Events that preceded Paulista Nursing School Federalization

Abstracts

Objective:

To describe the events that preceded the federalization of Paulista Nursing School (EPE).

Methods:

Documentary, historical study timeframe between 1956-77.

Results:

Research addressed the federalization of the Paulista Medical School (EPM) in 1956, with fear of lossing of autonomy of EPE, if this was federalized and attached to the medical school, and the national policy of subsidies to nursing courses, which requested that universities or medical schools keep nursing courses. It was identified and discussed the EPM's interest in expanding their autonomy, disconnected from the Federal University of São Carlos and to conquer university of health status, including the federalization of EPE as a strategy.

Conclusion:

Previous federalization of EPE showed that this was not a choice of its social body because it would not serve exclusively the interests of directors, students and teachers of that school, although it has been part of a project of emancipation of EPM and creation of future Federal University of São Paulo.

Nursing; History of Nursing; Education in Nursing

Objetivo:

Descrever os acontecimentos que precederam a federalização da Escola Paulista de Enfermagem (EPE).

Métodos:

Estudo histórico-documental, recorte temporal entre 1956-77.

Resultados:

Pesquisa abordou a federalização da Escola Paulista de Medicina (EPM) em 1956, o receio da perda de autonomia da EPE, caso esta fosse federalizada e anexada à escola médica e, a política nacional de subsídios aos cursos enfermagem, que solicitava que centros universitários ou faculdades de medicina mantivessem cursos de enfermagem. Identificou e discutiu o interesse da EPM em ampliar sua autonomia, desligar-se da Universidade Federal de São Carlos e conquistar o status de universidade da saúde, incluindo a federalização da EPE como estratégia.

Conclusão:

Precedentes da federalização da EPE evidenciaram que esta não foi uma escolha de seu corpo social propriamente, pois não serviria exclusivamente aos interesses dos dirigentes, estudantes e professores daquela escola, conquanto tenha feito parte de um projeto de emancipação da EPM e de criação da futura Universidade Federal de São Paulo.

Enfermagem; História da enfermagem; Educação em enfermagem

Objetivo:

Describir los acontecimientos que precedieron la federalización de la Escola Paulista de Enfermagem (EPE).

Métodos:

Estudio histórico-documental, de 1956-77.

Resultados:

Los precedentes discutidos fueron la federalización de la Escola Paulista de Medicina (EPM), las disposiciones políticas/administrativas relativas a la pérdida de autonomía de la EPE, ante la anexión eventual a la EPM y la política nacional de subsidios para los cursos de enfermería. Discutir el interés de la EPM para ampliar su autonomía, por medio de la desconexión de la Universidade Federal de São Carlos (UFSCar), incluyendo la federalización de la EPE como estrategia.

Conclusión:

La federalización no era una opción política. La pérdida de la condición de escuela, en 1977, ha proporcionado una solución temporal. La federalización de la EPE formaba parte de un proyecto más amplio de EPM en la creación de lo que sería la Universidade Federal de São Paulo.

Enfermería; Historia de la Enfermería; Educación en Enfermería

INTRODUCTION

Some events, people or institutions are able to transform and influence a society for many years. Such transformers agents deserve to be studied in depth in order to understand better our own reality. Thereby, the memories written, spoken and illustrated beyond limits of nostalgia and acquire a special role: becoming foundations of history¹. The rescue of people, events or places also contributes in building and preserving their respective identities, revealing how they were shaped and consolidated their contemporary functions.

The historical approach of educational institutions, although possibly skewed by social movements of the time, represents rich source in understanding the trajectory of certain professional groups.

In this sense, the study of Nursing School of São Paulo Hospital (EEHSP) writes an important chapter in the Nursing History in Brazil because it reinforces and strengthens the collective identity of the profession in the most populous state in the country.

According to investigations carried out by Cagnacci and Sanna, the greatest concentration of historical studies about Nursing schools lies in the State of Rio de Janeiro. Similarly, more often studied schools are "cariocas", with emphasis on the Anna Nery School of Nursing (EEAN). Such research showed lack in scientific literature about referential schools for Nursing, being current or previous¹.

The present study has as its objective the events leading up to the federalization of Nursing School of São Paulo Hospital (EEHSP), the current Paulista Nursing School (EPE) of the Federal University of São Paulo (UNIFESP).

The EEHSP was established in 1939 as result of the Alliance between the Paulista Medical School (EPM) and the Congregation of the Franciscan Sisters Missionaries of Mary and the Roman Catholic Archdiocese of São Paulo, represented by Don José Gaspar de Affonseca e Silva, then Archbishop of São Paulo. In March 24, 1942 it was equated to EEAN, regarded as standard school by Decree 9101/1931².

The idealization of the creation of the Nursing Undergraduate Program in EEHSP emerged from the construction of the Hospital São Paulo (HSP), initiated in 1936. The hospital was created to meet the demand of teaching and research of the newly established EPM². For the hospital reaching their goals, it was necessary that the leaders of EPM perform new alliances, approaching to the State Government and the Catholic Church - of great power in relation to education and experience in nursing. Thus, a new course of EPM was born.

The EEHSP has been characterized not only by producing new frames for Nursing, but also for ensuring the technical quality of the health care team, meeting the requirements of the new medical school³.

Nurse profile formed by this school was linked to the trends of the time elite conservative ethical of São Paulo: efficient and practical nurses. The most valued characteristic of nursing in this school was efficiency assistance³. This profile was based on technical competence and ethical and spiritual values supporting the lemma featured recently in the emblem of the Paulista Nursing School: non vivere nisi ad serviendum ("not live but to serve")².

The creation of the EEHSP took place with some difficulty, as it was Government's intention to establish a State School of Nursing. A result of this was the creation of the School of Nursing at the University of São Paulo (EEUSP), born in 1942 at the Medical School of USP. This intention was evidenced by the fact that both schools have been assimilated to EEAN the same year 1942, despite the EEHSP have been created three years before the EEUSP^2-4.

Due to the unfavorable circumstances, it was necessary for the leaders of new alliances that held EPM with the State Government, approaching to the federal Government of Getúlio Vargas and the Catholic Church of great power in education and experience in Nursing. In order to create the new course, the Institute of the Franciscan Missionaries of Mary and the Archbishop of Sao Paulo were contacted, in order to ensure the supply of the hospital's needs with a qualified, modern Nursing, focusing on individual and adherent to the model to the hospital care. This congregation had eight nursing schools around the world, among them: the Nursing School of Medical School of Tokyo².

The first Director of the EEHSP was a member of this religious congregation: Mother Maria das Dores. In 1944, she stepped down for health reasons, assuming the Mother Áurea Vieira da Cruz, graduated from the EEHSP. It is important to point out that Mother Domineuc^a was strong presence during the managements of the two directors cited and that decisions on the EEHSP passed by her.

In 1945, Mother Áurea asked the direction of the school for entry into religious order of Franciscan Missionaries, assuming Jacira de Araújo Cintra in the direction. In 1948, Mother Áurea reassumed the direction of the school where she stayed until 1973, at which point the direction of the Franciscan order repositioned several of its religious, including the Director. This change happened in a crucial moment, since the federalization of EPE was on the agenda⁵.

In 1973, Sister Francisca Nogueira Soares, religious and lecturer in the Department of obstetric nursing, assumed and having remained for three years. It was succeeded by Professor Esmeralda Augusto, the first lay Director of EPE, in the management occurring the federalization of the School and the beginning of postgraduate education strictu sensu.

It is important to make it clear that throughout the period studied the current name of the UNIFESP Nursing School has changed. It was created under the name School of Nurses at the Hospital of São Paulo (EEHSP) in 1939, and remained until 1968. In this year, by decision of the Congregation of the School Board, its name changed to Paulista Nursing School (EPE), name used until the federalization and incorporation to the Paulista Medical School (EPM).

The hierarchical structure comprised the school director, the heads of departments and the teachers included in the departments, which taught the subjects. With the federalization, in 1977, the EPE was transformed into a Department of EPM, sectors and subjects. By its constant presence on the national political scene of Brazilian Nursing, EPE is a reference school nursing that has for many years train professional for the Brazilian health care system. It is a model institution also to be located in one of the States in which nursing is highly prestigious in the country and where the economic and political activity has national impact.

Such considerations, reinforced by the transformations that have occurred during the period of federalization of EPE and by effects and strategies used by social actors involved in the process, endorsing the justifications for study of the background of the federalization of this institution. The objective is to describe the events preceded to the federalization of the Paulista Nursing School.

METHOD

Descriptive study of historical-documentary nature performed from written documentation. The timeframe has milestone in 1956, year of federalization of EPM and consolidation of the undergraduate program in nursing of EEHSP, and final milestone in 1977, when the end of the administration of the last religious Director, Sister Francisca Nogueira Soares. In this way, it was the transition from religious to lay director, with the arrival of Professor Esmeralda Augusto⁶.

The documentary sources are constituted by documents that made direct reference to the history of federalization of the Paulista Nursing School. Among them, there are books - minutes of meetings, publications of the official State and Union Journals, news of public newspapers and official decrees. In addition to these sources, the scientific literature that was about the object of study was also used. The study is part of a master's thesis titled "Process of Federalization of the Paulista Nursing School", whose project was submitted to the Ethics Committee in Research of the Fedearal University of São Paulo according to institutional protocol, although not involving research with human beings. Its approval is documented by the Research Ethics Committee Opinion 1690/2011.

The written documents, books - minutes of meetings and other administrative documents were obtained in the holdings of the Paulista Nursing School of UNIFESP and Dean of undergraduate studies of UNIFESP. After proper authorization of the organs that hold the ownership of these sources, the written documents were copied digitally and the images stored in electronic file, being identified through its original access place. Then, the stored images are organized into folders prints, with their respective titles. Each document had database identification registered with its title. This database was organized in Excel^® spreadsheet.

For the cataloguing of the sources abstract of each source with the main information contained was arranged. These abstracts were gathered and read several times, in order to establish relations of similarity and thematic relevance. The findings generated by these procedures were then analyzed, described and discussed based on scientific literature raised.

RESULTS AND DISCUSSION

Precedents of federalization of the Paulista Nursing School

Until 1956, both the EPM as the HSP and the EEHSP were supported by the Paulista Society for the Medical Development of (PSMD). This non-profit civil society had as purpose to develop the EPM and create other complementary or supplementary education institutes. However, it suffered from the underfunding of its developments. The federalization of the EPM came to meet the financial needs, for which, according to one of the minutes of meeting of the period, there were two possible solutions: federalizing the medical school or closing the medical cours⁷.

The federalization made public a private educational establishment, causing great impact and changes in the structure of EPM. Professors and staff have been incorporated into the framework of the civil service, continuing the PMDS as supporter of the HSP and the EEHSP, whose leaders were not, at that time, interest in similar changes.

In accordance with article 20 of the Law 775 of 1949, stating about the nursing education in Brazil, in each University Center or headquarters of the medical school should be a nursing school with both nursing area courses (Training for Nurses and Nursing Assistant). According to art. 23 of the same law, the Executive power would subsidize all nursing schools that were founded and would endeavor to extend the financial support granted to existing schools⁸.

Thus, according to said law, EPM had the obligation to maintain a nursing school, since the federal Government could subsidize it, federalizing or not its course. In addition, a nursing school was a good pickup of funds and incorporate it, seemed interesting to medical school.

The determinations of this law were clear and the EEHSP could suffer the consequences of these provisions, being attached to the medical school. About that, the then Director of the EEHSP, Mother Áurea da Cruz, published an article in the Brazilian Journal of Nursing, primary scientific nursing source at that time, with the title "About the federalization of the EEHSP". The article ran on the political appeals that resulted in project of law 3,257 A of 1957, written by the same Member who supported the federal government budget for the Nursing School - Lauro Monteiro da Cruz⁸.

This law project created the Nursing School attached to the Medical School of Paraná and supported to the federalization of EEHSP under the following justification: "lack of resources, feeling difficulty to collect the study of students and because of they reside in boarding school"^8:67. In addition, the author of the project justified the federalization because EEHSP already receive federal government support, being more reasonable the Government aggregate it, since it demonstrated "high technical capability, but showed financial embarrassments in contingency to close its activities"^8:67.

It is interesting to note that, even under the term of Law 775/1949, which promised the federal Government with the allowance of the nursing schools, Mr Lauro Monteiro da Cruz proposed the federalization EEHSP⁹.

Given the lack of clarity by the EPM direction about the problem, Mother Áurea questioned the then Director of EPM, Marcos Lindenberg, about his knowledge about this law project and on the reasons of not being consulted before the direction of Nursing School and the Archbishop D. José Gaspar. She also mentioned the ethics situation of the institution, because the school received over twenty years the collaboration of broad of teachers - formed by doctors, nurses and religious - but without any fees. Such collaboration justified to the Ministry of Education and Culture receiving funds that allowed the construction of the residence of the students^8,9.

Given this, the Director of EEHSP requested interference in this project and establishment of a subsidized school to keep "their legal personality and independence, with a smaller financial burden for the Union than would bring on its federalization"^8:68. It is noted that the fear of the Director of EEHSP was the same of EPM Board at the time of the federalization.

The federal Government proved to be favorable to supporting the EEHSP. This was evidenced through subsidies. However, the federalization of EPM and the proposition and advancement of law projects to extend the federalization to EEHSP, indicated that the solution of the allowance is no longer the favorite.

The Board of Directors of EEHSP, for their part, presented a significant aversion to federalization within the management of mother Áurea, believing that it would lose its autonomy, becoming dependent unit of a medical school. In addition, there would be guided on the dedication and selflessness of the teachers and staff of EEHSP, which would mean breaking with the religious model of management. In addition, it would represent additional burden to the State⁷.

The federalization of schools of higher education was sought by the Government not only for the EEHSP, but also to other institutions in the same condition. This intention is perceived not only in the text of laws promulgated at that time, but also in newspapers of the time. Article from the newspaper "O Globo" reported on the intention of the Government in federalizing not only the EEHSP and the Nursing School of Recife, as well as to create the Teachers of Economic Sciences of Ceará¹⁰.

The Federal Government, with the law 12/13/1960, federalized Paraíba University and created the Federal University of São Paulo (U.F.S.P.)^b, based in São Carlos. The U.F.S.P. incorporated the São Carlos Engineering courses; Philosophy, Science and Letters of Araraquara; Pharmacy and Odontology of Araçatuba, Economic Science of Santo André and the EPM of São Paulo. This was one of the hallmarks of Government of Juscelino Kubitschek de Oliveira, President of the Republic, having expanded Federal universities through the creation of new courses and incorporating existing courses¹¹. This law also federalized Medical School of Paraíba and it annexed Nursing School in a single legal act.

Unlike the case of Paraíba, the text of the law that created the U.F.S.P. expressed clearly that only the EPM, in São Paulo, was part of the U.F.S.P., excluding EEHSP. There was great fear of teachers of EEHSP of the Nursing School to be attached to the medical school, in the same way as the Nursing School Paraíba being federalized as annexed to the medical school of that State. Such feelings were justified by the way the EEHSP worked, since many teachers of EPM taught in the course of nursing of EEHSP. In addition, the laboratories were used together and there was the monthly contribution to the Nursing School receiving from the federal Government.

The speed with which information about the federalization of EEHSP came to the interested was slow, causing great impact among the social actors involved in the issue at the time. While a public newspaper denounced the Union Government's intentions in federalizing the school, its leaders still lacked access to law projects that regulated it. Thus, the intent of the federalization of EEHSP could seem obscure to the leaders and Teachers of EEHSP and of EPM. Probably, this lack of clarification of the direction of EPM and EEHSP about the direction of the process used, bring discomfort to teachers¹².

On the other hand, the headquarters of the Federal University of São Paulo in São Carlos was a fact that dislike medical leaders of EPM, causing those getting aid for the rectification of this law. The idea was to create a core theme of Health University based in the city of São Paulo. Mr Lauro Cruz was preparing a replacement of this law. Together, Marcos Lindenberg and other teachers of EPM presented project which requested the Deputy that the headquarters of the Federal University was in São Paulo.

The displeasure of the leadership of EPM with the fact that the city of Sao Paulo did not host the U.F.S.P. was big, and with the political pressure that resulted, the EPM disengaged from the Federal University of São Paulo and became isolated higher education establishment of municipal nature, fulfillment of the law 4421 of September 29, 1964¹³. It is assumed that the EPM Board feared the school would be just another unit within the U.F.S.P.

If the concern of the medical school leaders resided in not hosting the Federal University in the city of São Paulo and then experience the loss of power, the concern of teachers of Nursing School was similar, especially by Mother Áurea. She feared the possibility of setting up a Nursing school in the city of São Carlos, causing the EEHSP not being the school of nursing of the University¹².

Frequent meetings were held between the Teachers of EEHSP and its management, in order to make them aware of the situation, even though this was uncertain. For Mother Áurea was very difficult to be sure about it, because there was no governing law about federalization to nursing school. The EPM transformed into federal autarchy, but this had not occurred to the EEHSP, although both work in collaborative arrangements. Consequently, there was no definition as to the annexation to EPM¹².

The EEHSP counted with the help of the religious authorities to defend its continuity in the city of São Paulo. Mother Áurea had the support of her congregation, through the Auxiliary Bishop of Rio de Janeiro and member of the Federal Council of education, and asked him to their headquarters, if federalized, stayed in São Paulo. Other religious authorities were also contacted by Mother Áurea, which requested information on the situation of the school to the Ministry of Education. In addition to the contact with the religious authorities, Mother Áurea tried other strategies for better clarification on the possible federalization of EEHSP with the political authorities of the time¹².

Meanwhile, the Nursing School at the University of São Paulo (EEUSP) had its detaching of the Medical School of USP (FMUSP) defined through the decision taken by the University Council of the University of São Paulo in 1962, making it a higher education establishment by Decree 42.809/1963¹⁴.

In this event, Maria Rosa de Souza Pinheiro, Director of EEUSP, was consulted by the direction of EPE to clarify how the EEUSP had succeeded in their autonomy. She reported that a school attaches might have a College of Teachers. However, it could not have a C.T.A. (Administrative Council) and Congregation. She explained that, to be an autonomous school, the law required the existence of a congregation and to this end, it would be necessary to detach the Nursing School at C.T.A. of FMUSP. This detaching was requested and accepted. The EEUSP continued integrating the University of São Paulo as one of its units, receiving funds of University budget, ensuring thus its autonomy¹².

In contrast with the reality of USP, the dissatisfaction of both EPM and the EEHSP with the way in which the U.F.S.P. had been created, made it late both the process of federalization of EEHSP as the creation of the Core Federal University, based in the city of São Paulo. Several strategies were used to reach an agreement on the way of the relationship between these schools of health and the federal Government, but the negotiations have not progressed.

With the purpose of this core installation, Biomedical courses were created in 1966, Speech therapy in 1968, and the acknowledgment of the course of Orthoptics as higher level in 1970, making the neighborhood of Vila Clementino^c, the base of five courses in the area of health. All these courses were linked to existing departments in EPM or formed a new department. Thus, the consolidated departmental structure around the medical school and outlined the future UNIFESP. The term "University Specializing in Health Sciences", however, came to be used only in 1994.

Even when the EPM became federal authority in 1968, the course of Nursing, considered College, was still linked to the EPM, being dependent on federal subsidies and the SPDM. This caused fear about how would be its federalization¹³. In 1968, the Nursing School is no longer called EEHSP and started to be called Paulista Nursing School, perhaps to preserve its independence as a school. It can be assumed that the name change may have occurred in the EPE's attempt to approach under equal conditions of EPM, and thus a Department of EPM.

In June 25, 1968 reunion, Mother Áurea reported a meeting with the Minister of Education and Culture, in order to obtain guidance on the integration of EPE to the future University core planned by EPM - future UNIFESP. The Minister suggested to do a memorial directly to EPM. Mother Áurea had already done it, but some teachers did not agree with the wording, which placed the school as "privileged".

For Mother Áurea, the EPE was privileged in the sense of total acceptance by EPM and because there is a "very positive" climate between both colleges, which was not the case with other nursing schools in relation to local medical schools. An example, according to her, was the EEUSP, that it could not use the laboratories of FMUSP, while the EPE can always do it on EPM without any restriction. She pointed out that the counterpart to the EPE for using the physical and human resources of the EPM was granted in manpower to the HSP through the Teachers and students of Nursing¹².

Mother Áurea presented a proactive attitude to take sides publicly and position herself to connect with authorities at a time when few women demonstrating in public. Her works included an audience with the Minister of Education and Culture, Favorino Bastos Mércio, to treat the subject of the creation of the Federal University of São Paulo. Mother Áurea, besides the title of Director of EPE, has the power of the Catholic Church, her strength of Mother and a strong personality. These factors led her to connect directly with people in positions of great power and authority in the fight for ideals of nursing andreligious¹². The mother was different from the others religious women for her oratory ability and intellectual preparation. She was recognized by stop the power of the word, condition for the position.

Concessions for use of laboratories and teachers at EPE were asked indirectly by teachers of EPM. In the minutes of the Board meeting, there was a complaint of EPM teachers thought the EPE should collaborate more with the HSP, and believed the Nursing course of EPE was very theoretical. It may infer from these facts a way to recover the EPM with EPE, by the concessions made to EPM or maybe the exercise of medical power, which was in the right to demand anything of Nursing, as it often occupied a position subaltern in relation to medical authorities¹².

For these medical teachers, the first and second grade students could undertake their practical training in the HSP, serving as labor. Mother Áurea, in defense of EPE and Nursing, explained that the students of the first and second grade of graduation could not collaborate with the hospital, and that the creation of the new course (the course of Nursing Assistant, that teachers of EPM suggested, also with the aim of prepare the HSP) would mean hiring new teachers. In addition, she stressed that there would be to discuss the matter at a meeting of the EPE¹².

It was also proposed the creation of residence course in Nursing. The positioning of the EPE has made clear, in the opinion of many teachers, the school was a debtor to EPM and the HSP, in exchange for concessions of EPM, concessions not always equivalent, because the working time that the students and teachers dedicated to EPM and the HSP was bigger than the one that gave doctors to the EPE¹².

The number of hours that the nursing students dedicate to the course was big. The Nursing School had the intention of creating a housing for the students because the students and teachers were residing at the hospital to be at the disposal of the institution. To this end, it was necessary that the Director, Mother Áurea, together with the Ministry of Education and Culture build the housing. For this purpose, a document was prepared containing the requirements of the school, which was transferred to the Division of Higher Education for the conquest of funds for the creation of residences of students⁵.

In addition to having sought help from the Ministry of Education and Culture, Mother Áurea also sought help from the Mayor of São Paulo (SP), in order to get support to the EPE and guidelines for forwarding an Office to the Mayor, about the concession of land for the construction of the building of the Nursing School. Request for subsidies was also made to the Secretary of Education of the State of São Paulo, through the State Council⁵.

In 1972, the House of teachers and some students' religious went from the 11^th floor of the HSP to the building that today houses the EPE. Religious School teachers also stop living within the HSP, going to the building, which was used like shelter until the following year, when no longer used for this purpose to be only the installations of the Nursing School¹⁵.

The EPE won bigger status when conquer a physical headquarters, because that meant solidity. With this done, it gathered in one space the activities of nursing school, so that teachers and students have the satisfaction of attending an exclusive physical headquarters.

The University Core and the Departmentalization of EPM

The EPM cared about the Decree of creation of the University Core that should still be voted on by the legislature and countersigned by the federal executive. There was no resolution on the creation of the core, and the leaders of EPM effort for this to happen. These leaders conducted study on what it would be like the internal structure of EPM as a University in which the various courses that had been placed as departments.

Within this structure, each course was a Departmental Council and specific curriculum committees. A curricular chamber composed of elements from all departments would add the set of these courses. The EPM already planned on the two years of basic medical school in this new structure and Mother Áurea asked the same to the nursing teachers, especially teachers of Nursing Fundamentals.

The departmental structure prevailed between the courses of health that the EPM had and the EPE would figure as a Department of EPM, i.e. the departmental structure of EPM would be the existing structure so that the EPE if federalized. Thus, the EPM would achieve the title of University Health Core or Federal University of São Paulo⁵.

It was great the fear of loss of autonomy in decisions relating to EPE by the Directors. They tried to structure the process of federalization and incorporation of EPE by EPM, maybe consider it inexorable. There was a commission, composed of EPE teachers and its Director, who had studied the conditions under which nursing school would be federalized and the transition to EPE integrating the new federal university. This commission of Studies on EPE to the future university core of EPM was composed of teachers and student representative⁵.

The minutes of meeting do not make it clear what the existing committees for the federalization of the school are. In addition, there are not many records about them. The EPE passed through delicate political moment, hence the importance of the discussion of the subject among the actors involved and the record of their opinions.

It is assumed there are two possibilities: either those meetings were not recorded or their records were not properly stored. Thus, there was the absence of these records, assuming that other important records also ceased to be properly preserved, as in the case with the documentation on the output of Mother Áurea of the direction of the school.

The Congregation of the Franciscan Missionaries of Mary Sisters proposed changes, through its General Chapter, and on this was included the output of Mother Áurea of direction of the School. According to that Chapter, there would be many changes in positions occupied by several of the religious congregation, including the likely withdrawal of Mother Áurea of the direction of the School, as already pronounced verbally by Mother Provincial⁵.

The positioning of the teachers of EPE, regarding the leaving of its Director, was not convergent. The Director of the Department of Fundamentals of nursing and Medical-Surgical Nursing of EPE cared, because it was his opinion that the Department was not yet the right time for the change of Directors and that should remain until the federalization. Teacher Mariana Fernandes, Department I, also was of the opinion that each Department, through their representatives, should manifest as being for or against the output of Mother Áurea of direction of the school and send the Mother Provincial a letter explaining the subject, before the completion of the Chapter.

Each Department was studying the subject, having been decided that would not be sent the Mother Provincial a letter requesting the permanence of Mother Áurea for the direction of EPE. This decision implied the little support from the teachers of EPE to the Director, revealing some conflicts between departments and the power struggle among the teachers.

Mother Áurea directed the Nursing School since 1944, totaling nearly 30 years of direction. In 1973, Sister Francisca Nogueira was named the new Director, the last religious Director of EPE, originated from the Department of Obstetric Nursing and Deputy Director in the management of Mother Áurea.

Thus, Sister Francisca was the director, admitted new teachers and participated in events at the EPM Board. Together with Director of EPM, Horácio Kneese de Melo, explained in the event the operation of the EPM, and the EPE did not belong to the EPM, but that in the future, could be part of the same core. Sister Francisca spoke about the importance of the coexistence of students of medicine with the nursing. She said also that there was not a profession better than another but rather a dependency and complementation between a doctor and a nurse. Sister Francisca tried to quickly enter and participate in activities related to the direction of the school, when she started to live directly with the interference of teacher Mariana Augusto⁵.

Mariana Augusto was fighting for integration of EPE to the University. The integration would solve the financial problem, but the disadvantage would be the disappearance of the EPE, which would become only a Department of EPM. Sister Francisca said Mother Áurea always feared this integration, but, when she took possession, Melo said this integration would be better and that was a matter to be studied⁵.

For Mariana Fernandes, Nursing was still in a position to fight for greater prestige due to the lack of social and economic recognition of the profession lacked, perhaps because of the difficulty that nursing was facing having to be subjected to a medical school. In the opinion of Sister Francisca people did not understand Nursing and, perhaps, the integration solve this problem. She asked for the teachers to think about it, which led to the presentation of several different opinions, probably disagreeing with the opinion of the Director, because there were not recorded in the minutes. The position of Sister Francisca revealed the vote of confidence that she gave to the EPM⁵.

New Director positions were always in agreement and avoided conflicts with the EPM. Sister Francisca requested in meeting members' opinion regarding the campaign to win financial support for the HSP, on the occasion of the 40^th anniversary of EPM. The members of the Council were in favor of the collection of these funds⁵. It can be said that the forces that Director of EPE faced, searching in medical school to support their actions. Maybe because by not being able to count on the support of the teachers of the nursing school for their decisions.

In June 1973, the financial situation of EPE was complicated because the PSMD had not sent the promised resources. Therefore, payments of the month would not be effected. Sister Francisca had hired new teachers to the school and the Professor Rosa Pimenta, objected saying that hiring new teachers would increase payroll and new members would not accept the School's financial situation. The Director said that these teachers were aware and had accepted the situation⁵.

Probably, Sister Francisca hired teachers who were their political allies, because she had little support within EPE and still suffered the effects of the long direction of Mother Áurea. With the payroll deficit, Sister Francisca went on to win, maybe, new enemies and had to ally to the PSMD and EPM to conquer her goals.

The leaving of Mother Áurea not only meant the departure of a person. It represented an increase of power of lay teachers, because, with the weak support of teachers of nursing to the direction of Sister Francisca, the lay teachers have more power, passing to be more active in making decisions about the school. This fact would result in the achievement of the school's direction by a lay teacher member in 1977.

The understanding of society while history building refers the need for preservation of memory, because it is the wire that connects the generations to each other, giving a character of antiquity, ubiquity and continuity¹⁶.

CONCLUSION

The federalization of EPE was already a subject discussed and studied since the federalization of EPM in 1956. Committees had been formed and teachers had been certified. Reports described the functioning of EPE and the molds in which should be federalized. Political alliances have happened and teachers, students and staff were waiting for the federalization of EPE, as they had sought.

In fact, in February 7, 1977, teacher Esmeralda Augusto was in the direction of the school and the announcement of the federalization of the EPE was published in the Official Gazette on May 5, 1977. The study may describe the events that preceded the federalization of the Paulista Nursing School and allowed to conclude that such a process was the creation of the Federal University of São Paulo (U.F.S.P.) headquartered in São Paulo. As result, there was an increase of appropriations expected for the HSP and the EPM. The federalization of EPE was just one of the events for the achievement of these goals.

Problems between EPE and authorities regarding the federalization of EPE occurred mainly during the management of Mother Áurea because she believed that the federalization of the EPE would mean the loss of strength and autonomy of school nurses.

In 1973, the EPE presented different outlines related to financial aspects and wear of its teachers when Sister Francisca took over the direction of the school. Thus, the participation of teachers in the process of federalization was greater, decentralizing the voice of EPE of its director and strengthening the teaching and student movement.

The background to the federalization demonstrate that the subject has been extensively discussed by the EPE and EPM and that several of them were attempts and difficulties experienced by the realization of the fact. There have been problems between teachers of nursing and medical schools and nursing care, demonstrating the presence of conflicts of interest.

In a context of financial difficulties, the EPE of Mother Áurea, which dislike the power of the PSMD and the resulting transformation of EPM at a university health care theme, resisted the federalization, as EPE's autonomy would be undermined.

Undoubtedly, the process of federalization of EPE was long, fed expectations of diverse actors and represented a turbulent period. Marks of this experience are loaded until the present day. The loss of the status of school in 1977, even being the alternative found by actors involved in that context, caused discomfort to successive generations.

Become aware of the history of EPE allows knowing the foundations on which this nursing school is structured and still understand the nuances of its functioning. This allows the recognition of its institutional culture and perhaps to encourage the current decision-making better informed, enable to direct them to avoid old mistakes.

a

• Mother Maria Domineuc, born Jeannie Rouquet, became great icon of Brazilian Nursing. Among her many accomplishments there are the creation of Amparo Maternal (SP) in 1939, the first Week of Nursing Studies in SP and the contribution to the functioning of the Brazilian Association of Graduate Nurses (ABED). Source: Souza, AR; Baptista SS. The adoption of the Anglo-American model of nursing education in São Paulo capital. Esc Anna Nery Nursing Magazine 2002:6(2):211-227.
• b
  The Federal University of São Paulo was named as INUFESP so it was not confussed with U.F.S.P., University of São Paulo, with its headquarters in the city of São Carlos, becoming in UFSCar (Federal University of São Carlos)³.
• c
  In Vila Clementino neighborhood in São Paulo, EPM, HSP and EPE are located since mid 1933 untill today. Today, São Paulo campus from UNIFESP is located in this place and also it is located the Board of Directors of the university (N.AA.).

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• ¹¹
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• ¹³
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Publication Dates

• Publication in this collection
  Jan-Mar 2015

History

• Received
  26 July 2013
• Accepted
  22 May 2014