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Revista da Escola de Enfermagem da USP

Print version ISSN 0080-6234On-line version ISSN 1980-220X

Rev. esc. enferm. USP vol.43 no.3 São Paulo Sept. 2009 



Insertion of USP nursing graduates into the job market: facilities and difficulties


Inserción de los egresados de la Escuela de Enfermería de la USP en el mercado de trabajo: facilidades e dificultades



Vilanice Alves de Araújo PüschelI; Mariana Pereira InácioII; Patrícia Prici Agustini PucciIII

IRN. PhD. Faculty at Medical-Surgical Nursing Department, School of Nursing at University of São Paulo. São Paulo, SP, Brazil.
IINursing undergraduate. School of Nursing at University of São Paulo. São Paulo, SP, Brazil.
IIIRN. Holder of a scholarship from the "Ensinar com Pesquisa" program at University of São Paulo. São Paulo, SP, Brazil.

Correspondence addressed to




This descriptive, quantitative-based exploratory study was carried out between 2000 and 2005 and aimed at characterizing the profile of students who had completed the Nursing Course at the University of Sao Paulo. From the 465 graduates found in the period of the research, 175 (37.6%) provided responses for the data collection instrument. Their insertion in the job market occurred most of all into private hospitals by means of election processes in the city of Sao Paulo. The majority of the subjects remained in their first jobs from one to six months. The wage of the major part of the graduates ranged from US$ 950.50 to US$ 1,520.00. In the data collection process, most of the researched participants had a formal job in private healthcare institutions, with average salaries of US$ 1,437.50. Results showed that there was a quick insertion of the graduates into the job market.

Key Words: Nursing. Teaching. Job market.


Con el objetivo de caracterizar a los egresados del Curso de Graduación en Enfermería de la Escuela de Enfermería de la Universidad de San Pablo, en el período de 2.000 a 2.005, se realizó un estudio descriptivo y exploratorio, con un abordaje cuantitativo. De los 465 egresados en el período investigado, 175 (37,6%) respondieron al instrumento de recolección de datos. La inserción en el mercado de trabajo sucedió mayoritariamente en instituciones hospitalarias, privadas, por medio de proceso selectivo, en el municipio de San Pablo, en el área de asistencia. La mayoría permaneció en el primer empleo de uno a seis meses. El intervalo salarial predominante en el primer empleo varió de US$950.50 a US$1,520.00. En el momento de la recolección de datos, gran parte de los participantes poseía un vínculo de la institución y estaba actuando en instituciones hospitalarias, privadas, con un promedio salarial de US$1,437.50. Los resultados de esta investigación colocan en evidencia que hubo una rápida inserción de los egresados en el mercado de trabajo.

Descriptores: Enfermería. Enseñanza. Mercado de trabajo.




In a world in which constant transformation is the norm, it is a challenge to access a space for social and economical ascension, mainly because it is clear that the changes due to scientific and technological development and economic globalization have affected the work market. Technological and organizational innovations, as well as national and international competition aggressiveness, have interfered in the capacity for absorption of new workers, as well as in the quality of the occupational insertion. Professionals who are prepared for constant specialization and for the creation of proposals that differ the product environment in which they work are respected(1-2).

Autonomy, initiative, ability to solve problems, creativity, computing skills and speaking foreign languages are basic intellectual requisites and characteristics that future professionals must have in order to face the new work market(3).

An analysis of the scientific production of nursing human resources in Brazil shows that:

the need for personnel development has been reinforced by the technological advances and the changes in the work world, which lead organizations and individuals to acquire and update their knowledge. In this context, competencies such as communication and social interaction are emphasized, since they constitute intrinsic working tools in the nursing area, which are acquired throughout their life and educational processes, not in punctual qualifications...(4).

The recent evolution in the work market in Brazil in the 1990's was marked by an unstructured process, which is characterized by:

the elevation of the unemployment level, the increase of informality in the working relations, with a consequent deterioration in the quality of work units; the stagnation in work earnings and a worse income distribution(5).

The health work market has experienced significant changes, such as the growth of its service producing system and the occupational structure; in other words, the growth of the quantitative and qualitative profile of the work force in the area. This fact is observed in the increase of employment supply, which absorbs an important part of the economically active population in the country(6).

The analysis of the way this great market is presented to nursing professionals, according to data from the Brazilian Institute of Geography and Statistics (IBGE - Instituto Brasileiro de Geografia e Estatística) in 2005(7), shows that the healthcare team plays an important role in this scenario, including 41.9% (679,215 jobs) of the total health work force in the country, with 17.1% of nurses, 23.8% of nursing technicians and 59.1% of nursing assistants. Even though the participation of nurses in the team has increased over the years, these professionals still represent a small percentage of participation in the nursing work force.

According to data from IBGE(7), it is observed that 57.3% of the nursing professionals are employed in public health institutions, except for technicians, who are more often employed in the private sector.

Nursing schools play a fundamental role in the education of future professionals who will be inserted in the market. For this reason, it is essential to consider that the knowledge regarding how health professionals have been absorbed, particularly in nursing, constitutes an important parameter for educational institutions, which have a role in educating people in order to serve not only the work market, but also in responding to social and health demands and, specifically, in contributing to the transformation of society. In this context, the National Curricular Guidelines for Nursing Courses(8) specify the profile of the graduated student/professional, including their competencies and abilities, as well as the educational purposes to respond to the social needs of health and to assure health care integrality, quality and humanization.

There is also the institutional demand for

a nurse who is able to be in charge of the care of a group of people under his responsibility: a professional who is able to interact with a team, identifying and intervening properly in specific clinical situations; able to have the intellectual master of the unit's dynamics, including the practice context(9).

A study developed in 2000, with 808 nurses who had graduated from the Nursing School of USP in Ribeirão Preto from 1957 to 1990, showed that 81.81% were still working, 12.62% had worked for a period of time, 3.22% were retired and 2.35% had never worked. Those who explained the duration of their work stated their love of the profession and the work, and mentioned their personal and professional satisfaction as reasons for continuing their employment in nursing. The reasons presented by the nurses for abandoning the work market mentioned the difficulty of merging the family and the profession, the low earnings and the loss of motivation (10).

The Nursing School of the University of São Paulo (EEUSP), which was established on October 31, 1942, annually offers 80 places for candidates selected by the admission exam. The nursing course is a full-time course, which takes eight school semesters and aims to provide students with tools for the pedagogical, administrative and care practice, offering contents in the areas of biological and human sciences and those specific to the nursing area, such as the curative and preventive aspects(11).

The scientific initiation is highlighted as part of the professional education, culminating in the elaboration of the course conclusion work, which is a requisite for obtaining the degree(11).

The current curricular program of the nursing course was initiated in 1994. In 2002, this program began the process of evaluation, which led to the composition of working groups targeting its reformulation. In 2004, incorporating the suggestions of the Pedagogical Support Group (PSG), this curricular change process was reinforced and the proposal for the new curricular structure is in the elaboration stage at the school, with the goal of being implemented as of 2009.

Another aspect that reinforces the merit and the role of EEUSP in the education of nurses is the fact that it won the awards Melhores Universidades, Guia do Estudante and Banco Real [Best Universities, Student's Guide, and the award from a national bank, Banco Real], in the category of Employability for two consecutive years.

Therefore, since the school has the responsibility of preparing its graduate nurses for a competent performance in the work market, is in a full curricular reorientation process and has received awards for the employability of its students, it peaked our interest to study, together with the egressed student, how his insertion into the work market took place. Some questions were then formulated : Where were the egressed student from EEUSP inserted? How did this insertion happen? What were the facilitating and difficult points experienced? The authors believe the answers to these questions will support the discussions at the PSG and contribute to the construction of the new curricular program.



The purposes for the development of this study were to characterize egressed students from EEUSP's nursing course from 2000 to 2005; to analyze the way these egressed students were inserted into the work market; and to identify the facilitating and difficult aspects faced in this insertion.



This is a descriptive and exploratory study, using a quantitative approach. It was developed at the Nursing School of the USP and the subjects included 175 (37.6%) egressed students from this institution, encompassing the period from 2000 to 2005, who agreed to participate in the study and signed a Free and Clarified Consent, from a total of 465 students. The study project was approved by the Committee of Ethics in Research (Process no. 584/2006/CEP-EEUSP) and by EEUSP (Document AAc 108/241006).

Data were collected through a questionnaire with open and closed questions. The closed questions aimed to characterize the egressed students from EEUSP regarding their age, gender, religion, marital status, knowledge of foreign languages, graduation year, nursing course duration, any post graduation courses they may have taken, the time it took to be inserted in the work market, the place where they work or have worked, they way they were inserted in this job, the period of time they stayed in these job(s), their position, and the employment bonds they had at the time of data collection. The open questions aimed to identify the aspects that made the insertion into the work market easier or more difficult.

The questionnaires were sent to the electronic addresses of all egressed students from 2000 to 2005, according to the records obtained from the Graduation Service of EEUSP. Data were collected from January to October of 2007. There was a great difficulty in locating the egressed students, based on the records of the Graduation Service, due to the fact that several electronic addresses and telephone numbers were out-of-date. In an attempt to update these contacts, searches were performed on the websites Orkut and Plataforma Lattes, together with the Post Graduation Department of EEUSP, and several egressed students were contacted by telephone. As the instruments were answered, the participant was asked to provide the known electronic addresses of classmates from the period established in the study.

Data were stored and analyzed using the program SPSS version 13.0 (Statistical Package for the Social Sciences), and are presented through tables with relative and absolute frequencies.



Characterization of the egressed students

Most of the 175 (37.6%) egressed students who participated in the study completed their course in 2005 (25.1%), 18.2% finished in 2004 and the others (57.1%) graduated between 2000 and 2003.

It was observed that most of them were female (92%), single (68.8%) and catholic (53.9%). The average age was 27 years old (ranging from 21 to 47 years old) and most of them did not have children (85.1%). Studies developed in a private university in Santo Amaro and in the São Paulo region show that the profile of the egressed students from these respective universities is similar to the one found in this study (12, 13).

Regarding the time taken to finish the undergraduate course, 144 (82.2%) finished the course in four years, whereas the others took from 5 to 7 years to complete it.

Most of the participants mentioned they could read (95.4%), write (65.1%) and speak English (51.4%). Regarding Spanish, there were also participants that could read (50.3%), write (14.3%) and speak the language (12%).

Post graduation courses were highly regarded by 63.4% of all egressed students (Table 1).



The main specialization areas (lato sensu) were Intensive Care (8.5%) and Obstetrical Nursing (6.8%). The most popular institutions for these courses were the Hospital of the Medical School (17.7%), the Federal University of São Paulo (13.7%), the University of São Paulo (8.6%) and the Centro Universitário São Camilo (4.5%). From the total number of egressed students who took a specialization course, 82 (73.8%) finished it, most of them in 2003 (21.9%).

According to the table, 28.5% of the egressed students chose to take a Stricto sensu post- graduation course. Regarding those who decided to obtain a Master's degree (23.4%), 60.9% were still taking the course during the period in which data were collected and 39% had already finished it, most of them (37.5%) in 2006. The Adult Health area was the most demanded field of study (36.5%), and the second was the Collective Health area (26.8%). The most popular institution for taking a post-graduation course was EEUSP (87.8%). Only one person (2.4%) did not provide information regarding the institution in which they pursued their post-graduate work.

Regarding the 5.14% who opted for a Doctoral degree, 66.6% were taking a course in the Adult Health area at EEUSP (77.7%).

There was a greater preference for public institutions for both Lato sensu and Stricto sensu post-graduation courses (62.3% and 97.9%, respectively).

Insertion in the work market

Most of the egressed students (45.1%) took less than three months to join the work market. A study developed with egressed nursing students from a private university in Santo Amaro shows that 70% of their egressed students who were inserted in the work market also accomplished it in less than three months (12). Nevertheless, another study shows that formal employment bonds for nurses have decreased from 8.7% to 7.5% in the period from 1995 to 2000(5), which may indicate a change in the types of employment bonds for this category, since despite the decrease in the supply of formal bonds, their insertion into the work market is still relatively easy.

Institutions of the first, second and third jobs

Egressed students had a greater insertion in the first, second and third jobs in hospital institutions (53.9%, 34.2%, 17.1% respectively), as Table 2 indicates.



A study developed in 1989 showed that the greatest absorption of nurses occurred in the hospital area(14); which was also stated by another study from 2003(12). These results indicate that the hospital is still the institution that most highly absorbs the nursing professional in São Paulo.

Another field that has absorbed a great portion of the nurses is technical education. Table 2 shows that this area is the second greatest field for the insertion of egressed students in their first and second jobs (14.2% and 12%). Regarding their third job, the second greatest insertion (6.2%) took place in the Family Health Program (FHP) and the third in higher education (5.1%).

There was a higher insertion of egressed students in their first, second and third jobs in the private sector (45.1%, 37.5% and 20%).

Distribution of the first, second and third jobs by cities

São Paulo was the city with the greatest insertion of egressed students in their first, second and third jobs (69.1%, 42.2% and 25.1% respectively), followed by Santo André, São Bernardo do Campo, São Caetano, Guarulhos, Osasco and Campinas.

It was observed that in 2000, in the Southeast region, there was an increase of 2.94% in the number of work positions for nursing professionals in the public sector and 10.97% in the private sector(15). According to data from IBGE(7), in 2005 there were 54,022 (46.52%) work positions for nurses in the Southeast region, whereas there were only 31,488 (27.11%) in the Northeast, 16,790 (14.46%) in the South, 6,986 (6.2%) in the Midwest and 6,840 (5.9%) in the North. In the state of São Paulo there were 27,868 positions, and in the city of São Paulo there were 11,653 nurses employed in health institutions, representing, respectively, 51.59% and 21.57% in relation to the total in the southeast, which explains the greater concentration of egressed students in São Paulo.

This fact was also stated by other studies(12-13), in which egressed students from the studied universities were inserted in regions close to their origin universities.

Entrance in the first, second and third jobs

The study showed that the selective process was the main way to enter the first three jobs (52%, 33.7% and 18% respectively), followed by public selection exams (17.1%, 13.7% and 9.6% respectively).

The third way to enter the first two jobs, as presented by the egressed students, was through the recommendation of friends (8.5% and 9.7% respectively) and for the third job, the invitation of the employer (9%). This fact allows us to see the importance of the social network at the time of insertion in the work market. In other studies presented(12-13), egressed students from the studied universities also mentioned the social networks as the main insertion facilitators for the work market.

Duration of the first, second and third jobs

There was a greater concentration of egressed students in the period from 1 to 6 months (36.5%, 16.8% and 12% respectively) and, afterwards, in the period from 7 to 12 months (18.8%, 17.7% and 11.4%), as Table 3 indicates.



There is a tendency for a high turnover of egressed students in their first jobs. A great part of this turnover may be explained due to the dissatisfaction of the egressed student in their job, and the search for specialization and/or better opportunities that may occur as they acquire professional experience.

In the first job there was a variation in the duration from 1 to 61 months; in the second job the variation was from 1 to 70 months, and in the third from 1 to 60 months.

Salary/monthly income in the first, second and third jobs

In their first three jobs, most of the egressed students (36%, 28.5% and 16.5%) had a salary between US $950.50 and US $1,520.00 (Table 4). The minimum salary at the time of data collection was R$ 380.00 (US $190.00) and the commercial dollar was around R$2.00.



The second greatest range of salary in the first three jobs (26.8%, 14.2%, 10.2% respectively) was from US $570.50 to US 950.00.

The salary variation in the first job ranged from US $5.00/hour to US $5,000.00/month, and the income with the greatest concentration of egressed students was between US $900.00 and US $1,250.00 a month (8.11% average). The salary variation in the second job went from US $4.50/hour to US $4,000.00/month, with a greater concentration of egressed students (12%) in the income range of US $1,250.00 a month. The variation in the third job went from US 5.00/ hour to US $2,500.00/month, with a greater concentration of egressed students from US $850.00 to US $1,250.00 a month (7.89% average).

Other studies have shown that the prevalent income of egressed students from the studied private institutions ranged from US $697.85 to US $1,155.35 (35%), followed by a range from US $1,155.35 to US $1,612.85 (15%) and then from US $1,612.85 to US $2,070.35 (20%). It is important to highlight that at the time data were collected for this study the minimum salary was around US $81.35(12).

Position of the egressed students in their first, second and third jobs

In the first three jobs, the most common position found among the egressed students was of nurses providing direct care to patients (56.5%, 43.5% and 24.1%). Studies developed with egressed students from two private universities showed that this position was also the most common(12-13).

In these first jobs, the second most mentioned position by the egressed students was as an administrator (8.5%, 7.9% and 7.3%). The third most mentioned position in the first three jobs was the position as a teacher, generally in high school. The study with egressed students from a private university in Santo Amaro showed that 25% worked as teachers in high school (12). However, in a study with egressed students from a private university in the ABC of São Paulo, the authors(13) found 27.5% of the students working in these positions, which indicates good acceptance by the employers in this field towards newly-graduated professionals and/or an option for these professionals, since no previous professional experience is required.

Characterization of the fourth job

Regarding the distribution of the work field by egressed students in their fourth job, only 33 people (18.8%), out of 175 answered the study. According to them, it was observed that the hospital was the institution with the greatest insertion of egressed students (36.3%), followed by technical education (12.1%). Private institutions absorbed 54.5% of the egressed students and the city of São Paulo absorbed 63.6% of the analyzed population. The most common way to enter these jobs was through public selection exams and selective processes, both at a frequency of 3%. There was a variation in the job duration from 1 to 120 months, with a prevalence of 15.1% for the period of 36 months, even though five people (15.1%) did not provide this information. The income range with the greatest concentration of egressed students (9.68% average) was from US $1,050.00 to US $1,100.00 a month, with a variation from US $6.50/hour to US $5,000.00/month. Provided with these data, it was possible to observe that most of the insertion characteristics in the fourth job were similar to those of the first, second and third jobs.

Employment status of egressed students at the time of data collection

Most of the egressed students (70.8%) had only one job at the time data were collected. In the second position there were egressed students who had two jobs (16%), whereas only 11.4% were unemployed. Therefore, most of the studied population was inserted in the work market.

The study developed at a private university in Santo Amaro in 2003 indicated that 75% of the egressed students were employed at the time of the study; 55% had one job and 25% had two(13). At the private university in the ABC of São Paulo, in 2003, the authors(12) found 92% of the egressed students employed, 48.8% with one job and 46.3% with two jobs.

At the time data were collected, the institution with the greatest insertion of egressed students was the hospital (57.7%) and the highest average salary was at the laboratory (US $1,950.00), according to Table 5.



Similar to the analysis of the first three jobs, at the time of data collection most of the egressed students were inserted in a hospital (57.79%), followed by those who were inserted in a FHP (14.94%). There is still a tendency for nurses to work in a hospital. In addition, the ascension of the FHP is evidenced, which may be explained due to higher average salaries offered to these egressed students (US $1,750.00), exceeded only by the average salary paid by laboratories (US $1,950.00). The lowest average salary (US $387.50) was found in the technological education practice.

Facilitating points for the insertion of the egressed students in the work market

The egressed students mentioned several facilitating points for their insertion in the work market, and these were categorized and described as: facilitators related to their education, their social network, personal characteristics and others. Regarding education, they mentioned: the recognition of the name of the university where they studied (27.5%), the quality of their education in the undergraduate course (17.78%) and taking post-graduation courses (9.33). Concerning their social network, they listed: people's recommendation for a job (60%), having a good network of contacts (35%) and receiving the help of friends (5%). Regarding personal characteristics, they mentioned : having an appropriate professional behavior/attitude (25.3%), being dedicated and studious (19.71%), doing well during the selective process (14.09%) and having initiative/being pro-active (16.9%).

Others also mentioned that looking for jobs/public selection exams, specificities of the work place and the experience they acquired in previous jobs in nursing also facilitated their insertion. Few people said they do not work in the area (6.3%) and only some (8.3%) stated that nothing facilitated their insertion in the work market, which was a determining factor for abandoning the profession.

Difficult points for the insertion of the egressed students in the work market

The egressed students mentioned difficulties regarding their insertion in the work market, and these were categorized and described as: difficulties related to their education, the work market, personal characteristics and others. Regarding their education, the difficulties were: not having a post-graduation course (41.66%), the lack of professional practice during the undergraduate course (37.5%), not speaking a foreign language (28.34%) and not having extra internships (14.16%). Regarding the difficulties related to the work market, they mentioned: the lack of practical experience as a newly-graduated nurse (73.04%), the low job supply versus the high number of professionals (14.78%), not having contacts or a recommendation (3.48%) and the lack of experience in previous jobs (1.74%). Concerning personal characteristics, perceived difficulties included: not doing well in selective processes (25%), age (16.67 %), being immature (12.77%), the lack of time to carry out a work routine (13.88%), having preferences for an area (13.88%), having preferences for a location (8.34%), having critical thinking skills (8.34%) and gender (5.56%), whereas 18.3% of the egressed students mentioned they did not find any difficulties in their insertion in the work market.

These data reinforce the triad necessary for a good insertion in the work market, considering the student's education, personal characteristics and the current demands of the work market, which presents a great need for work ers and may select those who are more qualified, and who have more experience and a better education.



The development of this study allowed the authors to come to the following conclusions:

• From the 175 (37.6%) egressed students who participated in the study, most of them were female (92%), single (68.8%), Catholic (53.9%) and did not have children (85.1%) The average age was 27 years old, which varied from 21 to 47 years old, and most finished their course in 2005 (25.1%), which took 4 years (82.2%);

• 95.4% could read English well and 50.3% could read Spanish;

• There was a great demand for post-graduation courses (Lato and Stricto sensu), especially in public institutions;

• There was a fast insertion of the egressed students in the work market;

• The egressed students had a greater insertion, in their first, second and third jobs, in hospitals and in the technological education area;

• In the period of data collection, most of the egressed students (70.8%) had only one job, they were inserted in a hospital institution (57.7%) and the highest average salary was offered to those who worked at a laboratory (US $1,950.00);

• The greatest facilitators for the insertion in the work market were: taking a course at EEUSP, being recommended by other people for a job and having an appropriate professional behavior/attitude;

• The greatest difficulties for job insertion were: not having a post-graduation course, the lack of professional practice during the undergraduate course, the lack of practical experience as a newly-graduated nurse and not doing well in selective processes.

The data collected in this study allow us to consider that the facilitators and difficulties for the insertion in the work market were related to the student's education, their personal characteristics, their social network and the current demands of the work market, which may select the most qualified professionals, with more experience and a better education, due to the great supply of professionals. Therefore, the continuation of investigations is recommended, not only for obtaining a higher level of knowledge, but also for a systematized monitoring of students graduated from EEUSP.



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Correspondence addressed to:
Vilanice Alves de Araújo Püschel
Av. Dr. Enéas de Carvalho Aguiar, 419 - Cerqueira César
CEP 05403-000 - São Paulo, SP, Brazil

Received: 04/08/2008
Approved: 10/22/2008

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