Labor market and regulatory processes – Nursing in Brazil

Machado, Maria Helena; Koster, Isabella; Aguiar Filho, Wilson; Wermelinger, Mônica Carvalho de Mesquita Werner; Freire, Neyson Pinheiro; Pereira, Everson Justino

doi:10.1590/1413-81232020251.27552019

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ARTICLE • Ciênc. saúde coletiva 25 (1) • Jan 2020 • https://doi.org/10.1590/1413-81232020251.27552019 copy

Labor market and regulatory processes – Nursing in Brazil

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

The present article analyzes the job market of nursing professionals, based on data obtained through the survey “Nursing Profile in Brazil” (Cofen – Fiocruz), showing that a significant portion of these workers, mostly nursing aides and technicians, live in increasingly precarious conditions of survival, with low wages, multi-employment and insecurity in the work environment, which prevents them from performing their work activities with dignity. It also analyzes the Nursing regulation process, having as reference the sociology of professions, from the creation of the Federal Nursing Council/Regional Nursing Councils System, in the 1970s, when the category started to have self-regulation autonomy, and currently, the profession shows a robust and highly regulatory legal milestone, considering the number of resolutions issued by Cofen, which have an impact on professional practice. The article points out that it is essential for the government to develop and improve job management and regulation policies, in order to contribute to overcome the problems faced by nursing professionals.

Key words
Job Market; Professional Regulation; Nursing Profile in Brazil

Resolution	Standardization	Relevance
Cofen Res. N. 564/2017¹⁶16 Conselho Federal de Enfermagem (COFEN). Resolução COFEN nº 564, de 6 de novembro de 2017. Aprova a reformulação do Código de Ética dos profissionais de enfermagem. Diário Oficial da União 2017; 6 dez.	Code of Professional Ethics	Crucial instrument for the control and supervision of professional practice, which provides for the rights, duties, prohibitions, infractions and penalties. This version has been recreated with extensive discussion in the Regional Councils and public consultation.
Cofen Res. N. 374/2011¹⁷17 Conselho Federal de Enfermagem (COFEN). Resolução COFEN nº 374, de 23 de março de 2011. Normatiza o funcionamento do Sistema de Fiscalização do Exercício Profissional da Enfermagem e dá outras providências. Diário Oficial da União 2011; 25 mar.	It regulates the operating of the Nursing Professional Practice Supervision System and provides other measures.	It is based on a conception of an educational process, of stimulating ethical values and valorization of the nursing work process. Establishing limits for inspection actions. Standardization of administrative and legal conducts. Permanent review of work methods and tools and standards considering technological changes and insertion of new practices. Regulates the model for selection and training of inspection professionals.
Cofen Res. N. 0509/2016¹⁸18 Conselho Federal de Enfermagem (COFEN). Resolução COFEN nº 509, de 15 de março de 2016. Atualiza a norma técnica para Anotação de Responsabilidade Técnica pelo Serviço de Enfermagem e define as atribuições do enfermeiro Responsável Técnico. Diário Oficial da União 2016; 16 mar.	Updates the technical standard for Technical Term of Responsibility by the Nursing Service and defines the attributions of the Nursing Technical Manager (TM).	Inspection power granted to the TMs to act as a liaison between the institution's Nursing service and the Cofen System / Regional Councils, capillarizing the self-regulation.

Work	Public Sector		Private Sector
	Public Sector		For profit		Non profit
	Abs. V.	%	Abs. V.	%	Abs. V.	%
N. Of professionals	1,063,694	55.6	571,099	29.9	278,283	14.5
Employment bonds
Statutory	562,300	49.9	0	0.0	0	0.0
Clt	198,914	17.7	298,735	56.1	152,838	61.3
Temporary	94,087	8.4	23,747	4.5	9,776	3.9
Service provider	95,425	8.5	162,411	30.5	75,688	30.3
Others	175,417	15.6	47,646	8.9	11,122	4.5
Total	1,126,142	100.0	532,539	100.0	249,424	100.0
Modalities of institutions
Hospitals and Urgency/Emergency Units	976,242	68.7	533,566	70.1	259,812	73.6
Basic Health Units - bhus	261,682	18.4	18,904	2.5	0	0.0
Ambulatory units/polyclinics	88,122	6.2	78,643	10.3	43,007	12.2
Diagnosis and Therapy Support Units - SADT	19,486	1.4	67,212	8.8	46,751	13.3
Teaching, Research and Management	75,335	5.3	62,909	8.3	3,247	0.9
	1,420,867	100.0	761,234	100.0	352,817	100.0
Work regime
Daily work	445,725	42.9	220,296	43.8	117,402	45.2
Work shifts	593,336	57.1	282,308	56.2	142,132	54.8
	1,039,061	100.0	502,604	100.0	259,534	100.0
Weekly hours worked
Up to 20 hours	20,916	2.2	21,883	4.6	6,817	3.0
21 - 40 hours	607,561	63.8	240,271	50.0	120,591	52.6
> 41 hours	324,185	34.0	218,004	45.4	101,644	44.4
	952,662	100.0	480,157	100.0	229,052	100.0
Monthly income
Up to 2,000 reais	479,532	55.7	308,507	69.4	156,613	73.0
2,001 - 5,000 reais	339,421	39.4	125,839	28.3	55,414	25.8
More than 5,001 reais	41,472	4.8	10,052	2.3	2,562	1.2
	860,425	100.0	444,397	100.0	214,589	100.0
Occupational accident in the last 12 months
Yes	114,293	11.0	55,362	10.8	29,368	10.9
No	923,889	89.0	458,929	89.2	239,839	89.1
	1,038,182	100.0	514,291	100.0	269,207	100.0
Medical leavein thelast 12 months
Yes	230,647	22.5	87,892	17,2	37,046	13.9
No	795,316	77.5	421.949	82.8	229.073	86.1
	1,025,963	100.0	509.841	100.0	266.118	100.0
Unemployment in the last 12 months
Yes					182,548	10,7
No					1,519,893	89,3
					1,702,441	100,0
Difficulty infinding employment
Yes					121,697	70,0
No					52,068	30,0
					173,765	100,0

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[1] Collaborations

MH Machado, I Koster, MCMW Wermelinger, W Aguiar Filho, NP Freire and EJ Pereira participated in the study conception and design, writing and review of intellectual content until the final version of the manuscript.