Desafios, resistências e retomada de um NASF-AB: vivências de uma psicóloga residente

Abstract

The present work aims to analyze the work at the Núcleo de Apoio à Saúde da Família from the experience of a resident psychologist inserted in the NASF-AB of a municipality in the interior of Rio Grande do Sul. This is a qualitative study, constructed from the following instruments: field diary; participant observation; professionals' reports and document analysis. The experience was divided into two axes, called: Itineraries of the historical constitution of the municipality's NASF-AB and Experiencing the Resumption: clinical-assistance and technical-pedagogical activities. The first axis makes a historical resumption of the year 2014 until 2021, subdivided into three cycles: Introducing the NASF-AB of Santa Maria; Deployment and Consolidation; Challenges and Resistance. The second reports the activities carried out by the servants together with the resident team in the year 2022. Technical-pedagogical actions are described and analyzed, such as meetings with the supported teams; meeting spaces between the intra and intersectoral network; continued/permanent education in Health; meetings between the NASF-AB team and/or with other NASF teams. Also, clinical-assistance actions, such as home visits; consultations and consultations; groups; school health program/health fairs. As a result, it was pointed out that the NASF-AB faced challenges for its consolidation, which were overcome with the union between the team, as well as with the critical and reflective attitude of the professionals that make up the service. A local experience of sustaining and strengthening the NASF-AB is evident in the logic of Matrix Support and the Expanded Clinic, in contrast to a macropolitical context of dismantling. The team's resistance against the fragmented logic of health, the support of the municipal management and the support of the Multiprofessional Residency were essential in this process. The year 2022 introduces a resumption phase, which demanded persistence and re-signification of practices, since it follows a long period of confrontations, added to the expansion of the team and the return of collective activities, after the most critical period of the COVID pandemic -19. Obstacles were identified in the integration with the supported teams, which refer to a general aspect of precariousness of Primary Care, as well as the cultural devaluation of plural logics in health. It is noticed that, despite the obstacles, the work of the NASF-AB positively interferes with the work with the teams. Therefore, this report reflects an ethical-political position, as a resident psychologist, of reflection and support of an expanded work logic, thus representing the commitment to strengthening the SUS.