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Objetivo principal: Identificar los modos en que las enfermeras quirúrgicas adquieren su conocimiento y competencia. Metodología: Estudio cualitativo descriptivo de carácter exploratorio, mediante entrevistas semiestructuradas a seis enfermeras quirúrgicas. Los datos obtenidos fueron codificados y analizados con el software MAXQDA v.18.1. Resultados principales: La práctica, formación, experiencia, intuición y compañerismo son conceptos relacionados con la adquisición de conocimientos de las enfermeras. El alcance del desarrollo de cada uno de ellos es diferente en relación con el nivel competencial en el que se encuentren las enfermeras, competente, eficiente o experta. Conclusión principal: El proceso de adquisición de conocimientos prácticos en el área quirúrgica es un proceso dinámico y flexible, que se nutre de varias fuentes de conocimiento. Destaca el compañerismo como elemento fundamental en la obtención de información y ayuda en la resolución de problemas, proporcionando la mayor satisfacción. (AU)

Objective: To identify the ways surgical Nurses acquire their knowledge and competence. Methods: Descriptive qualitative study of an exploratory nature, through semi-structured interviews with six surgical nurses. The data gathered were codified and analyzed using MAXQDA v.18.1 software. Results: The practice, training, experience, intuition and fellowship are concepts related to the acquisition of knowledge of the Nurses. The scope of development of each of them is different in relation to the level of competence, competent, efficient or expert. Conclusions: The protocol of acquiring practical knowledge in the surgical block is a dynamical and flexible process, that relies on several sources of knowledge. Fellowship stands out as a key factor of obtaining information, solving problems, and providing the greatest satisfaction. (AU)

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BACKGROUND: The acquisition of experience is a major concern for nurses in intensive care units. Although the emotional component of the clinical practice of these nurses has been widely studied, greater examination is required to determine how this component influences their learning and practical experience. OBJECTIVE: To discover the relationships between emotion, memory and learning and the impacts on nursing clinical practice. RESEARCH DESIGN: This is a qualitative phenomenological study. The data were collected from open, in-depth interviews. A total of 22 intensive care unit nurses participated in this research between January 2012 and December 2014. Ethical considerations: The School of Nursing Ethics Committee approved the study, which complied with ethical principles and required informed consent. FINDINGS: We found a clear relationship between emotion, memory and the acquisition of experience. This relationship grouped three dimensions: (1) satisfaction, to relieve the patient's pain or discomfort, give confidence and a sense of security to the patient, enable the presence of family members into the intensive care unit and provide family members with a realistic view of the patient's situation; (2) error experience, which nurses feel when a patient dies, when they fail to accompany a patient in his or her decision to abandon the struggle to live or when they fail to lend support to the patient's family; and (3) the feel bad-feel good paradox, which occurs when a mistake in the patient's care or handling of his or her family is repaired. CONCLUSION: Emotion is a capacity that impacts on nurses' experience and influences improvements in clinical practice. Recalling stories of satisfaction helps to reinforce good practice, while recalling stories of errors helps to identify difficulties in the profession and recognise new forms of action. The articulation of emotional competencies may support the development of nursing ethics in the intensive care unit to protect and defend their patients and improve their relationships with families in order to maximise the potential for patient care.

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BACKGROUND: Scholars of nursing practices have claimed practical knowledge is source of knowledge in its own right, nevertheless we know little about this knowledge associated with day-to-day practice. The purpose of this study is to describe knowledge that the more experienced nurses the in ICU make use of and discover the components of care it includes. Understanding this knowledge can contribute to improving the working practices of nurses with less experience. METHODS: We used a phenomenologic and hermeneutic approach to conduct a qualitative study. Open in-depth dialogue interviews were conducted with 13 experienced ICU nurses selected by intentional sampling. Data was compiled on significant stories of their practice. The data analysis enabled units of meaning to be categorised and grouped into topics regarding everyday practical knowledge. RESULTS: Knowledge related to everyday practice was evaluated and grouped into seven topics corresponding to how the ICU nurses understand their patient care: 1) Connecting with, calming and situating patients who cannot communicate; 2) Situating and providing relief to patients in transitions of mechanical respiration and non-invasive ventilation; 3) Providing reassurance and guaranteeing the safety of immobilised patients; 4) The "connection" with patients in comas; 5) Taking care of the body; 6) The transition from saving life to palliative care; and 7) How to protect and defend the patient from errors. The components of caretaking that guarantee success include: the calm, care and affection with which they do things; the time devoted to understanding, situating and comforting patients and families; and the commitment they take on with new staff and doctors for the benefit of the patient. CONCLUSIONS: These results show that stories of experiences describe a contextual practical knowledge that the more experienced nurses develop as a natural and spontaneous response. In critical patients the application of everyday practical knowledge greatly influences their well-being. In those cases in which the nurses describe how they have protected the patients from error, this practical knowledge can mean the difference between life and death. The study highlights the need to manage practical knowledge and undertake further research. The study is useful in keeping clinical practice up-to-date.

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