Nurses' autonomy in Primary Care: From collaborative practices to advanced practice

Abstract

Objective: To assess how Primary Health Care (PHC) nurses identify their professional autonomy in daily work and how this autonomy is perceived by other professionals of the multiprofessional team. Methods: Exploratory, descriptive study in which the theoretical-methodological reference was dialectical hermeneutics anchored in the premises of the Sociology of Professions. Data were collected through semi-structured interviews with 27 nurses from the Family Health Strategy (FHS) and ten professionals from the Family Health Support Center (Portuguese acronym: NASF) in the city of São Paulo. The resulting empirical material underwent discourse analysis. Results: The findings revealed the professional autonomy of PHC nurses is perceived in the following categories: the possible autonomy, the autonomy dictated by protocols and the subordination to medical work. Conclusion: The study showed an expansion of the clinical scope of PHC nurses, and to a certain extent, it was closer to medical work. On the other hand, nurses are challenged to overcome such an approximation in the sense of interprofessional collaborative practice and advanced practice nursing.