News analysis of nursing work in the context of the COVID-19 pandemic

Abstract

Objective

To analyze the news published in the Brazilian press about nursing work during the COVID-19 pandemic period, between February 2020 and August 2021.

Methods

This is a documentary, descriptive study with a qualitative approach. Elaborated from information collected on news sites, through clipping, following the stages of monitoring, collection, analysis and archiving of mentions of work in nursing made by the Brazilian media. The sample totaled 432 news. Data analysis was performed using the Thematic Content Analysis proposed by Laurence Bardin.

Results

The year 2020 stood out among the analyzed news (59.96%), whose characters involved were nursing professionals, female (36.57%), technical (38.89%) and higher (38. 43%). There was a predominance of news in the Southeast (45.83%) and Midwest (17.36%) regions. Six categories were identified for data analysis: deaths among workers (40.74%), precarious working conditions (28.94%), vaccination (8.56%), contamination of workers (8.33%), suspected of ethical infraction (8.10%) and COVID-19 cure (5.32%).

Conclusion

The COVID-19 pandemic in Brazil brought nursing work and workers to the center of journalistic debate. Death, precarious working conditions and contamination of nursing workers, reported in the press, are related to the precariousness of nursing work in this study. It is conjectured that the journalistic debate on nursing work in the COVID-19 pandemic helped to strengthen political guidelines, such as the one that led to the enactment of Law 14,434/2022, which deals with the national wage floor for these professionals.

Mass media; Pandemics; COVID-19; Occupational diseases; Working conditions; Nurse practitioners

Resumo

Objetivo

Analisar as notícias veiculadas na imprensa brasileira sobre o trabalho em enfermagem no período da pandemia da COVID-19, compreendido entre fevereiro de 2020 a agosto de 2021.

Métodos

Estudo documental, descritivo, de abordagem qualitativa. Elaborado a partir de informações coletadas em sites de notícias, por meio de clipping, seguindo as etapas de monitoramento, coleta, análise e arquivamento de menções ao trabalho em enfermagem feitas pela mídia brasileira. A amostra totalizou 432 notícias. A análise dos dados se deu pela Análise de Conteúdo Temática proposta por Laurence Bardin.

Resultados

O ano de 2020 destacou-se dentre as notícias analisadas (59,96%), cujos personagens envolvidos foram profissionais da enfermagem, do sexo feminino (36,57%), de nível técnico (38,89%) e superior (38,43%). Houve predomínio de notícias nas regiões Sudeste (45,83%) e Centro-Oeste (17,36%). Foram identificadas seis categorias para análise dos dados: óbitos entre as trabalhadoras (40,74%), condições precárias de trabalho (28,94%), vacinação (8,56%), contaminação das trabalhadoras (8,33%), suspeita de infração ética (8,10%) e cura da COVID-19 (5,32%).

Conclusão

A pandemia da COVID-19 no Brasil trouxe o trabalho e as trabalhadoras da enfermagem para o centro de debate jornalístico. O óbito, as condições precárias de trabalho e a contaminação das trabalhadoras de enfermagem, veiculadas na imprensa, relacionam-se com a precarização do trabalho em enfermagem neste estudo. Conjectura-se que o debate jornalístico sobre o trabalho em enfermagem na pandemia da COVID-19 ajudou a fortalecer pautas políticas, como a que conduziu à promulgação da Lei n. 14.434/2022, que trata do piso salarial nacional para essas profissionais.

Meios de comunicação de massa; Pandemias; COVID-19; Doenças profissionais; Condições de trabalho; Profissionais de enfermagem

Resumen

Objetivo

Analizar las noticias difundidas en la prensa brasileña sobre el trabajo de enfermería en el período de la pandemia de COVID-19 comprendido entre febrero de 2020 y agosto de 2021.

Métodos

Estudio documental, descriptivo, de enfoque cualitativo. Elaborado a partir de información recopilada en sitios web de noticias, por medio de clipping, siguiendo las etapas de monitoreo, recopilación, análisis y archivo de menciones del trabajo de enfermería realizadas por los medios de comunicación brasileños. La muestra totalizó 432 noticias. El análisis de los datos se realizó mediante el análisis de contenido temático propuesto por Laurence Bardin.

Resultados

El año 2020 se destacó entre las noticias analizadas (59,96 %), cuyos personajes involucrados fueron profesionales de enfermería, de sexo femenino (36,57 %), de nivel técnico (38,89 %) y superior (38,43 %). Hubo un predominio de noticias en la región Sudeste (45,83 %) y Centro-Oeste (17,36 %). Se identificaron seis categorías para el análisis de datos: fallecimiento entre las trabajadoras (40,74 %), condiciones de trabajo precarias (28,94 %), vacunación (8,56 %), contaminación de las trabajadoras (8,33 %), sospecha de infracción ética (8,10 %) y cura de COVID-19 (5,32 %).

Conclusión

La pandemia de COVID-19 en Brasil colocó el trabajo de enfermería y sus trabajadoras en el centro del debate periodístico. Los fallecimientos, las condiciones de trabajo precarias y la contaminación de las trabajadoras de enfermería, difundidas en la prensa, se relacionan con la precarización del trabajo de enfermería en este estudio. Se presume que el debate periodístico sobre el trabajo de enfermería durante la pandemia de COVID-19 ayudó a fortalecer debates políticos, como el que llevó a la promulgación de la ley n°. 14.434/2022, que trata sobre el salario mínimo nacional para estas profesionales.

Medios de comunicación de masas; Pandemias; COVID-19; Enfermedades profesionales; Condiciones de trabajo; Enfermeras practicantes

Introduction

On March 11, 2020, due to the worrying levels of spread of the SARS-CoV-2 virus and its transmissibility, the WHO declared COVID-19 to be a pandemic. The virus spread rapidly around the world and brought challenges and consequences for all social segments, especially for health systems that began to deal with high demand and low response capacity for an unknown disease.

Depending on the demand for reliable information, the mass media or specific audiences have become an auxiliary arm of science and public health around the world. The scoping review of published meta-analyses on COVID-19 pointed to China and the United States as the largest producers of these studies, but only 8.9% of them with some degree of reliability.(¹)In Latin America, Brazil and Mexico were the main producers of scientific studies on the subject, with Chile being the largest producer of original studies.(²)A study on the media coverage of the COVID-19 pandemic in 17 countries revealed that in the first eight months there was a 6.7-fold increase in the diversity of the types of media related to the disease.(³)

As for information, a survey showed that 70% of respondents rated press’ work as excellent or good and that, in a time of fear and uncertainty, citizens tend to trust solid institutions more, accepting their reports in a less critical way.(⁴)In fact, studies were rapidly being produced, published and consumed by researchers, health professionals and the general population. However, it raised an alert about the possible fragility of fast science, the circulation of fake news and the need to broaden the nuances of scientific methods and processes to the public.(⁵,⁶)

The media role also helped to (re)construct health professionals’ social identity by disseminating facts, such as visual representations (paintings of health professionals on murals, billboards, posters, etc.), applause in gratitude for work, journalistic texts and labor demonstrations and/or tributes.(⁷)

Specifically in relation to nursing, in 2019 the World Health Assembly announced that the year 2020 would be designated as the International Year of the Nurse and Midwife, whose commemorative milestone would allude to the recognition of the work carried out by these workers around the world.(⁸)With the coronavirus pandemic, this trend has expanded and celebrations and tributes to these workers have become more visible, reaching all media globally.

The objective of this study was to analyze the news published by communication channels of the Brazilian press about nursing work during the COVID-19 pandemic period, between February 2020 and August 2021.

Methods

This is documentary, descriptive research with a qualitative approach. Developed based on information collected on news sites, through clipping, following the steps of monitoring, collecting, analyzing and archiving mentions of work in nursing made by the Brazilian media, during the period between February 2020 and August 2021, which encompasses the first five of the six phases of the pandemic in Brazil.(⁹)

The initial baseline was raised through Google clipping, using the keywords “Nursing” and “COVID-19”, with personalized time delimitation month by month. Inclusion criteria were having a national reach, being accessible via the internet, having been published within the defined period and that it addressed, in its statement and scope of episodes, the involvement of nursing workers in the pandemic context. Of the 654 news found, 222 were excluded from the sample because they were repetitions of the same fact, international news and/or not consistent with the object of this study, leaving 432 news that were analyzed (Figure 1).

Figure 1
Number of news published about nursing work in the context of COVID-19 from February 2020 to August 2021 (n=432)

Data analysis was performed through thematic content analysis,(¹⁰)according to the following phases: 1) pre-analysis: material text skimming in order to identify the meanings of the units of analysis; 2) material exploration: coding/definition of recording units, context and categorization. After defining the units of analysis, they were quantified using simple frequency; and 3) treatment of results, inference and interpretation: the results were described from a synthesis that expresses the set of meanings present in the various units of analysis, seeking interconnections between nursing work and the context of the COVID-19 pandemic. Ethical aspects such as transparency, publicity and anonymity were observed and complied with. As these are reports already published by digital communication vehicles, with free transmission, it does not involve any additional risk to the reports’ authors, the articles’ characters and the vehicles.

Results

In 2020, when the COVID-19 pandemic was decreed and when the first cases of the disease were reported in Brazil, there was a greater number of articles whose object was related to work and/or nursing workers (59, 96%) than in the following year, 2021 (40.04), as shown in Table 1.

Table 1
Characterization of news published in the media about nursing workers and COVID-19

Characteristics	n (%)
Year	259(59.96)
2020	173(40.04)
2021
Sex
Unidentified	179(41.44)
Female	158(36.57)
Male	95(21.99)
News publishing regions
Southeast	198(45.83)
Midwest	75(17.36)
North East	74(17.13)
North	30(6.94)
National	30(6.94)
South	25(5.79)
Professional categories
Nursing technician	168(38.89)
Nurse	166(38.43)
Health team	82(18.98)
Nursing assistant	16(3.70)
Thematic categories identified in the study
Deaths	176(40.74)
Precarious working conditions	125(28.94)
Vaccination	37(8.56)
Contamination of workers	36(8.33)
Suspected ethical breach	35(8.10)
COVID-19 cure	23(5.32)

When observing the publications of the articles and the media vehicles that published them, distributed in the five regions that divide Brazil, there is a predominance of productions in the Southeast (45.83%) and Midwest (17.36%) regions. Among the characters who starred in the articles, in 41.44% of analyzed publications it was not possible to identify sex, since the publications address the field of work “nursing” or the “nursing team”, without the identification of subjects. However, in the articles in which it was possible to identify the characters by sex, there was a higher frequency of females (36.57%). Nursing technicians (38.89%) and nurses (38.43%) occupied similar spaces in the analyzed news publications. The thematic analysis of the corpus of this study allowed identifying six analytical categories that are presented below in order of frequency.

Category 1 – Deaths among workers

There was a difference in the frequency of publications between 2020 and 2021. For 2020, between February and December, this study analyzed 142 journalistic articles on this topic, with emphasis from April to August (86.61%). In 2021, between January and August, 34 articles were analyzed, especially from February to May (76.47%).

Category 2 – Precarious working conditions

Thematic variation was noted in the articles in this category between 2020 and 2021. In 2020, the articles analyzed were presented in the form of denunciations of scarcity, lack of access, of questionable protocols of time of use and training for using personal protective equipment. As the months progressed, that year, the subjects presented other weaknesses in working conditions as the object of denunciation, such as lack of testing for workers, absence of necessary inputs and psychological support, undersizing of personnel, physical, mental and emotional exhaustion. In 2021, the articles published on this topic highlighted the precariousness of labor relations: low wages, delays in payments for field hospitals managed by social organizations, and also the reaction of workers: political acts, protests, stoppages, strike threats and their pressure on the Federal Senate and the Chamber of Deputies for the approval of the national minimum wage for nursing.

Category 3 – Vaccination

Of the articles analyzed in this category, 97.29% were published in 2021. COVID-19 vaccine had its use in humans authorized by the Brazilian National Health Regulatory Agency (ANVISA - Agência Nacional de Vigilância Sanitária) on January 17, 2021. On the same day, the first person to be vaccinated in the country was a nurse, in the city of São Paulo. All over the country, nursing workers were chosen to be the first people to receive the immunobiological agent, which yielded 30 (81.08%) journalistic articles in January of that year.

Category 4 – Workers’ contamination

In 8.33% of the stories, the focus of the news was nursing workers’ contamination by the SARS-CoV-2 virus, with emphasis on May to August 2020, with 22 (73.33%) stories. It should be noted that the object of debate in these matters dealt with the second contamination of these workers by the virus.

Category 5 - Suspected ethical breach

Of the articles analyzed in this category, 97.14% were published in 2021. These articles, mainly those published between February and June 2021 (91.42%), dealt with allegations of false (staged) immunobiological applications, with emphasis on the nursing techniques during the application of vaccines in older adults.

Category 6 – COVID-19 cure

Of the total articles analyzed about nursing workers who recovered from COVID-19, 65.21% were published in May and June 2020, the initial phase of the pandemic in the country.

Discussion

This study recorded a greater thematic coverage of nursing work in the media in the context of the COVID-19 pandemic in Brazil in relation to the categories found in a study with a similar method, such as political and professional role of Brazilian nursing, nursing professionals’ working conditions, vulnerability, illness and death.(¹¹)There is a predominance of media coverage in the Southeast axis, in the states of São Paulo, Rio de Janeiro and Minas Gerais, and in the Midwest, especially in Brasília, the capital of Brazil, the same result found in the aforementioned study,(¹¹)which reflects the centralized structure of the media in Brazil in the economic and political axes, respectively.

If, on the one hand, gender data in this study reveal the erasure of this identification in most of the articles analyzed, on the other hand, in Brazil, 86% of the nursing workforce is made up of women and, of this total, 53% declared themselves to be black and brown. Nursing technicians account for 77% of the workforce and 57.4% of them declared themselves to be black and brown.(¹²)It is the women who are most inserted in the formal care market and who are at the forefront as health workers, occupying the places of greatest exposure to contamination by the new coronavirus in multiple precarious and unhealthy jobs.(¹³)

In Brazil, nursing workers were the first to appear in journalistic articles because they were becoming infected and, above all, dying from COVID-19, even in the initial weeks of the pandemic in the country. The technical and social division of work in nursing is at the base of the different work processes of nurses, which is care-managerial, and of nursing techniques, which is care.(¹⁴)These professionals work with greater physical proximity to the patient, making them more vulnerable to contamination by the coronavirus.

The analysis of socioeconomic inequalities, modulated according to racial belonging, showed that among nursing workers in Brazil, black and brown nursing technicians have lower income levels and that these inequalities are greater in the poorest regions of the country.(¹⁵)

According to the Federal Nursing Council (COFEN),(¹⁶) up to September 14, 2022, 872 deaths among nursing professionals were recorded in Brazil, with emphasis on the states of São Paulo, Amazonas and Rio de Janeiro, with the lethality rate among these workers (2.29%) higher than that registered in Brazil (2%).(¹⁷) Although these data are not disaggregated by professional category, the journalistic coverage analyzed in this study reveals, however, a greater number of articles on deaths among nursing technicians.

In the background of nursing work in the context of the COVID-19 pandemic is the precariousness of work, with the generalization of insecurity and exploitation, meaning more work and lower salary.(¹⁴)Studies show that the pandemic has intensified the precarious conditions of existing nursing work, such as undersizing, increased workload, lack or difficulties in accessing personal protective equipment and material resources for care, just as it affected workers’ health, increasing mental distress due to the risk of contamination, the fear of their own death and the frequent death of patients, co-workers and family members.(¹⁵-²²)

In December 2020, the Ministry of Health published the Brazilian National Plan for the Operationalization of COVID-19 Vaccination (PNO), which appears on its priority list to preserve the functioning of health services, listing health workers as one of the main priority populations for immunization.(²³,²⁴)Initiated on January 17, 2021, immunization in Brazil took place after approval by ANVISA of the emergency use of two immunizers: Coronavac, from the Chinese laboratory Sinovac, in collaboration with the Instituto Butantã, and Astrazeneca/University of Oxford, prepared together with the Foundation Oswaldo Cruz. The meeting of ANVISA’s Collegiate Board had wide media coverage, being broadcast in real time on various communication channels throughout the country.

The first person immunized in Brazil against the SARS-CoV-2 virus was a 54-year-old black nurse, who worked as a nursing assistant for 26 years and graduated as a nurse at the age of 47. The choice of nursing workers as the first people to be vaccinated was repeated across the country, yielding coverage in various communication vehicles. This symbolic gesture, associated with wide media coverage, was received by these workers with feelings of gratitude, relief and recognition for risky work during the pandemic. From the articles analyzed, it is also noticed that the nursing technicians were the professionals who most appeared in the reports as being the first people to be vaccinated in their respective states and cities.

The symbolism of the gesture of these choices is not neutral. While a large part of the population experienced the worst phases⁹ of the COVID-19 pandemic at home, health workers were at the forefront of care services. Thus, in addition to complying with the PNO, these choices denote a movement on the part of the managers to appease the tension with these professionals, since by analyzing the media news production, during 2020, it is possible to infer a relationship between precarious working conditions and the high number of deaths among nursing workers, a hypothesis that needs to be tested.

From May to August 2020, the media focused on nursing workers who were experiencing their second COVID-19 contamination. At that moment, two arguments prevailed in the public debate, but both without scientific evidence. The first, coming from common sense, was that it would be possible after the first contamination to acquire immunity against COVID-19. Some articles raise frustration with new contamination and fear of new possibilities, which were later proven by the emergence of different variants of the SARS-CoV-2 virus.

The second, coming from the Federal Government, expressly from the President of the Republic, was the idea that after 70% of the population had been contaminated by the SARS-CoV-2 virus, “herd immunity” would be achieved. Such an argument, denied by health professionals and epidemiologists, reinforced the idea that social distancing, a measure scientifically proven to be effective in the face of the absence of vaccines and/or curative treatment for COVID-19, harmed the country’s economy.(²⁵)This argument was also denied by economists, who advocated for that moment an inevitable economic recession, that is, the reduction of consumption and production in favor of social distancing as a public health measure.(²⁶)

Despite the errant and unscientific way in which the entire COVID-19 pandemic was handled by the President of the Republic and the Ministry of Health,(²⁵)the Brazilian population looked forward to immunization. However, between February and June 2021, the object of the articles on nursing work began to have complaints and suspicions against nursing technicians who worked on the front lines of vaccination, pointing out that some of these professionals were falsifying vaccination, especially in older adults. To remedy distrust in these professionals’ work, COFEN suggested a change in the attitude of the population, encouraging reporting, and of the professionals in the immunization procedure, showing the citizen the syringe with the immunobiological agent before the application and, after, the empty syringe.(²⁷)

New studies need to be carried out to investigate whether there is an association between the findings of this research and the mortality of these workers in Brazil. The media role and its developments were also observed, such as the use of this highlight by nursing workers to strengthen the debate on political agendas, since this field of work becomes an agenda for social and political discussions only in scenarios of disasters and health emergencies. This scenario collaborated as a driving force for the approval of Constitutional Amendment 11/2022 and the enactment of Law 14,434/2022, which deals with the national salary floor for nurses, nursing technicians, nursing assistants and midwives.

Conclusion

The COVID-19 pandemic in Brazil brought nursing work and workers to the center of journalistic debate. There is no other period in Brazil’s recent history in which journalistic coverage and production involving the field of nursing work in the dimensions analyzed here are recorded. It was observed that time and the COVID-19 pandemic epidemiological dynamics caused the themes and frequency of journalistic publications on nursing work to vary. In the period analyzed in this study, approximately 60% of publications occurred in 2020, with emphasis on May, linked to two factors: 1) nursing workers’ mortality; and 2) celebration of International Nurses Day, May 12^th, and the Day of Nursing Technicians and Assistants, May 20^th, articulated at that historic moment to spontaneous manifestations of support and thanks for the work in the form of applause and for the Nurse Now campaign. Half of the analysis categories, respectively, Death among workers, Precarious working conditions and Workers’ contamination are directly related to precarious nursing work.

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Edited by

Associate Editor (Peer review process): Alexandre Pazetto Balsanelli (https://orcid.org/0000-0003-3757-1061) Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, SP, Brazil

Publication Dates

• Publication in this collection
  18 Aug 2023
• Date of issue
  2023

History

• Received
  8 Dec 2022
• Accepted
  16 May 2023