A morte da criança no hospital: o fazer da equipe de enfermagem e a presença do psicanalista

Abstract

This research focuses on the performance of nursing professionals who take care of children in the Intensive Care Unit, given their continuous daily work, marked by a condition of intimacy with the child, their family and the medical procedures. The professional practice in the field of nursing is intensely close to the experience with death and even facing its most “raw” face, when it is under the aegis of this practice under which all procedures take place, from the treatment to the preparation of bodies after death. The “intimate”, which we seek to place, is specified by the entrance, in the hospital institution, of rites proper to each family, but also of by the unique work that each one performs, when confronted with death. The research cutout, as well as its methodological referral, are the result of a journey in public hospitals, of secondary and tertiary levels, integral part of the Brazilian Unified Health System and to which the research turns its focus aiming to investigate the clinical performance in the Intensive Care Unit. Such performance confronts professionals with the limits of life and narrows the articulation of the terms proposed herein: the child, the death and its resonance within the nursing team. The first part of the research problematizes the clinical practice in the health institutions from the conceptual operators from the discourses proposed by Lacan. The practice carried out within these institutions is challenged from the medical and psychoanalyst’s discourses tensioning, which implies observing that nurses, physicians and psychoanalysts attend to such discourses without being confused with the comprehensive realization of any discursive setting. This implies that each discourse contains a fracture, an opening that makes its turn possible, and from there we seek to collect what we name as the remains produced in this meeting of different discursive positions. Remains with which the nursing team is confronted and which, paradoxically, indicate the relationship between life and death in a context marked by the presence of death. From this point on, we continue articulating the subject’s clinic in its intersection with the propositions of the expanded clinic within the Unified Health System. From this approach to the discourses, practices and propositions of the expanded clinic, the research turns more precisely to the problem of death in the hospital context and to the movement of palliative care. Interrogating the destinations of mourning in the context of this event that shook the world in the 21st century – the COVID-19 pandemic – we then present the main contributions of the research in a journey that goes from the formulations about exposed death to the decantation of important levels or dimensions of the nursing team’s practice in the specific context of the child’s death. We also point out the pertinence of researches that focuses on the presence of women in the health field, if we consider thecontingent of women that make up a hospital unit and the specificities of their practice, as well as the reverberations of the condition of women in the scope of the health practices.