Competências do profissional de enfermagem no atendimento à urgência e emergência: revisão integrativa

Abstract

Introduction: emergency and urgent care require nurses to mobilize complex competencies that integrate knowledge, technical skills and professional attitudes to ensure safe, rapid and effective responses in critical situations, especially in prehospital settings characterized by instability, unpredictability and high clinical risk. Objective: this study aimed to identify and analyze the essential competencies required of nurses for safe, effective and humanized performance in emergency and urgent care, both in prehospital and hospital environments. Methods: this is an integrative literature review conducted through searches in the LILACS, SciELO, PubMed, BVS and Google Scholar databases, including publications from 2012 to 2025. Inclusion and exclusion criteria were applied, resulting in 12 studies selected after screening by titles, abstracts and full-text reading. Data were analyzed using a structured process that organized the findings into thematic axes representing the competencies required of nurses in emergency care. Results: the selected studies highlight five core competency domains: technical-scientific knowledge, technical-operational skills, professional attitudes, worker safety, and patient safety. Technical-scientific knowledge includes mastery of Basic Life Support (BLS), Intermediate Life Support (ILS), Advanced Life Support (ALS), Advanced Cardiovascular Life Support (ACLS), trauma protocols, clinical algorithms and regulatory guidelines, such as COFEN Resolutions nº 648/2020 and 713/2022. Technical-operational skills involve performing critical procedures, rapid clinical reasoning, leadership, communication under pressure and coordination of multidisciplinary teams, particularly in unpredictable and resource-limited environments. Professional attitudes include empathy, ethical conduct, emotional self-control, teamwork, assertive communication and humanized care. Regarding worker safety, the literature identifies significant physical, emotional and occupational risks in emergency and prehospital settings, reinforcing the need for institutional support, adequate working conditions, emotional assistance and continuing education. Patient safety emerged as a direct outcome of nursing competence, strengthened by adherence to standardized clinical protocols, effective interprofessional communication, integrated care networks and structured processes such as the Nursing Care Systematization. Conclusion: the study concludes that the nurse’s performance in urgent and emergency care depends on the integration of knowledge, technical proficiency and professional attitudes, forming a dynamic and multidimensional set of competencies essential for safe and effective practice. Continuous training, periodic certification, realistic simulation, standardization of clinical protocols and the strengthening of institutional policies are essential strategies to improve care quality and reduce adverse events. The findings emphasize the need for permanent education programs, professional support and the valorization of nurses in critical care settings to enhance patient safety, optimize clinical outcomes and consolidate evidence-based, ethical and humanized care across all levels of emergency and prehospital services.