (CM) technique, created by Joseph Donald Novak, which presents as a strategy, method or schematic feature, which is an indicator to identify the cognitive organization of the knowledge acquired by students. The survey was conducted in the light of TML in relation to learning concepts involving students of undergraduate nursing in a public university in the state of Rio Grande do Norte. Thus, the study aimed to compare the concept learning of students of undergraduate nursing, when subjected to different forms of education, to point approaches that promote more effective and meaningful results. It was a quasi - experimental study with a qualitative analysis, conducted with students of the Undergraduate Nursing of the Universidade Federal do Rio Grande do Norte (UFRN), approved by the Research Ethics Committee/UFRN Certification of Presention for Ethics Appreciation (CPEA) in 11706412.3.0000.5537. The study took place at two different times and involved content on complications mediate postoperative surgical wound in the same discipline with students who attended the 5th semester of the degree course in Nursing. For the viability of data collection, in the second half of 2013, we used the technique of CM, to represent the concept of complications mediate postoperative surgical wound covered in the classroom. CM were built at a different time from that of the discipline, with the support of tutors and preceded by a brief description and explanation about the form of preparation and application. In this study were subjected, 31 students of undergraduate nursing, registered in the discipline of Integral Attention to health I. In the first stage, 18 students participated in the survey, they had the teaching intervention based on TML, and in the second stage, all students participated in the lesson provided curriculum with the responsible teacher of the subject, on the same issue occurred. At the end of each meeting, the students 11 developed concept maps with the aid of software Cmap Tools®. Data analysis happened upon the technique of content analysis, supported by a conceptual map "glass", previously developed by researchers and aid in the preparation of the categories in which the concepts found were classified. The study found that the teaching intervention based on TML with the help of CM, managed to develop in students a more expressive teaching learning process than just classroom curriculum with the traditional teaching method, and also that the association between the intervention motion teaching with the traditional method and the use of the technique of CM encourages the student the ability to articulate the various acquired knowledge as well as apply them in real situations

Protocolo de avaliação do cuidado de enfermagem e da segurança do paciente em unidades de terapia intensiva

The reports of adverse events date from 1990 up to the present day. Conceptually, these adverse events are unintentional injuries unrelated to the underlying disease, causing measurable lesions in patients, extending the period of hospitalization, or leading to death. These issues require discussions with regard to patient safety, improved quality of service, and preventing medical errors. In the Intensive Care Units, this concern is greater because these are sectors of intensive care to individuals with hemodynamic changes and imminent risk of death. Therefore, it is essential to conduct evaluation processes to investigate aspects of quality of nursing care and patient safety in these spaces. For that reason, we aimed to propose the Evaluation protocol of nursing care and patient safety in Intensive Care Units. For its achievement, we needed to: 1) analyze the evolution of the patient safety concept used in scientific productions, under Rodgers evolutionary concept; 2) identify the necessary items to build the evaluation protocol of nursing care and patient safety in the Intensive Care Unit, from the available evidence in literature; 3) construct an instrument for content validation of the evaluation protocol of nursing care and patient safety in the Intensive Care Unit; and 4) describe and evaluate the appropriateness of the content for an evaluation protocol of nursing care and patient safety in the Intensive Care Unit. This is a methodological study for the content validation of the abovementioned protocol. To meet the first three specific objectives, we used the integrative literature review in Theses Database of the Coordination for the Improvement of Higher Education Personnel and the portal of the Collaborating Centre for Quality of Care and Patient Safety. The fourth specific objective happened through the participation of judges, located from the Lattes curricula, in the content validation process developed in two stages: Delphi 1 and Delphi 2. As instrument, we used the electronic form of Google docs. We present in tables the answers from the evaluation instruments by Delphi consensus and Content Validity Index (CVI) of the entire protocol. We summarized the results in articles entitled Analysis of the patient safety concept: Rodgers evolutionary concept ; Scientific evidence regarding patient safety in the Intensive Care Unit ; Technological device for the content validation process: experience report ; and Evaluation protocol of nursing care and patient safety in Intensive Care Units. The Embodied Opinion of the Research Ethics Committee of the Universidade Federal do Rio Grande do Norte, No. 461,246, under CAAE 19586813.2.0000.5537, approved the study. Thus, we conclude the protocol valid in its content, constituting an important tool for evaluating the quality of nursing care and patient safety in Intensive Care Units

Acurácia dos indicadores clínicos do diagnóstico de enfermagem volume de líquidos excessivo em pacientes submetidos à hemodiálise

Trasnversal study, with the objective of evaluating the accuracy of clinical indicators of nursing diagnosis excessive fluid volume in patients undergoing hemodialysis. The study occurred in two stages, the first consisted of the evaluation of the diagnostic indicators in study; and the second, the diagnostic inference conducted by nurse diagnosticians. The first stage occurred from december 2012 to april 2013, in a University Hospital and a Hemodialysis Clinic in Northeastern of Brazil, with a sample of 100 chronic renal failure patients on hemodialysis. The data were selected through an interview form and a physical examination, organized into spreadsheets and analyzed as to the presence or absence of the indicators of diagnosis excessive fluid volume. In the second step, the spreadsheets were sent to three nurses diagnosticians, who judged the presence or absence of diagnosis in the clientele searched. This step was conducted from july to september 2013. For analysis of the data, we used descriptive and inferential statistics. In the descriptive analysis, we used measures of central tendency and dispersion. In inferential analysis, we used the tests Chi- square, Fisher and prevalence ratios. The accuracy of the clinical indicators pertaining to the diagnosis were measured as to the specificity, sensitivity, predictive values, likelihood ratios and Diagnostic Odds Ratio. Also developed a logistic regression. The results were organized in tables and discussed with literature. This study was approved by the Ethics Committee in Research of the Federal University of Rio Grande do Norte, with Presentation Certificate for Ethics Appreciation nº 08696212.7.0000.5537. The results revealed that the diagnosis studied was present in 82% of patients. The characteristics with prevalence above 50 % that stood out were: azotemia, decreased hematocrit, electrolyte imbalance, intake exceeds output, anxiety, edema, decreased hemoglobin, oliguria and blood pressure changes. Eight defining characteristics were presented statistically significant association with the nursing diagnosis investigated: pulmonary congestion, intake exceeds output, electrolytes imbalance, jugular vein distension, edema, weight gain over short period of time, agitation and adventitious breath sounds. Among these, the 10 characteristics which showed higher prevalence ratios were: edema and weight gain over short period of time. The features with the highest sensitivity were edema, electrolytes imbalance and intake exceeds output and the standing out with greater specificity were: anasarca, weight gain over short period of time, change in respiratory pattern, adventitious breath sounds, pulmonary congestion, agitation and jugular vein distension. The indicators jugular vein distension, electrolytes imbalance, intake exceeds output, increased central venous pressure and edema, together, were identified in the logistic regression model as the most significant predictors. It is concluded that the identification of accurate clinical indicators allow a good prediction of the nursing diagnosis of excessive fluid volume in patients undergoing hemodialysis in order to assist the nurse in the inference process, which will contribute to the success of patient care. In addition, nurses will consider for diagnostic inference not only his clinical experience, but also scientific evidence of the occurrence of excessive fluid volume, contributing to the control of volemia in these patients

Assistência de enfermagem às urgências e emergências psiquiátricas no serviço de atendimento móvel de urgência em Mossoró-RN

This study aims to identify the concepts of professional nursing team on assistance in urgency and psychiatric emergencies in SAMU in Mossoró/RN, identifying the difficulties in implementing an emergency assistance to the user in psychiatric distress in this service and point strategies in pursuit of consolidation and expansion of comprehensive health care to the public. It is a descriptive research with qualitative and exploratory approach. The subjects were employees of the nursing staff of SAMU of that mentioned municipality. Semi-structured interviews are applied as tool for data collection. It was counted on the consent of the institution where the study was developed and approval by the Ethics Committee in Research of UFRN with CAAE No 17326513.0.0000.5537, besides signing the Informed Free Consent Term by the participants. Data analysis was done by means of thematic analysis proposed by Bardin. Thus , as a result of the research produced the following categories: mechanistic practice; dehumanization of care; need for qualification, barriers to assistance in urgency and psychiatric emergency and strategies in pursuit of comprehensive care, which proceeded in preparing two articles entitled "Nursing care to the emergency room and psychiatric emergencies in the mobile emergency care service" and "Barriers for emergency service and psychiatric emergencies in the mobile emergency care service". In the studied reality it was identified that nursing care offered to users in situations of urgency and psychiatric emergency is made based primarily on the use of chemical and physical restraints, as well as transportation to the general hospital, constantly using the police force support, which meets the guidelines of the Psychiatric Reform and thereby undermining the provision of an effective and humane care. This scenario is worsened by the lack of an organized network of services in mental health, where after the service the user is taken to a general hospital, considering that there is no ready or appropriate psychiatric emergency service as a Center of Psychosocial Care - CAPs III to reference it, thereby precluding the realization of a resolute and comprehensive care. Thus, it is concluded that nursing care is based on biologicist and medicine-centered model advocated by classical psychiatry, and that despite all the advances in psychiatric reform, still guides the mental health care, so the lack of service network organized in hierarchical and mental health, where the user in urgency and emergency service can be watched in full and the guidelines of the psychiatric reform can be realized in practice

O ensino de enfermagem gerontológica na formação do enfermeiro

At the current time of demographic changes in the world , it is observed that the health sector requires restructuring of its practices in caring for the elderly , in order to enable a comprehensive and humane care . In this sense, we identify the need for qualified professionals to assist the elderly and, therefore , it is important that training curricula are adequate to this reality . The study aims to analyze how it develops teaching gerontological nursing component in undergraduate nursing . This is a descriptive , exploratory study with a qualitative approach, in two higher education institutions in the city of Natal / RN . The population involved corresponded to the coordinators of graduate courses in nursing and teachers who teach content of health care for the elderly, a total of seven participants . The data collection instruments were used: a questionnaire containing questions related to the characterization of the participants and the teaching of gerontological nursing in undergraduate courses in nursing and a form with items of analysis for pedagogical projects . The results were presented descriptively in tables and analyzed from coming themes of the main themes of the instruments defined in: knowledge about the research participants , knowledge of teaching gerontological nursing component and knowledge of pedagogical projects , discussed under Resolution paragraph . 03 of 7/11/2001 , which establishes standards for the nursing program , the educational projects of educational institutions , the Theoretical Donald Shoon and thematically relevant literature . The results indicate that the majority of participants were female (four), all have graduate though , none of them stated in the qualification of aging or elderly health area; the organization of the contents of the component in the curriculum, workload theoretical- methodological and practical teaching strategies presented was heterogeneous and sometimes diverging at the same institution . On the definition of gerontological nursing component was identified that is not well defined along the pedagogical design of educational institutions surveyed . It was concluded that in the context of this study , teaching gerontological nursing is present in the course of nursing education, but needs reevaluation and updating in order to teach a wider range of driving and health practices

Estágio supervisionado em enfermagem: visão de preceptores

The present study aimed to analyze the vision of tutors from a university hospital about supervised internship in nursing. It is a descriptive nature research with qualitative approach, developed at the University Hospital Onofre Lopes (HUOL), located in Natal/RN. The population was composed of eleven assisting nurses engaged the precentorship of undergraduate course students in nursing, from the Federal University of Rio Grande do Norte (UFRN). For the empirical research, conducted in the period from September to November 2013, the semi-structured interview involving questions directed to the stage was used, as advocate the national curriculum guidelines, as regards this curricular component. With the consent of the institution where the study has been developed and approved by the Research Ethics Committee of UFRN, as n° 17800613.9.0000.5537, besides CAAE signing an informed consent by participants. The analysis of the information was held from the analysis of content, thematic mode. Thereby four categories were defined a priori, namely: the supervised internship in the vision of nurses; To be preceptor; The internship concerned: contributions and difficulties; Do the institutional actors communicate? The results indicate that in the view of the supervised internship preceptors is a sine qua non for the training of nurses, considering that it prepares for professional life. Besides being a moment conducive to the exercise of management and a greater rapprochement between theory and practice, stimulates the preceptor to upgrade to better exercise the function and also provides an exchange of knowledge between students and tutors, thus contributing to optimize the service. Nevertheless, the respondents indicate the existence of a distancing and little communication with the academic institution. In summary, it is realized that the nurses understand the importance of its function of tutors and supervised stage for vocational training. It is necessary, however, to reflect on the paths to be pinched in the confrontation of difficulties in this process, especially as regards the teaching/service relationship, which, while remaining at a distance, strengthens the existing dichotomy between theory and practice

Atuação e o conhecimento dos profissionais de enfermagem quanto a morte encefálica e manutenção do potencial doador de órgãos e tecidos para transplantes

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

O cidadão técnico em enfermagem :analisando as mudanças na sua profissionalização

The study analyzes the changes occurring in the professional qualification of the Nursing Technician in the Natal School of Nursing. It provides a historical discussion of Brazilian professional education, of the pertinent legislation in this type of teaching, and the repercussions related to the institutionalization of the Educational Directives Law. It interprets the discourse of the graduates of the complementary course of nursing auxiliary to nursing technician, for the year 2002, using the collective subject analysis and individual interviews. These revealed changes in the areas of knowledge-learning, knowledge-doing, knowledge-being, and an awakening to other changes besides the challenges being confronted. In this sense, nursing as a participant in a society that is effervescent with process changes, interacts socially, politically and professionally in this context, able to experience advances and retrogrades, depending on its political competency

Efeitos cognitivos e emocionais do estresse ocupacional em profissionais de enfermagem

Objective: Investigating the indicators of stress, anxiety, depression and the cognitive changes in members of the nursing team at Santa Casa de Misericordia de Assis - SP. Methods: 66 nursing professionals participated in the study, evaluated by psychological and cognitive tracking instruments. Results: The stress experience was not homogenous in the nursing team; high scores in the depression tracking were associated to low cognitive scores. Conclusion: Nursing auxiliaries and technicians were affected by stress. Therefore, workers healthcare should be provided for the whole nursing team.

Registros de ordens e ocorrências: uma prática de letramento no trabalho da enfermagem hospitalar

Nursing documentation is a literacy practice which is regulated by law. Among the written practices of the literacy field, nursing registration is understood as the attendance resume of the main problems and occurrences on duty. In other words it is a document and a communication instrument used by hospital orderly on duty. It s main goal is to keep a record of the information which is necessary to the continuity of the activities as well as to the assistance to the patients. Taking into consideration the complexity of this kind of literacy practice, this study which took place in a hospital context, aims at studying the nursing registration process in order to explain its implementation in the nursing field. The discussion is situated in the area of applied linguistics, and it makes a linkage between linguistics approaches and language questions which are related to the area of discourse at work. The theoretical foundations come from contemporary literacy studies such as Hamilton (2000) who proposes the following categories: participants, domain, artifacts and activities. The analysis was guided by the principles of the ethnographic methodology which proposes that the researcher spends much time in the field and uses a set of techniques in order to collect data related to the subjects speech as well as their deeds concerning the research main object. The data were collected through field observations, analysis of 100 nursing records, 04 reflective sessions and interviews as well involving 36 nurses. On one hand, the analysis reveals the importance of the nursing records in terms of documentation and communication. On the other hand, it shows informational, compositional as well as normative difficulties in terms of linguistics and legal aspects. For, we conclude that these questions need to be addressed through the process of intervention especially in events of teacher in service activities so that the professional nurses may improve their practice in relation to the elaboration of the nursing documentation on duty

Tradução e adaptação transcultural do instrumento de avaliação prenatal selfevaluation questionnaire

Introduction: The human gestation period is 40 weeks. This is the essential time for maternal psychosocial adaptation, in which there is the intense transformation of a life without offspring into a life with one or more children. The Pregnancy Self-Evaluation Questionnaire (PSEQ) has 79 items, subdivided into seven subcategories: acceptance of pregnancy, identification with the maternal role, well-being of mother and baby, preparing for labor, control in labor, relationship with the mother and the relationship with the partner. Objective: To translate and cross-culturally adapt the instrument PSEQ to be used with Brazilian women. Methods: It is a cross-sectional observational study. We followed some methodological steps to achieve the cross-cultural adaptation of this measuring instrument. They are: translation, synthesis, back translation, analysis of the committee of specialists and pre-test. Another questionnaire was applied to characterize the socio-demographic and clinical status of the pregnant women (n = 36). The descriptive statistics was gotten through the average, standard deviation (SD), absolute and relative frequency. The statistical test used for the analysis of the internal consistency was Cronbach's alpha coefficient, using SPSS version 17.0. Results: The volunteers had low socioeconomic status, average age of 25.1 years (± 5.52), and average gestational age of 25.9 weeks (± 8.11). 58.3% of these volunteers had not planned their current pregnancy. The pretest showed that 75% of pregnant women found the questionnaire easy to understand. There was an average of 76.9 (± 3.23) answered items among the participants. Regarding the instrument PSEQ, the identification with the maternal role was the subcategory which showed the highest average 24.8 (± 5.6), while the relationship with the mother had the lowest average 15.4 (± 7.7). The internal consistency ranged from 0.52-0.89. Conclusion: The translation and cross-cultural adaptation of the PSEQ to Portuguese language were carried out with methodological rigor and can be considered an instrument with good internal consistency

Resiliência e socialização organizacional de novos servidores: um estudo transcultural

The main aim of the study was to analyze the relationship between resilience and organizational socialization among newcomers from the Federal University of Rio Grande do Norte (UFRN), and the Norwegian University of Science and Technology (NTNU), comparing the results obtained in a cross-cultural perspective. The sample (N=205) was composed of mentored (N=70) and non-mentored (N=72) professors and technical-administrative employees at UFRN, and their non-mentored counterparts at NTNU (N=63). The data collection instruments used were the Organizational Socialization Inventory (OSI), the Resilience Scale for Adults (RSA) and a sociodemographic form. Data analysis was preceded by a number of tests to verify possible distinct response styles among the respondents, as they came from different cultures. Descriptive analysis and t-tests were performed to identify and compare organizational socialization and resilience outcomes. Hierarchical regression analyses were carried out, the first ones involving all participants (N=205), to observe the predictive power of resilience factors in relation to organizational socialization factors, beyond the effects of nationality, occupation and mentoring experience. The other hierarchical regression analyses were conducted separately for the professors (N=109) and technical-administrative employees (N=96); and for the mentored (N=70) and non-mentored newcomers from UFRN (N=72), and nonmentored newcomers from NTNU (N=63), to compare the predictive power of resilience in relation to organizational socialization between newcomers from the two occupations, and also among the three groups of participants. The results of this study showed that socialization and resilience profiles differed according to demographic and cultural characteristics, and to the socialization strategies adopted in the institutions studied. Furthermore, it was observed that resilience added a significant incremental prediction to all socialization factors, beyond nationality, occupation, and mentoring experience. The predictive contribution from each of the resilience factors was also noteworthy, mainly those of Planned Future and Social Resources. With respect to nationality, occupation and mentoring experience, it was noted that they explained a significant part of the variance in almost all organizational socialization factors, in addition to playing a meaningful role in predicting the scores of such factors, with some evidence of moderation or mediation by the resilience factors. Considering these and the comparative results of the predictive power of resilience in relation to the organizational socialization, between the two occupations and among the three groups of participants, as a whole, the main findings of this study were as follows: resilience tends to contribute to organizational socialization outcomes; the resilience of some subjects may be a differential factor for success in those situations in which individuals face working conditions that are less favorable to promoting their adaptation; and, a formal mentoring program may contribute to improving newcomer resilience, producing better and more homogeneous organizational socialization outcomes. The practical implications, limitations and main contributions of the study are discussed, with a number of suggestions for future research

Adaptação transcultural para o Português/Brasil do instrumento vulnerability to abuse screening scale (VASS)

Esse trabalho objetivou promover a adaptação transcultural para o Brasil da VASS. Os passos para adaptação transcultural seguirão a proposta de operacionalização alicerçado na apreciação de diferentes tipos de equivalência: a conceitual e de itens, a semântica e a de mensuração. Para alcançar as duas primeiras etapas utilizou-se as técnicas de tradução e retrotradução associada ao procedimento intitulado Painel de Especialistas. Para o pré-teste e verificação de equivalência de mensuração, aplicou-se o questionário com uma população de 30 e 66 idosos, respectivamente. Para as análises dos resultados foi utilizada a estatística descritiva e inferencial, em especial o KR-20, teste T de student, correlação de Pearson e ANOVA univariada, bem como o método kappa de Fleiss para verificação do índice de confiabilidade. Verificou-se que o conceito utilizado para construção do instrumento, bem como seus itens se mostram adequados à investigação do fenômeno. Evidenciou-se boa equivalência semântica entre os itens das retrotraduções e do instrumento original, especialmente quanto aos resultados de T1 R1. Os juízes optaram pelo uso de 11 itens de T1 à versão-síntese. A equivalência operacional mostrou-se satisfatória. Em geral, os resultados apresentados mostraram-se aceitáveis. Quanto à etapa da equivalência de mensuração, verificou-se que a idade dos participantes variou entre 60 a 84 anos, prevalecendo respondentes idosas (n = 38), representando 57,6% da amostra estudada. O valor do KR-20 para o escore geral do instrumento foi de 0,688 (IC95%: 0,670). Os valores encontrados para as quatro dimensões propostas pelos autores do estudo inicial do instrumento foram 0,528, 0,289, 0,552 e 0,303, respectivamente. Apenas os valores de consistência interna das subescalas Vulnerabilidade e Coerção mostraram-se aproximados aos encontrados no estudo original, a saber, 0,550 e 0,390, respectivamente. Verificou-se que com a retirada dos itens nº 04, nº 06 e nº 10, houve aumento do índice de consistência interna da escala total. Já quanto aos valores da consistência interna das subescalas, percebeu-se que apenas com a retirada dos itens nº 09, referente à escala que dimensiona o Desânimo, e nº 12, item da subescala Coerção, é que houve acréscimo nesses valores. Destaca-se que esses são resultados preliminares, uma vez que após a verificação da adequabilidade e de padrões psicométricos iniciais acerca do uso do instrumento para a população idosa, ainda há de se dar continuidade à etapa concernente à verificação de propriedades psicométricas robustas do instrumento, que indiquem, por exemplo, evidências de fidedignidade em situação de teste-reteste, validade de constructo e de critério, se possível e aplicável. A principal limitação do estudo é a falta de um instrumento padrão-ouro para testar a fidedignidade, sensibilidade e especificidade do instrumento em questão. Apesar desta limitação, a adaptação transcultural e a verificação de propriedades psicométricas preliminares do instrumento de uma medida de autorrelato que afere indicativo de violência doméstica contra o idoso tem sua relevância e foi satisfatória

A ousadia como horizonte: religando vida e ideias na formação em enfermagem

A proposal of formation in health/nursing built on classic science, on reducing thought and flexnerian paradigm is insufficient to comprehend and intervening with an amplified way on health needs of population, given that it is produced by fragmentation of knowledge, rationalization of thought, mechanizing and biological attitudes. It is necessary that formation in health/nursing allows the construction of effectiveness of principles and guidelines of Unique System of Health (Sistema Único de Saúde - SUS). In this context of emergency of a complex formation in health/nursing, life trajectories and formation of the nurses: Abigail Moura, Francisca Valda and Raimunda Germano are examples of transgressor and successful experiences which allow inquietude, changing and transforming formation patterns and self-formation. The present study is built from the comprehension of method as strategy , defended by Morin and complexity sciences. Has as objects building biographies of formation of these three nurses who express a formation model more totalizing and humanitarian, analyzing and discussing starting from the three biographic fragments guiding principles for the current process of formation in health/nursing. From the biographies, the courage and humbleness emerge as landmarking principles of their experiences. Humbleness neither as self-depreciation nor humiliation but as consciousness of our uncompleted and unfinished essence, acceptance of boundaries and potential and reduction of intellectual vanity. Courage, for its part, is the human pulsing, uncertain for nature, which brings us to act, to face and persevere on moments of fear and difficulties. A formation in health and nursing based on courage and humbleness allows the subjects to be taken away from indifference, arrogance, inertia, pragmatism: bets on ethic and political subjects capable of minimizing unequal, inhumane and excluding processes. Na intellectual and Professional attitude which politizes the thought and science is what must be expected from a complex formation in health field, in latu mode on nursing, in particular