Dialectics for humanized care in ICU's: contradictions between professional nursing discourse and practice

This study attempts to unveil contradictions in humanized nursing care in ICUs. It is a qualitative, dialectic-based study involving 7 nurses, 4 family members and one patient of the Adult ICU of the Hospital of the Federal Universityof Santa Catarina. Participatory observation and semi-structured interviews were applied to collect the data. Marxist and Gramscian ideas of contradiction were used as the theoretical-philosophical reference. This study demonstrates that humanized care is part of a complex network, in which care knowledge seems to give way to closer network ties, while care practicefollows an impersonalized strategy within the logic of partitioned and routine health care production. The dissociation between knowledge and practice also contemplates the difficulties in dealing with the burdens of suffering and institutional-professional limitations. The conclusion is that knowledge of this reality should be a renewed, yet age-old challenge for the nurse in the search for the constant construction/ reconstruction of Nursing in terms of practice, knowledge and work relations.