A VIDA PELA VIDA: O TRABALHO DOS PROFISSIONAIS DO SERVIÇO DE ATENDIMENTO MÓVEL DE URGÊNCIA – 192: UMA LEITURA DA PSICODINÂMICA DO TRABALHO

Abstract

This study aims to describe and analyze the work of professionals working in SAMU 192, located in the Midwest Region of Brazil, and its impact on the subjectivity of workers based on the categories of Work Psychodynamics. The research was performed within the qualitative perspective, descriptive case study modality and action research. The empirical procedure took place in three stages, the first of which was visits to the field of research, documentary analysis and constitution of demand. In the second, three collective clinical listening sessions were held with 14 workers (six physicians, three nurses, two ambulance drivers, three ambulance motorbikers) who provide advanced support service. The speeches were recorded and transcribed, the verbalizations were submitted to the clinical analysis of the work proposed by Dejours. The categories of analysis defined a priori were: work organization and subjective mobilization. To guarantee the validity of the collected material, we used the triangulation of data made by three researchers. In the third step, the data were validated with the participants of the research. The results indicate that the organization of the prescribed work of SAMU 192 adopts norms and procedures linked to the logic of productivity (greater number of services, for the lowest cost and time, within a quality standard), being disconnected from the needs, desires and expectations of the workers and real activities. There are aspects related to working conditions that hinder the development of work activities, such as: impairment of the full functionality of some mobile units due to lack of maintenance, which exposes teams and patients to possible accidents; the lack of materials and equipment required for the procedures; the number of vehicles and equipment available, which is insufficient to meet the population’s demand; the physical structure provided, which offers little comfort to the work group rest time. The management of labor in the SAMU 192, in turn, also contributes to the intrapsychic conflicts of the workers, especially when: it hires an unprepared worker to perform as a lifeguard; it allows disorganizes employees at work; it does not involve workers in decision-making and change processes; it ceases to invest in effective communication; it does not establish the collective space for discussion. It is noteworthy that SAMU 192 public managers in Brazil have budgetary restrictions that make it difficult to guarantee quality care and to promote a healthy work environment for workers. The social relations of work between coworkers, peers and management are shown to be healthy. Workers feel satisfied with their activities, perceive the social usefulness of their own work, feel recognized for their dedication to work and for the results obtained (survival of the victim). The results indicate that workers experience pleasure and suffering at work and use strategies of individual (psychic) defenses, as well as individual and collective operative strategies to face suffering and get to work. Operative strategies, in many situations, avoid possible physical and / or verbal aggression. In addition, signs of mental and physical illness were identified in some participants. The adoption of the theoretical-methodological approach of Work Psychodynamics was adequate to investigate the work of these professionals. It is believed that this research contributes significantly to the advances in studies related to SAMU 192 in Brazil from the Work Psychodynamics.