Nursing Now Brazil Campaign: alignments with global evidence for the development of national nursing

Campaña Nursing Now Brasil: lineamentos con las evidencias globales para el desarrollo de la enfermería nacional

ABSTRACT

Objective:

To analyze the goals and strategies of the Nursing Now Brazil Campaign in the light of global documents that focus on perspectives for the strengthening of Brazilian Nursing.

Methods:

Documentary research, carried out from the comparative analysis of the goals and strategies of the Nursing Now Brazil Campaign and documents with high global repercussion for social and economic development in the health context. Data were collected between May and July 2020.

Results:

The evidence set bases the need for strategies to achieve excellence in the training of nurses, better working conditions and the dissemination of successful experiences undertaken by these professionals in different health contexts for the strengthening of leadership and competencies capable of boosting socioeconomic development and people’s quality of life.

Conclusion:

The achievement of the Nursing Now Brazil Campaign goals, based on global health evidence, may directly impact the socioeconomic development of the country.

Keywords:
Nursing; Global health; Leadership; Nursing staff

RESUMEN

Objetivo:

Analizar las metas y estrategias de la Campaña Nursing Now Brasil a luz de los documentos globales que enfocan perspectivas para el fortalecimiento de la Enfermería brasileña.

Métodos:

Investigación documental, realizada a partir del análisis comparativo entre metas y estrategias de la Campaña Nursing Now Brasil y documentos de elevada repercusión global para el desarrollo social y económico en el contexto de la salud. Los datos fueron recolectados entre mayo y junio de 2020.

Resultados:

El conjunto de evidencias fundamenta la necesidad de estrategias para la formación de excelencia de Enfermería, mejores condiciones de trabajo y diseminación de experiencias exitosas de eses profesionales en los diferentes contextos de salud para el fortalecimiento del liderazgo y competencias para aumentar el desarrollo socioeconómico y la calidad de vida de las personas.

Conclusión:

El cumplimiento de las metas de la Campaña Nursing Now Brasil, pautada en evidencias globales de salud, podrá impactar directamente en el desarrollo socioeconómico del país.

Palabras clave:
Enfermería; Salud global; Liderazgo; Personal de enfermería

RESUMO

Objetivo:

Analisar as metas e estratégias da Campanha Nursing Now Brasil à luz de documentos globais que focam em perspectivas para o fortalecimento da Enfermagem brasileira.

Métodos:

Pesquisa documental, realizada a partir da análise comparativa entre metas e estratégias da Campanha Nursing Now Brasil e documentos de elevada repercussão global para o desenvolvimento social e econômico no contexto da saúde. Os dados foram coletados entre maio e julho de 2020.

Resultados:

O conjunto de evidências fundamenta a necessidade de estratégias para a formação de excelência da Enfermagem, melhores condições de trabalho e disseminação de experiências exitosas desses profissionais nos diferentes contextos de saúde para o fortalecimento da liderança e competências capazes de impulsionar o desenvolvimento socioeconômico e a qualidade de vida das pessoas.

Conclusão:

O cumprimento das metas da Campanha Nursing Now Brasil, pautada em evidências globais de saúde, poderá impactar diretamente o desenvolvimento socioeconômico do país.

Palavras-chave:
Enfermagem; Saúde global; Liderança; Recursos humanos de enfermagem

INTRODUCTION

The improvement of health indicators and determinants constitutes a condition for the effective social and economic development of countries. In this context, it is essential that the governments of different nations strengthen their health systems in accordance with the new global and local demands for health care of their people1^-2.

Therefore, Nursing, the largest contingent of human resources in health, with nearly 28 million professionals worldwide1, must be valued with expanded roles in the contexts of care for people and collectivities, in line with its updated professional training and aligned with scientific, technological and social progress to be able to offer qualified services1^-2. In this logic, its involvement with the health team is essential, focused on efficiency and effectiveness, as well as its leadership role, with the perspective of constantly introducing changes and assuming an expanded profile of action, in line with the dynamics that health systems are demanding at all levels of care1.

The recognition of the meaning of Nursing for the success of public policies, construction, implementation and strengthening of complex health systems is reflected in the global literature2^-3⁾ and in specialized analyzes of different entities, academic disciplines and distinct professions, in which are observed some consensus, among which: the importance of nurses’ work performance, in line with a training with quality ; possibilities to reach high levels of education through an improved system of training, integrated and inducing academic progression; strengthening of interdisciplinarity to redesign health systems4, among others.

It is from this perspective that, in the United States of America, a country with three million nurses, the Institute of Medicine, in a publication about the Future of Nursing, recommended the need to transform the profession based on three key areas, namely: practice, education and leadership. These recommendations were reiterated by other evidence that supports the importance of strengthening Nursing in these areas of knowledge and action, in addition to its impacts on the economy and social development1^-2.

In terms of education, there is a political challenge that consists of the versatility of Nursing, whose dynamics resulted in realities in which the profession evolved faster than the policies that affect it. Furthermore, the mismatch between nursing needs and outdated government policies, which cross the nurses’ work process for the full development of their care, imply issues of support for professional education, workforce priorities, limiting aspects of care practice touched by cultural tensions of power, in addition to inconsistent regulations and remuneration policies4.

Despite the above and based on the evidence of growing recognition of the transformative potential to be played by Nursing, from changes in the training of its human resources, changes in their working conditions and investment in leadership of these professionals, in 2018 it was launched by the International Council of Nurses (ICN), together with the World Health Organization (WHO), the Nursing Now Global Campaign5. This campaign reinforces that investment in Nursing is an essential condition for strengthening the health systems of all nations and for countries to reach their goals related to the Sustainable Development Goals (SDGs) of the 2030 Global Agenda6, in particular for the goals centered on health and quality of life, gender equality, social justice and economic growth.

As a result of this global movement, national campaigns to value Nursing were promoted and the set of evidence and mobilizations in favor of the profession legitimized, even before the COVID-19 pandemic, the acclaim of 2020, the year that marks the bicentenary of Florence Nightingale’s birth, as the International Year of Nurses7.

In Brazil, in April 2019, in the country’s capital, the Nursing Now Brazil Campaign was launched by the Federal Council of Nursing, an agency linked to the ICN, together with the Collaborating Centre of the Pan American Health Organization (PAHO/WHO) for the Development of Nursing Research at the School of Nursing of Ribeirão Preto of the Universidade de São Paulo. The launch was marked by the approval, by acclamation, of the Brasília Letter8, which lists as goals: 1) investing in strengthening the education and development of nursing professionals with a focus on leadership; 2) investing in improving the working conditions of nursing professionals; 3) disseminating effective and innovative nursing practices based on updated scientific evidence, at national and regional levels. Each goal highlights a group of closely related strategies for achieving it.

The Campaign, in its national translation, is based on the observation that Nursing, from the workforce of its more than 2,400,000 registered professionals in Brazil, plays a central role in the transformation of the Unified Health System (Sistema Único de Saúde - SUS) from its interfaces between health, social and economic development. Therefore, valuing this profession is essential to face the current and future health challenges estimated by epidemiology, whether those related to population aging, increasing chronical health conditions, emerging and neglected diseases, as well as the challenges related to combating inequities from the perspective of health. However, to achieve better conditions for strengthening Nursing, from the Nursing Now Brazil Campaign, it is essential to understand the evidence related to health demands and needs that underlie the actions envisaged by the campaign in question.

At this conjuncture, it is evoked the understanding that it is necessary to know in order to better intervene in the reality that one wishes to modify. Therefore, this study presents as objective: to analyze the goals and strategies of the Nursing Now Brazil Campaign in the light of global documents that focus on perspectives for the strengthening of Brazilian Nursing.

METHODS

Documentary, descriptive research, carried out from the analysis of official documents that reinforce the possibilities of the impact of the Nursing Now Brazil Campaign for socioeconomic development.

Thus, the following documents consisted the scope of analysis: Sustainable Development Goals5; Triple Impact Report2; Strategy on Human Resources for Universal Access to Health and Universal Health Coverage9; Strategic Directions for Nursing in the Region of the Americas11; State of the World’s Nursing Report1.

These historical documents were accessed from the official websites of the United Nations (UN), WHO and ICN. Together, these documents establish and reiterate the global campaign and its national interfaces, lefting the need for a specific movement to value Nursing as a mean of investing effectively in strengthening health systems and improving the population’s health conditions. As inclusion criteria, it was established, therefore: document in its entirety and in the public domain.

These documents were read repeatedly by independent researchers, authors of the study, who individually filled out a data collection form that they designed. This form consisted by the items: goal and strategy of the Nursing Now Brazil campaign and evidence related to each strategy, which, together, contemplated each of the three goals of the campaign.

The data collection and organization form favored the synthesis capacity for data description and grounding from the evidence of the documents listed for the scope of analysis. After completing each item on the form, for each strategy and documents analyzed, it was started the process of comparative data analysis. Thus, elements that presented similarities were grouped for each set of evidence that established a potential relationship with the strategies and goals of the Nursing Now Brazil Campaign. The common elements were, therefore, compared with each other, forming axioms around each of the strategies, grouped in their respective goals. In this sense, it was possible to establish a synthesis between the documents based on the evidence signaled for each strategy of the Nursing Now Brazil Campaign.

The data for this research were collected from May to July 2020. As they are official documents, in the public domain, with online access, it was not necessary to register the research and, therefore, approval by the Ethics Committee in Research with human beings. However, it is worth highlighting the ethical and legal respect related to the copyright of the analyzed documents.

RESULTS

The research results are presented in charts that relate each strategy, in groups, which integrate each campaign goal with the international evidence for its development.

The Nursing Now Brazil Campaign goals and the strategies listed in each of them to achieve are supported by global evidence. In this sense, the set of factors that reveal the background and validate the need for strategies to achieve Goal 1, which consists of Investing in strengthening the education and development of nursing professionals, with a focus on leadership, are presented in Chart 1:

Chart 1 -
Goal 1 of the Nursing Now Brazil Campaign and related evidence

Goal 1 Nursing Now Brazil: Investing in strengthening the education and development of nursing professionals, with a focus on leadership
Strategies	Related evidence
Invest in technical training linked to leadership training	- Importance of developing competencies to intervene in the implementation of the SDGs that consider health and well-being; gender equality; decent work and economic growth; reduction of inequalities, among others5; - Relevance of competencies for leadership in strategic contexts that influence the practice of Nursing; leadership and governance in Nursing as ideal for strengthening health systems2; - Need for leadership and social dialogue to reach intersectoral dimensions that influence the health sector, in the scopes of education, work and finance(9), without, however, failing to consider that leadership spaces involve power relations1
Train nurses in the professional master’s degree mode, in strategic areas, which directly impact the quality of care	- PAHO proposes expanding the role of advanced practice nurses. This training modality allows for deepening and interventions with a high level of expertise, with immediate return to care practice, from planning to the live act of care10; - In this same prerogative, it is necessary to develop and implement strategies that allow the ability to achieve the maximum of professional competencies and, at the same time, measures that boost the formation of specialties to better intervene9
Offer update courses for mid-level professionals on priority topics	- Brazilian Nursing is, for the most part, composed of nursing technicians (out of a total of 2,305,946 active nursing professionals registered in Brazil, only 24.5% are nurses); this proportion remains approximately the same in all of Latin America10; - Achieving the sustainable development goals5, as well as the impacts related to health and economy2 require technical skills consistent with the social demands of health and care throughout Nursing10.
Strengthen the importance of training the nursing professionals in the face-to-face modality	- Although global nursing is made up of about 27.9 million professionals1, it is important to consider the quality of training and development of competencies that articulate global health needs5,9, as well as the contextual priorities of acting. These challenges reveal the importance of excellent training, in line with the high standards of Nursing9.

• Source: Authors, 2020.

In a chronological list of these documents publication, there is the following evidence: the achievement of part of the SDGs, which make up the 2030 agenda for the transformation of the world, it will only be possible from the development and full use of competencies of health professionals, especially in Nursing, which composes the majority of these human resources in all health systems. This reality places the need for investments in the quality of professional training, at different levels of health care and for the multiple possibilities of intervention, which are connected in the areas of assistance, research, management and public health policies.

Furthermore, the Triple Impact Report2 signals the importance of nurses fully exercising the potential of their competencies so that it is possible to achieve broader consequences in improving people's health, promoting gender equality and in the economy of nations. Therefore, it advocates the need for nurses to increasingly develop leadership competencies and occupy strategic decision-making spaces that influence the nursing work process.

The Strategy on Human Resources for Universal Access to Health and Universal Health Coverage9 considered that investment in human resources for health contributes to improving employment rates and economic development. In this sense, it points out the importance of professional training based on competencies that accompany the dynamics of social transformations, in a contextualized perspective.

The Strategic Directions for Nursing in the Region of the Americas10 reinforces the evidence in the aforementioned document by considering that investment in human resources needs to think the panorama of professional Nursing education, thus signaling the quality of education and the lack of human resources in health. Corroborating these indicators, the State of the World’s Nursing Report1 highlighted the deficit of nursing professionals, estimated at 5.9 million worldwide. However, it highlighted the heterogeneous relationship of distribution/concentration of nurses in certain countries around the world and the working conditions.

In addition to the training of excellence, the Nursing Now Campaign reinforces, therefore, that no global health agenda will be achieved without the proper appreciation of the working conditions of Nursing. It is inferred from these evidence the elements that support background and validate the need for Goal 2 of the Nursing Now Brazil Campaign, aimed at Investing in improving the working conditions of nursing professionals.

In this way, the following chart (2) brings together the set of evidence that supports strategies of the Goal 2.

Chart 2 -
Goal 2 of the Nursing Now Brazil Campaign and related evidence

Goal 2 Nursing Now Brazil: investing in improving the working conditions of nursing professionals
Strategies	Related evidence
Map the difference in working conditions and prioritizing demands according to local specificities	- The plurality of Nursing may reveal different conditions for different work realities. The mapping of these realities is essential for the development, implementation and evaluation of strategies positioned in each intervention context2; - Facing up to current challenges and the development of regional strategic solutions for the progress of Nursing can be favored from the situational diagnosis of the working conditions of nursing professionals10; - With knowledge of the multiple realities of health professionals, it will be possible to devise strategies to capture decentralized information that reveal the need for specific measures for decision-making by health managers and leaders9
Encourage the participation and acting of nursing professionals in strategic decision-making positions in the health system	- The gap between the importance of the Nursing workforce and policies translated into better working conditions signals the need for Nursing to occupy local, regional and national leadership contexts that reflect influences for the entire profession2.
Foster dialogue and negotiation with various political instances in micro and macro spaces	- The financial investment translated into the strengthening of human resources, especially for the expansion of jobs in Nursing, better working conditions to reduce the burden and evasion of professionals in the area, should include strategic measures that encourage dialogues based on evidence that highlight the importance of such investments1-2,0-10. - Furthermore, it is necessary to consider, in this process, the importance of intersectionality for the integration of interests of the health, education, labor and financial system/organs, especially those of a public nature10.

• Source: Authors, 2020.

The documents indicate, therefore, that the Nursing workforce impacts on health systems, in global and local perspectives, the quality of life of people, the confrontation of social inequities from a health perspective, especially related to gender, and boost the economic development, is what the analyzed documents reveal, especially in the Triple Impact Report and the State of the World’s Nursing Report. However, this same evidence indicate that the precarious working conditions, associated with the devaluation of these professionals, are barriers that threaten all these possible consequences. Part of this reality may be directly related to the elements signaled in Goal 2, regarding the insertion of Nursing in strategic decision-making contexts that influence, even, investments in improvements for safe and efficient work.

The strengthening of Nursing demands the need for the profession itself to show to the world the impact that, from its workforce, it exerts on the social and economic development of nations. In this sense, the Goal 3 of the Nursing Now Brazil Campaign consists in Disseminating effective and innovative nursing practices based on scientific evidence, at national and regional levels. The strategies to achieve this goal are listed in evidence signaled in chart 3.

Chart 3 -
Goal 3 of the Nursing Now Brazil Campaign and related evidence

Goal 3 Nursing Now Brazil: disseminating effective and innovative nursing practices based on scientific evidence, at national and regional levels
Strategies	Supporting evidence
Map innovative practices led by nursing professionals	- Valuing Nursing, among other elements, may be related to popular and leadership knowledge about the impact that professionals in this area of ​​knowledge exert2.
Stimulate the development of scientific research that strengthen professional practice	- Nursing profession, walk in line with social demands that are dynamic and therefore require constant investments in research for training capable of developing the necessary competencies to act in the face of current and upcoming challenges2,10.
Identify gaps and possible interfaces between organizational sectors for the development of research and products that solve problems in favor of quality of care	- The replication and expansion of studies that scale the impact of Nursing in strategic sectors of society (quality of life, economy, social justice, among others) can strengthen the understanding of society and leaders about the importance of Nursing, in order to translate this understanding in professional valuation policies for decent working conditions1-2,10. - Government and even health leaders have had difficulties in accessing consolidated information on health systems and, therefore, on the systems that involve the Nursing work. Thus, methodological strategies that reinforce evidence on the impacts of valuing/precariousness of Nursing, as the largest professional category in health systems, are possibilities for changing the panorama of professional devaluation9.
Produce and validate Nursing protocols supported by evidence that qualify Nursing care	- Health challenges are increasingly dynamic and accelerated, which requires in-depth and updated knowledge to better intervene(9-10). In this sense, protocols based on the best evidence for advanced Nursing practice are essential to monitor the dynamics of these challenges according to the health demands of people and collectivities1,9-10.
Foster strategies that disseminate innovative products and practices, resulting from research processes, aiming at their wide dissemination in health services	- To achieve high impacts on health, reducing social inequalities from the perspective of gender and the economy, Nursing needs to develop new ways of sharing successful practices, in a global perspective, as well as national and local, with strategies that favor the understanding of leaders, policy makers and managers for the expanded importance of the profession2; - The lack of financial investment to quantitatively and qualitatively boost Nursing conditions the chances of good performance of health systems around the world. It is, however, necessary to expand studies and strategies that show such impacts in the different contexts of Nursing work, in each region of the country and in priority areas for health, social and economic development, quality of life and social justice9-10.

• Source: Authors, 2020.

The analyzed documents indicate the impact of nursing from the science it develops, as well as its consequences in the areas of innovation and technology, whether of process or product1^,9^-10 for the management and execution of their care. However, society as a whole, as well as decision makers, in the political context, must also reach this understanding from the dissemination of these successful Nursing experiences/initiatives, despite the impact they exert in the social and economic spheres and in people’s quality of life9^-10.

DISCUSSION

The Goal 1 of the Nursing Now Brazil Campaign highlights the importance of specific actions to strengthen the education of nursing professionals with a focus on leadership. From this perspective, the training of competent health professionals is central to achieving the SDGs, based on the development of knowledge, skills and attitudes necessary to offer quality and person-centered care. Therefore, the training of nurses, in the context of education, is critical, aiming at the adoption of new approaches in the planning, organization, implementation and evaluation of educational programs capable of articulating competencies for a broader view of health demands11.

The investment in nursing education is, therefore, fundamental for the future of the profession. Proof of this importance is reflected in the very title of the State of the World’s Nursing 2020 Report, “investing in education, jobs and leadership”1. In unprecedented times, such as the COVID-19 pandemic, the response capacity of different health systems is directly related to the acting of Nursing, stimulating public opinion and the various affected countries to recognize and value the education and training of nursing professionals. Thus, it is important that the training of these professionals is in line with global needs and contextual demands, while responsive to technological changes, with the purpose of improving integrated health models1.

In order to deal with these challenges, among the strategies listed by the Nursing Now Campaign in Brazil, the training of nurses in the professional master’s modality is valued, in strategic areas, which directly impact the quality of care from advanced practices, aligned with the updated knowledge8. Also in the context of continuing education for different professional categories of nursing, other Campaign strategies, reiterated by the evidence related in this study, emphasize the offer of update courses for mid-level professionals in priority themes, as well as strengthening the importance of training of the nursing professional in the face-to-face modality8.

The future development of the Nursing profession requires leadership and governance. Current and future leaders in Nursing perform the essential mission of ensuring the participation of nurses in the formulation and decision-making processes about health policies, thus contributing to the effectiveness of health systems. The strategy of the Nursing Now Campaign in Brazil of investing in technical training combined with leadership training has the potential to contribute to the country’s achievement of its goals related to the SDGs on education, gender, decent work and inclusive economic growth2. Alongside this potential, there are hopeful signs of change, whether due to the global recognition of Nursing's expressive contribution to health, gender equality and strengthening the economy, as well as the nurses’ courage to break the silence, joining the “wave protests against violence, sexual harassment and other predatory, abusive behavior against women”12.

The health policies shape the practice and work of nurses at local, regional, national, and international levels. In this sense, the education of nurses with a focus on leadership and directed to the development of policies is a key condition for them to acquire professional competencies and be able to act effectively in different scenarios. The leadership crisis is evident at local and global levels as is the underrepresentation of Nursing in health organizations and governments, where nurses are excluded from the possibility of applying for positions reserved for physicians, even when the job description is fully compatible with the profile of the nurse13.

The diversity of global changes creates and recreates opportunities for adapting the role of nursing professionals in shaping health policies, practices and education. The involvement of nurses as catalysts for change in their working environments is vital to achieving the goals of advancing global health. In this sense, Goal 2 of the Nursing Now Campaign in Brazil advocates for investment in improving the working conditions of nursing professionals. Global and national disparities in the quantity, distribution and skills of health workers impose threats to the achievement of the goals of the SDGs and further deepen inequities in health14. Considering the continental dimensions of Brazil and its extreme regional inequalities that are reflected in the working conditions of nursing professionals, it was proposed, as a goal of the Campaign, mapping the differences in working conditions and prioritize existing demands according to local specificities8.

The working conditions are directly related to organizational commitment to the quality of care, interfering with nurses’ productivity and job satisfaction15. In this context, nursing is a profession with great physical and emotional demand. High expectations added to the difficulties of working conditions increase nurses’ risks of stress and burnout. Furthermore, despite all the challenges that exist in the different health systems, nursing professionals continue to offer high quality care, facing the existing challenges and valuing the continuous exercise of resilience in the face of adversities16.

In order for them to contribute to the development of more effective policies aimed at improving working conditions, it is essential, as highlighted in the Brasília Letter, to stimulate the participation and performance of nursing professionals in strategic decision-making positions in health systems, as well as to foster dialogue and negotiation with different political instances in micro and macro spaces. Furthermore, the temporal expansion of the Nursing Now Campaign to June 2021 focuses on the Nightingale Challenge, a special program linked to the Campaign aimed at challenging employers to take up the training of leading nurses. This program is based on the understanding that, without this type of investment, it will not be possible to reach the number and quality of professionals essential to assume strategic positions in decision-making forums and political spaces. From this perspective, initiatives are needed to offer leadership training, both in services and in academia, in which, in this context, it is imperative that postgraduate courses at the doctoral level assume such a commitment, as their role is to train researchers who are able to lead in the different fields of action of Nursing and health.

Such action is supported by records of international agencies that recommend mobilization that generates change. In this sense, the protagonism of Nursing faculties should be valued, which house granaries for the production of scientific evidence to be used, in arguments capable of convincing political leaders to invest in Nursing education and in the development of the profession17.

The International Council of Nurses has made efforts to stimulate nurses in all countries to take a seat at decision-making tables on health. However, this same council found, at the end of 2019, that only 50% of countries have the position of head nurse in government. Position at a strategic level, as the head nurse of government has the authority to lead Nursing in order to contribute to the determination of health policies in their countries7 and, therefore, directly and indirectly impact the socioeconomic development of these nations.

The ICN advocates for this position in all countries, supported by WHO, but gaps in translating political commitments into action still persist. However, Goal 3 signals the importance of Nursing empowering its voice in different public spheres, with special emphasis on decision-making contexts. This need shows the importance of managers, in central levels of power, conceiving the importance of the impact of nursing for the socioeconomic development of nations. In this sense, policy makers, including the head nurses of government, who need more support, as well as more consistent efforts so that they become a reality in the other half of the world18.

In Brazil, a country in which Nursing constitutes more than 60% of human resources in health and, therefore, directly affects the SUS and public health policies, it does not present the figure of the head nurse of government, nor a similar policy capable of articulating information and decisions, at a central level for decentralized developments of Nursing valorization.

CONCLUSION

The goals and strategies of the Nursing Now Brazil Campaign are supported by global scientific evidence, gathered in reports that ground the importance of strengthening and valuing Nursing to achieve impacts on people’s health, quality of life, and the reduction of social inequities that, in together, reflect essential aspects for social and economic development based on health as a condition for its guarantee and progress.

In this sense, the research results showed that the evidence for the valorization of Nursing is transversal to the development of the Nursing Now Campaign, whereas, even after its global launch, in 2018 and, in Brazil, in 2019, current evidence of International level, as the state of the world’s nursing report of 2020, reiterates that without the proper investment in Nursing, it will not be possible to achieve the necessary conditions for satisfactory socioeconomic development, nor for decent living conditions based on the health of people and collectivities. This is because Nursing is inserted in different care contexts, transforming realities based on its workforce, which requires quality in training and valorization translated into better working conditions and remuneration.

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Edited by

Associate editor:

Dagmar Elaine Kaiser

Editor-in-chief:

Maria da Graça Oliveira Crossetti

Publication Dates

• Publication in this collection
  12 Nov 2021
• Date of issue
  2021

History

• Received
  19 Oct 2020
• Accepted
  17 Mar 2021