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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.spe2 São Paulo Dec. 2009

http://dx.doi.org/10.1590/S0080-62342009000600025 

ORIGINAL ARTICLE

 

Pleasure and suffering in the work process of the faculty nursing

 

Placer y sufrimiento en el trabajo del enfermero docente

 

 

Elaine Maria FerreiraI; Maria de Fátima Prado FernandesII; Cláudia PradoIII; Patricia Campos Pavan BaptistaIV; Genival Fernandes de FreitasV; Bárbara Barrionuevo Bonini VI

INurse. Student of the Master's in Nursing Program at School of Nursing, University of São Paulo. São Paulo, SP, Brazil. elainemogi@yahoo.com.br
IINurse. Ph.D. Professsor. Department of Professional Guidance at School of Nursing, University of São Paulo. São Paulo, SP, Brazil. fátima@usp.br
IIINurse. Ph.D. Professsor. Department of Professional Guidance at School of Nursing, University of São Paulo. São Paulo, SP, Brazil. claupra@usp.br
IVNurse. Ph.D. Professsor. Department of Professional Guidance at School of Nursing, University of São Paulo. São Paulo, SP, Brazil. pavanpati@usp.br
VNurse. Ph.D. Professsor. Department of Professional Guidance at School of Nursing, University of São Paulo. São Paulo, SP, Brazil. genivalf@usp.br
VINurse. Student of the Master's in Nursing Program at School of Nursing, University of São Paulo. Holder of a FAPESP fellowship. São Paulo, SP, Brazil. barbarabbonini@gmail.com

Correspondence addressed to

 

 


ABSTRACT

This is an exploratory and descriptive qualitative approach, which includes feelings that go through the work process of nurses in three private universities in the city of São Paulo, revealing rich experiences of know-how meanings in the teaching practice. Thus, this research aims to identify the causes of pleasure and suffering in the work of the faculty nursing, and analyze then according to Christophe Dejours' theory, pointing the importance of psychosocial factors in relation to the studied object. The results of the research point to the ambiguous relationships present in the work process of facultys, expressing pleasure and suffering resulting from the practice and showing the conditions and organization of work as elements that enhance these feelings in the daily work of nurses in these institutions.

Key words: Faculty. Faculty, Nursing. Teaching. Education, nursing.


RESUMEN

Se trata de un estudio exploratorio y descriptivo, que comprende los sentimientos que pasan por el proceso de trabajo del enfermero en tres universidades privadas de la ciudad de São Paulo, mostrando experiencias ricas de significados del saber hacer de la práctica docente. Así, el presente estudio tiene como objetivo identificar los aspectos generadores de placer y de sufrimiento en el proceso de trabajo del enfermero docente, analizados según el referencial teórico de Christophe Dejours, señalando la importancia de factores psicosociales en relación con el objeto de estudio. Los resultados de la investigación apuntan para las relaciones ambiguas presentes en el proceso de trabajo de los docentes, expresando sentimientos de placer y sufrimiento derivados de esa práctica y evidenciando las condiciones y la organización del trabajo como elementos que pueden potenciar estos sentimientos en el cotidiano del trabajo enfermero en estas instituciones.

Descriptores: Docentes. Docente de Enfermería. Enseñanza. Educación en enfermería.


 

 

INTRODUCTION

With the studies by the French psychiatrist Cristophe Dejours about suffering according to the psychopathology of work, it can be said that

satisfaction at work is associated to the workers' health, in the aspects of `mental health' and `working capacity', showing the importance of psychosocial factors in relation to pleasure and suffering at work(1).

Such a reference supports normalcy as being the psychic balance between embarrassment by unstable or pathogenic work and psychic defenses, where balance is the result of a regulation that requires defensive strategies, elaborated by the professionals themselves(2).

In this aspect, work is an activity that, from a human viewpoint, implies know-how, the mobilization of intelligence, the ability of reflecting, interpreting and respond to situations; it is the ability of feeling, thinking and inventing. In other words, work is not, primarily, a salary-based relationship or the job, but a mode of social insertion with the extraordinary ability of revealing subjectivity, as long as it is qualified; or the ability of destroying subjectivity, when it is not qualified, repetitive and lacking meaning. Well-being is related to the idea of a pleasurable environment. Therefore, when performed in such an environment, the professionals will naturally enjoy the product of their work. Suffering at work is understood as the struggle that occurs in the space between well-being and a mental disease or madness(3-4).

When we analyze the working process in the nursing field, several studies reporting the suffering of nurses in hospitals are worth noting, considering the demands of such a wearisome work, especially due to the proximity of suffering, pain and death(5-6).

More recently, concerns about suffering in the nurse's work have reached the university environment, revealing conflicts and demands in the roles of nurse, teacher and researcher. Therefore, the interest in developing this study arises from the researchers' experience as university teachers, where the plethora of tasks, allied to the demands of educational practices makes up an antagonistic routine of pleasure and suffering at work(7).

Studies in the nursing education field in private universities have reported that when the professors develop their daily actions in the educational practice, they are shown to experience distinct feelings that encompass satisfaction, pleasure, achievement and ease to perform their work. However, problems regarding salaries, working conditions and difficulties in submitting to certain organizational criteria are also observed, and deserve a more in-depth investigation(7-9).

Therefore, this article is relevant as it exposes, synthetically, part of the Dejourian thinking about pleasure and suffering at work, a theme that is ubiquitous and linked to the reality of doing nursing due to the impact that professional satisfaction at work can have in the life of the individual and because it has not been sufficiently studied in the fields of healthcare and education.

 

OBJECTIVES

To identify the aspects that cause suffering and pleasure in the working pleasure of the faculty nurse.

 

METHOD

This is an exploratory, descriptive study with a qualitative approach. The study was performed in three private University Nursing departments, located in the city of São Paulo. The inclusion criteria to select subjects demanded them to have been linked to the institution for at least three years and holding a Ph.D degree. Therefore, six faculty nurses took part in the study.

The present study was approved by the review board of Federal University of São Paulo (file #1539), and the subjects provided written consent. The interviews were held by one of the researchers in October/2007, using the following guiding question: Which are the aspects that cause pleasure and suffering in your working process as a faculty nurse? The interviews were ended when the study object was responded to, according to literature(10). The responses were recorded in audio and the respondents had their names changed in order to preserve their anonymity.

Bardin's content analysis technique was used to analyze the responses, organized in three phases: pre-analysis (floating reading and data preparation), exploration of the material and treatment of results and interpretation(11). This method produced registry and content units, obtained with the analysis and selection of aspects that cause pleasure and suffering in the work of the faculty nurse, which expressed meaning and consonance with the study object.

 

RESULTS AND DISCUSSION

According to the Dejourian reference, the discourses were analyzed in an attempt to apprehend the aspects that cause pleasure and those that cause distress in the faculty-related work. As such, the analysis of the discourses made it possible to formulate two categories: Feeling pleasure at work and feeling distress at work. They will be explained next.

Feeling pleasure in the daily working routine

This category reveals that the work of the faculty nurse has positive components that bring satisfaction and pleasure, where they feel responsible for the education of the students. Therefore, the reports show aspects that are present in the daily routine and that make their work meaningful:

The students motivate me. They're my greatest reason. A well-done paper, a lecture where they ask questions, when you realize you made them think; a lecture that they enjoyed, or that they didn't, but they come to you to ask questions, to discuss, or to get more material (Amélia).

It's very pleasant to work with the students, and I regard them highly because our public is the working students. Nowadays they have jobs, sometimes they have two, and they seek to improve their knowledge. I respect this student profile because I experience with them the difficulties of handling family, jobs and the college. You see that they are struggling students, but, on the other hand, they are hard-working and creative… that satisfies me immensely (Márcia).

The excerpts of the discourses show the teacher-student relationship as a refreshing point in the working process, since the teachers feel that they are committed to building knowledge and the students respond with trust, interest and creativity.

Because of its peculiarities, nursing education usually happens in an environment where the educational phenomena are performed within a complex relationship, since, in addition to teachers and students, the figure of the patient is also present. This occurrence implies that the student should also be instructed in ethics, in addition to the technical and scientific education. That would require the teacher to assume this function in a competent way, focused on social transformations(12).

Students' acknowledgement regarding the work performed is a factor that influences the beneficial aspects of the profession, i.e., the faculty nurses report satisfaction in the teaching-learning relation, where pleasure is made evident not only by their creative capacity, but by the students' acknowledgement, as shown below:

And being recognized: when I go to hospitals, there's always an ex-student that we often can't remember the name, and he always recognizes us. That's really rewarding (Joana).

The Dejourian school highlights that inventiveness, cooperation, trust and the feeling of social utility are essential aspects in the feeling of pleasure at work (4). As such, by seeing themselves as part of the process of building a new professional, the faculty nurses manifest feelings of pleasure at work:

It means seeing that the beginning undergraduate student in this institution is later admitted in several admission tests, they are called to work in this institution and others, and therefore we can see a general renewal of the nursing professionals. That and seeing the term papers of students being approved for presentations in congresses, international events… I think that's the response expected from our professional commitment (Luísa).

It is worth noting that the well-being in the working process does not stem only from the absence of work - on the other hand, it stems from freedom, being dialectically articulated with the task contents, which are, in turn, expressed in the task itself and thus renewed(4).

For the teachers, it should be observed that the diversity of tasks, contact with people and the process of elaborating a lecture represents an opportunity to exercise their creativity and autonomy, becoming a relevant component of the meaningfulness of the tasks, as shown below:

Fortunately, each lecture is a new challenge. If you're the kind of teacher that has been doing the same lecture for the past ten years, that's how far you get and that won't work. Each group is different, each lecture is different. I have eight groups nowadays and the challenge of presenting the same lecture eight times in different ways, according to the characteristics of each group, is delicious (Sônia)

The fact of being able to work in theory and practice is rewarding… being able to relate to the patient and communicate with people. When you're a teacher, the situations are very diverse, when a group is compared to another; even if you focus on a given topic, it will always feel like new because different people take part in it. I really like it! (Paula)

Working is not equal to simply producing. It means living together. Therefore, work is the irreplaceable opportunity of learning how to respect another, trust, living together, solidarity and how to contribute for the construction of working rules that are not absolutely limited to technical rules, but social rules that may favor the pleasurable aspects at work.

Feeling distress at work

The reports about the category bring the negative aspects that are present in the organization of work and that cause distress to the faculty members. The division of tasks, hierarchy, command and lack of autonomy are important aspects in the process of suffering at work. Pressures related to the working conditions focus mainly the group of professionals, where they can cause stress, early aging and somatic diseases(4).

The only thing that bothers me in faculty is seeing the students' lack of interest. Their responsibility towards their professional future and knowing what they will be required to do. They must have this knowledge; they must know how to provide good care to their clients. Then, when I see that a student is not interested, who does not study, who depends only on the theoretical aspects that they are taught, this is the greatest cause of distress for me (Amélia).

As such, literature has demonstrated certain difficulties, such as working undergraduate students with particular characteristics such as time constraints due to a busy routine, meaning that their professional activities take up most of their time(13).

… in private colleges, nowadays, the students have the final word on which teachers stay and which are fired… it's weird, a strong inversion of values… (Sônia).

When the student is not very interested in what I have to say, or when he doesn't see any value in what I'm trying to teach (Luísa).

The students' lack of interest is an important factor in the working process, as it is capable of causing suffering, since the teacher is committed to the construction of the professionals and feels that his or her role is undervalued.

The common working situations are permeated by unexpected events, burnouts, incidents, organizational incoherence, unpredictable events that stem from the curriculum, the tools and machines, and also from other workers, co-workers, bosses, employees, teams, the hierarchy and clients (2). Therefore, the institution, in its formal aspect, is also loaded with elements that cause distress in the daily routine of the teacher, as shown below:

We know that there are some restrictions beyond the institution, in terms of physical structure, equipment and such… but we try to keep an honest and frank relation (Joana).

… the bureaucratic demands of the college. As such, there are things to be done at home, process evaluations… there's always paper to be filled out. For example, we've been asking the school to implant a computerized grading system, which would make it easier for us. We still don't have it, so you need to fill in the grades in the book, one by one… (Sônia).

Studies performed with teachers show the difficulties that are inherent to the organization, such as the existence of groups with many students, lack of resources, difficulties for the participation of students, inadequate number of hours for a given class subject, among others(9).

The organizational pressure, instability regarding hourly loads and the need of holding a job are another cause for the teachers to feel distress at work, as shown below:

Regarding the educational institution, one of the things that happen on occasion is the turnover of teachers because of their salaries. The teacher often holds a title, but is at risk of being laid off because the institution considers that his or her salary is too high. That is discouraging, because, as teachers, we need to study and update, and later these new titles turn against you (Paula).

What really makes me sad and insecure is that there is no fixed hourly workload. The course is based on semesters, and you never know what will happen next semester in terms of hourly load. It's not a fixed hourly load, and it's not for a year, it's for six months only. So, now we're already concerned about what will happen next semester and how many working hours we'll be assigned (Joana).

The situations presented by the teachers reveal that suffering has an important relation with the organization of work, understood as the division of work, hierarchy, relations of power and command, the objectives of the organization and which of them reflect in the workers' health(3).

Therefore, the culture of a given organization supports the process of socialization with the system of values, as these values are experienced as a shared subjectivity, which aims to meet the organizational objectives and the individuals' needs(14).

As such, autonomy is indispensable for a rewarding and pleasurable working routine. When teachers are not allowed freedom to create, this causes suffering:

As a private institution, we teachers do not have much freedom, time for research or for teachers' meetings in order to discuss the type of education that we have to develop (Márcia).

The difficulties that are inherent to interpersonal relations are also important for the suffering, as this is a space for interacting and socializing with peers. When it does not occur, suffering is reported:

Those are the difficulties in relations with the peers. I don't know if that happens because of the female gender, but it's very difficult to work in a place full of women. I don't know what happens… there's a lot of competition, which is often unfair. You can see the backstabbing clearly. The only reason I keep working in this institution is the great support I have from management. I saw the same things in other places I used to work, but, since those institutions were larger, the problems were more diluted. Not here. Here, the place is small, few teachers and there are even fewer that you can have a closer relation. Professional relations are very complicated; the tasks you have to do are blocked by ridiculous reasons. Unnecessary difficulties and bureaucracy are created for the approval and publication of articles, for example (Amélia).

As such, it is possible to observe the antagonistic relationships in the working process of faculty nurses, which shows that the working conditions and organization can interfere and intensify situations of suffering and pleasure. The plethora of activities, the institutional demands, the difficulties in relationships among peers and the students' profiles in private universities are important elements in the apprehension of the working process of faculty nurses.

 

FINAL CONSIDERATIONS

The conclusion of the present study made it possible to identify the aspects that generate pleasure and suffering in the working process of the faculty nurse. The teacher-student interaction, the commitment with educational activities and professional education are important elements in the feelings of pleasure at work, as they allow the teacher to exercise his or her creativity and attributes a social meaning in the activity. Suffering arises when there is no articulation between the commitment of the teacher and the student, marred by the lack of interest or commitment. It should also be observed that there are important issues related to the organization of work and interpersonal relationships, which intensify the suffering at work.

 

REFERENCES

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Correspondence addressed to:
Elaine Maria Ferreira
Dr. Enéas de Carvalho Aguiar, 419 - Cerqueira César
CEP 05403-000 - São Paulo, SP, Brazil

 

 

Received: 09/15/2009
Approved: 11/13/2009

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