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Acta Paulista de Enfermagem

On-line version ISSN 1982-0194

Acta paul. enferm. vol.30 no.6 São Paulo Nov./Dec. 2017

http://dx.doi.org/10.1590/1982-0194201700084 

Original Articles

Nursing disciplinary resources: a historical and foucauldian study

Deybson Borba de Almeida1 

Gilberto Tadeu Reis da Silva2 

Genival Fernandes de Freitas3 

Flávia Regina Souza Ramos4 

Gelson Luiz de Albuquerque4 

Igor Ferreira Borba de Almeida2 

Rosana Maria de Oliveira Silva2 

Álvaro Pereira2 

1Universidade Estadual de Feira de Santana, Feira de Santana, BA, Brazil.

2Universidade Federal da Bahia, Salvador, BA, Brazil.

3Universidade de São Paulo, São Paulo, SP, Brazil.

4Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil.

Abstract

Objective:

To analyze disciplinary resources in nursing based on the life histories of militant nurses.

Methods:

Historical research, using a qualitative approach, that was conducted with nurses who militate for professional reasons. Data were collected using semi-structured interviews, organized using NVivo 10 software, and analyzed based on dialectical hermeneutics.

Results:

The following disciplinary resources were identified: religiosity, gender, surveillance, coercion, and punishment strategies.

Conclusion:

These resources constitute a panoptic structure, and are used for domination and maintenance of the subaltern role of nurses, beginning in the educational process and moving into the labor market. Finally, this study indicates the need to review nursing education, as well as pedagogical practices, in order to favor professional formation and actions that are effectively critical, reflexive, and emancipatory.

Keywords Nursing; Politics; Leadership; History of nursing; Education; nursing

Introduction

Nursing is understood as an action or activity performed, predominantly by women, who need it to reproduce their own existence; it uses knowledge coming from other sciences, and a synthesis produced by itself, to apprehend its object of work, in what matters to the field of nursing care, aiming to meet social and health needs of the Brazilian population and keeping, therefore, an intrinsic relationship with the political dimension and its social processes.(1)

In this sense, the authors of this study chose to treat the profession in the feminine, using the terms nurses and nurse, considering that in the majority of cases, we speak about women who exercise a profession.

We understand that this area of knowledge has a close relationship with the theme of politics and social processes. This area of knowledge is involved in the technical and social division of work, both from a vertical and horizontal perspective, due to sociopolitical issues, resulting from conflicting issues that arise in nursing between physicians and nurses, nurses and patients, nurses and nursing technicians or auxiliaries, and between nursing technicians and auxiliaries.(2)

Therefore, discussing the disciplinary and power resources used to historically maintain a submissive and self-denying attitude of nurses is important, to promote reflection on emancipatory projects for the exercise of the profession.

The disciplinary training in nurses’ education can enable their submission and the (im) possibilities of counter power in the exercise of an eminently feminine profession. And, the partial understanding of power relationships during formation contributes to the reproduction of submissive professionals.(3)

The retrospective analysis of the professional aspects also enables us to identify marks of religion, gender, and social issues that have influenced, and still interfere greatly in, the practice of these professionals. These concepts can be observed in Florence Nightingale's pledge that is still used today: “I swear to dedicate my professional life to the service of humanity, respecting the dignity and the rights of the human person, exercising Nursing with awareness and dedication, keeping the secrets entrusted to me. Respecting life from conception to death, not voluntarily participating in acts that put at risk the physical and mental integrity of the human being, keeping elevated the ideals of my profession, obeying the precepts of ethics and morality, preserving its honor, its prestige and its traditions” (nursing graduation oath).

In the ritualistic oath that marks the entry into the profession, Florence Nightingale's expressions are still used today to characterize the nursing commitment as a dedication, to keep secrets without fainting, to obey, to preserve the honor and traditions, at the same time that concepts strongly linked to a conscientious, humanistic and ethical practice are followed.

Authors state that an oath takes on meaning by consecrating tradition and exercising symbolic institutional power based on the intention of the words, making visible and explicit the social divisions imposed by power. Through it, the statute of permanence is expressed to organize itself as an established group. Thus, for example, the cross is one of the most recurrent symbols of nursing, as an imaginary signature of nursing schools in the beginning of the last century, with the purpose of highlighting professionalization and evidencing the religious influence on this career.(4)

Recognizing historical roots and boundaries justifies the interest in political militancy and power relationships within the profession. In addition, knowledge gaps are identified, as demonstrated by research in the Virtual Health Library (VHL) database: the search for the term “political militancy” results in 53 studies; the “nursing” term was found only in one study on the student movement; when combined with the term, “nurse”, or the terms “political engagement and activism” were used, no publications were identified.

Due to lack of publications regarding arguments/disagreements and power within the profession - political power or militancy - the following guiding question was adopted for this study: what resources are used for nursing subjugation? The objective of this study was to analyze nursing disciplinary resources based on the life histories of militant nurses.

As theoretical support, the study is based on the Foucauldian understanding of power and the expression of disciplinary principles, materialized in an architectural design known as the Bentham Panopticon. Michel Foucault (MF) assumes this architectural figure as a mark of the disciplinary societies proposed in prisons, but applied in an expansive way in different institutions and social practices, with a view to hidden surveillance and ultimately, domination.(5)

The very understanding of power differs in Foucault, insofar as it only exists in action, it is exercised; it is not something that is owned or held, nor is it fixed, but it is a relationship of forces in multiple capillaries, which represses nature, individuals, instinct and classes. Its analysis does not take place from a theoretical and contractual perspective, but in terms of combat and confrontation.(6)

Power is revealed as the form by which, in our culture, human beings become subjects. There are, in brief, three modes of objectification that operate this transformation: the first one is determined by knowledge, the second is represented by the subjects’ domination/liberation practices, and the third is the way a human being becomes an ethical subject. (5) Thus, the analysis of subjugation resources is centered on the practices of domination.

Methods

The study was approved by the Research Ethics Committee of the Federal University of Bahia/Nursing School, under protocol CAEE n. 28775614.2.0000.5531 and followed the ethical precepts stipulated by the resolution that deals with research involving human beings. The interviewees were identified as Rosa dos Ventos (Rose of Winds), followed by cardinal numbers.

The oral history method was used, which is defined as a qualitative approach that requires an organized and rigid investigational procedure, capable of guaranteeing valid results and whose essential attention lies in the interviews. It is a recognized method to establish relationships of higher quality and depth between the researcher and the participants of the study, and in this research, the objective was to reveal the narratives as tools to see them for themselves, which are configured in a biographical type.(7)

Oral history provides the possibility of empirical approximation with historical meanings, allowing one to critically analyze the application of macrossociological theories about the past.(8)

The study scenario was the state of Bahia, Northeastern region of Brazil, where about 17 thousand nursing assistants, 60 thousand nursing technicians, and 27 thousand nurses are currently working, totaling more than 104 thousand professionals.(9)

Data were collected using semi-structured interviews with militant nurses, those officially recognized as exercising a position of the Brazilian Nursing Association (ABEn) president, and of the Union of Nurses of the State of Bahia (SEEB). Additionally, those who were socially recognized, although they did not take leadership positions to represent entities, were included, based on the following inclusion criteria: a nurse, a militate for political reasons specific to the profession, as well as for valuation, visibility, respect, and professional recognition for a period of at least one year, in a systematic, regular and socially recognized manner, covering the period of the 1980s, taking on and participating in social and public movements and mobilizations in nursing.

In the historical research, there was a need to understand the centrality of the subjects who experienced these facts, as well as to make possible the interpretations of the phenomena based on the diversity of the agents who lived through the events. Therefore, we chose to include militants recognized as entity leaders, but also those who were socially recognized, without holding the management position.

The snowball technique was used, in which the first participants contacted were the seeds, in this case, the presidents of the two mentioned entities, with positions assumed during the 1980s. Secondly these seeds indicated daughters, according to the criteria outlined above.

Among the 14 invited professionals, 12 participated in the study, with five former occupants of the (ABEn-Bahia or SEEB) presidency, and seven who were identified through the snowball technique. In this group only one man was included.

The interviews were conducted individually from July to December of 2015, by a trained professional, in a private environment, with a mean duration of 2 hours and 55 minutes, recorded and transcribed in full. There was a script of four blocks, composed of: sociodemographic issues; political militancy in nursing; process of election of the formal representatives of nursing; and life history of the militant subject.

For data analysis, the dialectic Hermeneutics method was used, based on comprehensive sociology, which contains two key aspects: the theory of experience, and reconstruction - searching for the experience of political nursing activists in the development of the phenomenon.(10)

From the operational point of view, the following steps were considered when analyzing the data: 1- level of fundamental determinations (exploratory phase of the socio-historical context of the social group, fundamental in Foucauldian studies); 2- data ordering (arrangement of the militants’ life histories); 3- data classification (data development and questioning); 4- final analysis (articulation between theoretical reference data), retaking the foundations, formulated questions and objectives.(11)

During the data ordering stage, the NVivo 10 for Windows software was used to organize portions of statements by their significance. This program is widely used in qualitative health research, including in other fields such as anthropology, and in several countries, such as Australia and the United Kingdom.

Categories and their respective subcategories were developed, as well as their vertical and horizontal syntheses, based on a comparison of the possibilities found in the NVivo software with the theoretical-philosophical framework of the study.

Horizontal syntheses are the convergences, divergences, complementarities, and differences in the participants’ statements; vertical syntheses represent the individualized analysis of the statement itself, covering all subcategories of analysis.(12)

The objectifying mode of domination and liberation practices revealed in the daily life of the militants was adopted, which made it imperative to discuss key conceptual modules, discipline and disciplinary techniques that converge towards alienation and, in another module, for liberation practices.(6)

Results

The main analytical categories were organized in order to express the resources of religiosity, gender and vigilance, coercion and punishment, according to the synthesis and excerpts selected in charts 1, 2 and 3.

Chart 1 Religiosity resources in the life history of militant nurses 

Corpus Synthesis Hermeneutics
[…] If someone came to the service, the nurse would have to stand. You did not call a teacher by name. […] On the bus it was the same thing, the teacher sat in the first chairs, and we from the middle to the end. […] The teacher could not enter the elevator if she was not the first. […] the School of Nursing had a very religious basis […] ethics of the School of Nursing was based on the precept of religion. […] but it was about the life of saints, things connected with the Catholic religion. Priests were brought to lecture in ethics classes. […] (Rosa dos Ventos 1). Religiosity resources
[…] I remember the time I was a student, I was censored because I was standing in a work environment, leaning against the wall […] at the time I was a student […] commented thus that some nurses felt like St. Peter, had a bunch of keys that was in their hands and that only they could open, take, take that material and something like that. […] (Rosa dos Ventos 5). […] (the director) she used to bribed, bribed people and made threats, with me the threats were like this: every time […] we went to meetings with her, she began to cry, she became be fragile (She) […] bribed the poor, but with me, for example, she began to cry, can you think about that? The dean of the nursing school crying, why are you doing this to me? […] Then I replied, […] I am not here as your friend I do not like or dislike you; the question is not personal. I am here as president of the student union, bringing the claims of students […] (Rosa dos Ventos 6).
[…] you do not have to feel like a criminal for charging to take care of someone … the influence of the Catholic Church, where the nuns’ work was indirectly charged for, and the economic value of nursing work was not established, generated a rather submissive, accommodating category, with moments of sporadic militancy. […] the religious question […] brought several problems and I would cite just two: submission and subalternity because most of them worked in exchange for a place to live and for generosity, it is not by chance that today it has the angelic symbols. […] (Rosa dos Ventos 10).
[…] [about choosing the candidates for Association president] things were something like this: Look, we had a conversation and we think it's better that, at this moment, you should not be the president, we already have the president, It must be So- and-So (pause), she is more calm, more moderate […] (Rosa dos Ventos 4).
[…] the choice of who will be part of the board was the choice of someone, who had a sponsor […] if you join the board it is going to be good. And so the board was formed. […] (Rosa dos Ventos 11).

Chart 2 Gender resources in the life story of militant nurses 

Corpus Synthesis Hermeneutics
[…] the director cleared the school of unwanted people, for example, she offered courses in medicine, dentistry to the boys, the few that appeared […] only (one) remained here […] (Rosa dos Ventos 6). Gender resources
[…] We are about more than 80% of female workers in the field nursing work. how can we not participate in the feminist movement? […] Historically, women were morally devalued, socially, and their work was economically devalued. […] (Rosa dos Ventos 9).
[…] Nursing has expanded; today we have family health groups, and even still, the nurse has the preponderant role in family health, but her salary is always lower […] is lower because she is a woman and lower because she is a nurse […] (Rosa dos Ventos 4).
[…] As a manager in my house, I am a manager in the hospital. Just as I obey my husband, I obey the doctor inside the infirmary, right? So the relationship I have with a patient is my little boy, my dear […]. And the auxiliaries and technicians are my employees […] Why do you have in association a lot of women and in the council a lot of men? It is linked to money; it is linked to power […] (Rosa dos Ventos 10).
[…] then I think that we managed the association as if we were a domestic administration. Do you understand? […] (Rosa dos Ventos 2).

Chart 3 Resources of vigilance coercion and punishment in the life history of militant nurses 

Corpus Synthesis Hermeneutics
[…] because if you take the nursing communications itself, even the Brazilian Nursing Journal itself, you will see that many papers, i.e., the State was an entity that you could not say anything about. It's a paternal one, do you understand ?! […] (Rosa dos Ventos 4).
[…] the assembly of delegates (from ABEn) was a “horror” in terms of authoritarianism; difficult people who did not agree with what was being talked about and expressed and… […] Enough to say that there was a delegation whose president ruled the state delegates’ voting: she got up and turned with her finger up, so everyone in her delegation knew she had to get up and vote yes […] (Rosa dos Ventos 5).
Surveillance, coercion and punishment resources.
[…] I used to occupy the 7th floor on the side [Nursing students who were at risk of arrest at the time of the Military Dictatorship] […] the police surrounded the school to capture us […] then we were in total silence, turn off all the lights of the school, understand? And I remember that we were crouching… we took some books and documents from the movement, which we then burned […] (Rosa dos Ventos 4).
[…] [speaks as the teachers saw him] I was seen … as a communist […] as a person, termite or noxious element that contaminated the rest of the group. […]most of the teachers were only technical, competent, if they said they were politically neutral, as if this were possible. I have always been called a communist as a student and later as a school teacher. Some things I was unable to attend. […] I experienced this situation where there was a resurgence of political militancy … a brake … in face of the repression situation, torture and murder of some militants (I lost friends). In Bahia, some students of the nursing school […] [speaks of the murder of Edma and Marcos] remember the meeting called by ABEn-BA in June or July of the year they were murdered to discuss the situation of the system. Some national leaders participated. Edma and Marcos were present and on this occasion he told me that he was threatened with death, and in September, if I'm not wrong, they were murdered. […] the COFEN president at the time of the denunciations had, at certain moments, police security. The symposium we did in Santa Catarina, I believe it was in 1999, we had to have police security, we were only going to the meeting place with the police in front of us, to get there, afraid […] (Rosa dos Ventos 10).
[…] Another thing like this, there was the issue of the time of our arrival (she refers to leaving the nursing residence) was scary; people lied, to go out every weekend we used to say that was a birthday of someone, I invented birthdays at the house of many people, because I could not leave, then I had to be there at the established time. […] At that moment I was doing a master's degree in São Paulo […], we started to work […] because we wanted the ABEn… And we won the election of São Paulo. And we also made a lot of changes in São Paulo, I practically had to leave my master's degree, I was invited to go back to Salvador […] after I was appointed (again) to ABEn Nacional […] I was already doing my doctorate. So I was also called several times, by the coordinator of the course, […] always harassing me as a person who militated in ABEn as if it were a crime. […] (Rosa dos Ventos 11).

In this category (Chart 1) we identify the resource of religiosity, with a discipline-mechanism that includes strategies for good training. Some of these resources are used in the regional processes of disciplining schools, armies, prisons and hospitals: the distribution of individuals in space, activity control, perpetual surveillance, normalizing sanctions, and recording of observations; nursing is another example of this type of strategy.(13)

From the conceptual point of view, disciplinary procedures interfere more in the processes of the activity than in its results. In the constant assertion of forces, such procedures impose a docile reaction, being initially applied in convents, training of the armed forces, and in prisons.(13)

For other authors, religion occupies a privileged place in the history of Brazilian nursing, to the extent of being a voice in the formulation of thought, and in the consolidation of attitudes that influence the education and professional practice of nurses and nursing auxiliaries.(14)

The discursive statements of Rosa dos Ventos 1, 5, 6 and 10 point to very characteristic experiences of the religious sphere: hierarchy, charitable work, and centrality in the control of behaviors. Habits that refer us to personality characteristics of a nun and mother superior, at times, and at others to coercive policy, also existing in these spaces.

As with priests or nuns of the Catholic Church, the teacher should be treated well, as hierarchically superior and different from others, since this posture contributed to keeping active the resources of good training.

Hospitals and schools were treated as fertile ground for spreading Christian ideals, and an efficient way to achieve this goal was to maintain control of both the person receiving care and the workers, as well as modern nursing led by Florence Nightingale was grounded in Christian presuppositions, where sanctified care exercised by these women was part of religious identity.(15)

Disciplinary power is a power that, instead of appropriating and withdrawing, has as its main objective training to withdraw and to appropriate of the other, reducing its forces, taking the other at the same time as an object and as an instrument of its exercise, by means of simple instruments: the hierarchical look, the normalizing sanction, and the examination.(5)

It is worth emphasizing that the aforementioned experiences occur in educational spaces, and are centralized in the behavioral aspects, moral and religious rules that are consubstantiated by the findings highlighted in the Foucauldian studies, which defend the thesis of the school as a space for disciplining the subjects.

Another aspect, revealed in the words of Rosa dos Ventos 4 and 11, are related to the formation of slates for the association president, and showed that an analysis of the profile was necessary, which means, being a calm and moderate person, a profile very characteristic of a nun, and one that establishes good relationships with the hegemonic group, also characteristic of the rites of indication to mother superior.

When analyzing the repercussions of this training on nurses’ professional lives, one can understand the effect of the process of training, both in the historical aspects of nursing student housing, and in the attribution of value to nurses’ work, which demonstrates the embarrassment of charging for professional practices centered on morality, hierarchy, and vigilance.

These findings converge to allow us to understand the religious implications in the political dimension of the nurse, as they are seen as angels who do not have their own power, but only that which is delegated. Relationships based on hierarchy and submission are expressed, which are expressed in the social and technical division of labor: an aspect that will be discussed in another subcategory.(14)

In this block of results (Chart 2), we highlight the resources linked to gender, understood here as a historical, plural construction, permeated by social and historically constructed delimitations on the feminine and the masculine. The plurality idea would imply admitting not only that different societies would have different conceptions of man and woman, but that within such a society such conceptions would be diversified according to class, religion, race, age, and other concepts.(15)

The statement by Rosa dos Ventos 6 expresses the predominantly feminine profile of the School of Nursing, and that selection was essentially directed at women; the men, when they insisted and obtained approval in the vestibular, were invited to other courses, mainly dentistry and medicine.

Another study indicates that the activities initially under the responsibility of nurses were historically characterized as work to be performed only by them, using several arguments: natural impulse of the woman, related to the maternal instinct, that which would have more concern with the conservation of the species. (16) Such a relationship is, in fact, a social-historical construction, in which caring for people was assigned to women because it was believed that it was unnecessary to have to learn this. Thus, it served to occupy the women with tasks considered to be of less social value, considered as subsidiaries to those of the man, characterizing the disqualification of the feminine.

The nuns played an important role in the development of female labor, for in the famous boarding-houses of the nineteenth century, women worked under their control, and they were specially trained to exercise the factory discipline.(12) From this perspective, considering the religious influence and the social role of women of that time, it is observed that nursing work was designed to be feminine, submissive, vocational, and devoid of social and voluntary value.

As for the scope of the nurses’ work, the statements of Rosa dos Ventos 4 and 9 display the fragile social value of women's and nurses’ work. The statements from Rosa dos Ventos 2 and 10 portrayed the manner as nurses developed their role, based on that which was developed in the domestic sphere, whether in the hospital or in the association, which reveals a feedback posture: what they expect me to do, and what I do.

This study indicates that the expected activities for the nurses’ responsibility were considered as women's work, including several arguments: due to an impulse of the woman who is identified as having a maternal instinct, and an instinct for species preservation, even in irrational animals.**

Consequently, from the political point of view, nursing presents some limitations, among which are: the conflict between two perspectives in the nurses’ education - one linked to the idea of preparing professionals who are submissive to the professional exercise, and another to favor a new culture in the profession, of a nursing working class that was harshly expropriated from the participatory class awareness, militant, necessary to confront the labor market, the collective nursing worker as a form founded by capitalism to keep the labor force's low wage levels, and female segregation in nursing as a historical fact, in the education of women, and by extension, of nursing workers, ideology that propagates that the nurse must be someone disciplined, obedient, who does not criticize society, but who consoles and helps society's victims.(17)

These highlights, despite their multiplicity, are structured around the social conception of being a woman, and her work value, demonstrating the determinations that expropriate the militancy or political engagement of the formation and the social identity of the nurse.

These limitations contain the intentions of the why nursing is born determined to be feminine, with practical eminence, especially collective, linked to social and economic determinants that define the social and technical division of work in nursing.

Finally, taking up the idea of subject, with a view to Foucauldian thinking, there are three modes of objectification that transform human beings into subjects: the first is the mode of investigation, which attempts to achieve the status of science. The second is the objectification of the subject in the divisive practices, and the third is the manner in which a human being becomes a subject.(18)

In the same way that practices define the nurse, the actuation and political participation of nurses can redefine their practices; enough that they become and recognize themselves as subjects of the profession they have chosen and, for that, a political, critical and reflexive formation is necessary to operate the decision processes.

Another category (Chart 3) revealed in this study was the resources of surveillance, coercion, and punishment, represented in the Foucauldian theoretical framework as disciplinary devices, present in the statement of Rosa dos Ventos 5, 4, 10, 11, explaining the existing practices in undergraduate and postgraduate training spaces, at ABEn and COREN (Regional Council of Nursing - Conselho Regional de Enfermagem-COREN) at the time, a political representation entity of the profession.

The discursive statements of Rosa dos Ventos 4 and 5, dealing with the coercion of those who participated in the ABEn, is also described in the Foucauldian studies, when it points out that the widespread panopticism operate a machine which is, at the same time, immense and tiny, and which sustains, reinforces, multiplies the asymmetry of powers and makes vain the limits that have been traced. The tiny disciplines, the panopticism of every day, may be below the emergency level of the great apparatus and the great political struggles.(19)

On the other hand, the appeal to fear is exemplified in the statements of Rosa dos Ventos 4, 10 and 11, addressing graduation training spaces at the postgraduate level, reinforcing the central thesis of the study that training spaces often have a policy of inhibiting militants.

In this direction, Foucault exemplifies the penitentiary as a space of multiple functions to exercise vigilance, automatic control, confinement, solitude, forced labor, and instruction by means of managing fear. We can then speak, on education of a disciplinary society, in this movement that begins with closed disciplines, a kind of social “quarantine”, to the indefinitely generalizable mechanism of panopticism, in whcih the housing for undergraduate nursing students presents a panoptic possibility.(19)

Another feature revealed in a statement by Rosa dos Ventos 4 is about the military dictatorship, and how fear and coercion of the subjects in the student movement was established during that time, which may have generated the current implications for minimal participation in movements, and politically disinterested.

Finally, all manifest phenomena are in some way connected with the symbolic domination developed by the desire to dominate the suppression of subjectivity of one to another, always with more structured and apparently more legitimate knowledge. It should be emphasized that, for the alienation or submission of one over another, it is necessary to understand two simultaneous movements: the mystification of the knowledge of some, and the disqualification of the knowledge of others, who will come to believe themselves to be heteronomous in their processes of living, getting sick, and learning.(16)

This study has limitations related to the lack of generalizability of qualitative research, with comprehensiveness and historical methodology. Additionally, it deals with people developed socially and historically, and who are influenced by that time.

Conclusion

Several Foucauldian resources were used for domination and to guarantee subalternity of nurses, beginning in the formative process, carried through to the labor market and representative entities of the profession, especially the stereotypes implanted socially for political militancy, which characterize a certain impropriety of such practice.

Thus, by designing the Panopticon as a set of devices that allow efficient surveillance and social control, disciplinary and subordination resources were identified, with an emphasis on religiosity, gender, vigilance, coercion, and punishment. In the field of disciplinary aspects identified in nursing, which demonstrate the relationships of power, between instituted and instituting, which is the architectural model of the Panopticon, represented by the housing of undergraduate nursing students at the time, and the use of these disciplinary resources present in the training practices, the world of work and the way of conducting representative bodies and Council.

Based on the dialectical hermeneutic analysis, it is concluded that some divergences are present in the school role, when this is identified as inhibiting political activism, and in the ABEn role, when the management practices are not very participative and also not very democratic, in the scenario in which the participants developed their identities as militant professionals. At convergences, when internal coherence of results was intended, the use of disciplinary resources, religiosity, gender, vigilance, coercion, and punishment in the Brazilian Nursing Association and in the world of work was identified.

Finally, this study indicates the need to review nursing education as well as pedagogical practices, with the purpose of favoring critical and emancipatory critical citizen formation and actuation, which is in fact committed to the legitimate and current purposes of Brazilian nursing.

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Received: November 07, 2017; Accepted: November 27, 2017

Corresponding author Deybson Borba de Almeida Av. Transnordestina, S/N, 44000-000, Feira de Santana, BA, Brazil. deybsonborba@yahoo.com.br

Conflicts of interest: There are no conflicts of interest to declare.

Collaborations

Almeida DB, Silva GTR, Freitas GF, Ramos FRS, Albuquerque GL, Almeida IFB, Silva RMO and Pereira A contributed to the study design, analysis, data interpretation, article writing, relevant critical review of the intellectual content, and final approval of the version to be published.

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