OPPOSITION TO THE AMERICAN LEADERSHIP BY BRAZILIAN NURSES ( 1934-1938 )

Disponible en castellano/Disponível em língua portuguesa SciELO Brasil www.scielo.br/rlae 1 Ph.D. in Nursing, Adjunct Professor, Rio de Janeiro Federal University Anna Nery School of Nursing, Brazil, e-mail: taniacristinafsc@terra.com.br; 2 Free Lecturer, Full Professor, Rio de Janeiro State University School of Nursing, Brazil, e-mail: gertrudeslopes@uol.com.br; 3 RN Doctoral Student in Nursing, Rio de Janeiro Federal University Anna Nery School of Nursing, Brasil, Assistant Professor, Rio de Janeiro State Federal University Alfredo Pinto School of Nursing, Brasil, e-mail: ramosporto@openlink.com.br; 4 Undergraduate Nursing Student, Rio de Janeiro Federal University Anna Nery School of Nursing, Brazil, e-mail: alinefonte@globo.com Rev Latino-am Enfermagem 2008 janeiro-fevereiro; 16(1):130-5 www.eerp.usp.br/rlae Artigo Original


RESISTENCIA AL LIDERAZGO NORTE-AMERICANO EN LA FORMACIÓN DE LA ENFERMERA BRASILEÑA (1934-1938)
Estudio histórico-social que tuvo como objetivos: describir las circunstancias en las que Bertha Pullen asume la dirección de la Escuela de Enfermería Anna Nery; analizar las estrategias emprendidas por Pullen para asegurar su posición de poder y prestigio en la escuela y en la enfermería brasileña y discutir las oposiciones frente a su presencia y autoridad como directora americana por parte de las enfermeras y alumnas en la lucha por una identidad nacional.El análisis de los documentos fue a través de la contextualización de fotografías, con base en documentos y fuentes secundarios.El estudio demostró que la segunda gestión de Bertha Pullen reiteró la presencia americana dentro del liderazgo de la Escuela de Enfermería de Anna Nery, a pesar de la resistencia de   .
The space studied is that of Anna Nery Nursing School, seen in this study as a social space where agents (nurses, professors and students) achieve their position in the division of work that enable them to legitimately manipulate certain symbolic products such as cultural assets (2)   .
Primary sources were located at the Document Center of Anna Nery Nursing School in the Federal University of Rio de Janeiro, they are photographs and written documents, such as reports, letters, minutes, conference texts, and speeches, both related to the issue and according to the period of time studied.Secondary sources were about the History of Brazil and of Nursing, located in articles, dissertations and theses.
After documents had been selected, external and internal critics were performed to validate the findings of the study, since the critics to sources helped to determine historical evidences that supported the assessment of findings (3) .
Corpus analysis was conducted as of contextualization of photographs, based on written documents and secondary sources, allowing linking what was expressed in photographs with the external information.These aspects determine content structure and provided subsidies to assess the object in study (4) .

RESULTS
The Regarding the professors, a mandatory course was introduced "Teaching of Nursing and Infirmary Management".The first classes dealt with "studying building of character: how to study and rebuild it".This determination shows the concern with standardizing behavior of students and professors, through strategies that aim at producing agents [nurses] with a secondary habitus that is, of a secondary ethos, as a result of internalizing the structures of this field, since the education system, as a reproductive instance "when it performs its inculcation task, makes the culture that it has to reproduce worth of being preserved" (5) .
In other words, the strategy of the principal of offering a mandatory course for professors, made it possible to update the professional habitus, to adjust it to the new demands, since the habitus while it was modus operandi and primary condition for any purpose, demands, from the groups and/or agent classes, a minimal control and domain of a common code, even if it is an unaware record (5) , since the habitus as it is incorporated and introduced by family education, is constantly updated over the social path, tracing the limits of agents.The rituals and symbols of the profession, introduced since the inauguration of the course at Anna Nery Nursing School, in 1923, by American nurses as "symbols of the social reality" (5) had, above all, the role of introducing and legitimating a new symbolic order, since these rituals gave visibility to this new profession that was eager for social recognition.
Additionally, the symbolic efficiency of rituals is in the possibility of stating the identity of a profession.
Bertha Pullen, on her second tenure as principal, continued with the "Capping ceremony" which represented the effective integration of students to the student body of the school, symbolizing Nursing as a universal value and at the same time using a strategy of making the group equal and different, giving duties and advantages, in the symbolic level, to those who wore it, and who belonged to that group (4) , because rituals are a set of formal, expressive acts, with a symbolic dimension that uses as a resource specific language and behavior systems, as well as symbolic objects with meaning representing a symbolic asset of the group (6) .
Figure 1 shows Bertha Pullen, helped by Zaíra Cintra Vidal, puts the coif in the head of one of the students, while the student lights her candle on the flame of the previous student's candle.Lighting candles in the ritual gives it one more symbolic meaning since "primary symbolism of candles is that of faith in ones truth and beauty that goes beyond existence in itself, determined by enduring commitment to a service" (4) .
Receiving the coif in front of the bulb and passing on the flames to all candles by all students reinforces the commitment with the future profession.
Understanding the importance of these symbols can be seen in this extract of a text produced by a student at Anna Nery Nursing School called "A Lâmpada simbolo de nossa Fé" ("The Bulb, a symbol of our faith"), published at Revista Anaes de Enfermagem (A Nursing Journal), currently the Brazilian Nursing Journal, in September 1937, she states: "Let us show to be worth of such advantages and benefits, that is, let us perform our duty.Only this way may we see the bulb that is our symbol shining on the universal light".
The rituals of receiving the degree at Anna Nery Nursing School were always a time and space important for all principals of the school who called people from different sectors of society making the group important for them and for the others.
Institutional rituals produced by the school had the effect of making the group legitimate, because the symbolic efficiency of rituals depend on the power of the authorities introducing them and the provisions of the receivers to know and acknowledge the institutional conditions for a valid ritual (7) .
Thus, the ritual of receiving the degree reassured the commitment of students with their profession, since the symbolic efficiency of rituals lie in changing the representation that agents have on the legitimate person, changing the nature of social relations and at the same time, transforming the representation that people have of themselves, as well as behaviors that are considered essential to be adopted in order to adjust to this representation (7) .
Thus, rituals have the effect as the symbolic record, because they do not show the passage from one state to another, but they determine incorporation of a professional habitus in accordance with the social expectations connected with its category.
Realigning positions of power and prestige: resistance  This data becomes more expressive when put together with the fact that she did not speak during the event, therefore, she was not acknowledged by nurses and students as an authorized spokesperson, since the "spokesperson is that who is supposed to talk on behalf of the community; it is at the same time their privilege or duty, their role; that is, their competence" (7) .
Not withstanding, the positioning of the principal can be explained at the light of what Bourdieu called "strategy of condescension", since Bertha Pullen, when she positioned herself away from Rachel Haddock Lobo's portrait and did not speak, she makes evident the case of symbolic transgressions, where the "legitimate condescending people, have the privilege of all privileges, and take advantage of them" (7) , therefore, transgressions that are prohibited to other agents are authorized, expressing that she is aware of her cultural capital and professional identity.
However, the spatial distribution of Brazilian nurses in the ceremony reflects the struggle for imposing the view of the world "in glasses that enable people to see the world according to certain divisions" (8) which defines hierarchical positions of the field, in the specific case, Anna Nery Nursing School, when Brazilian nurses placed themselves next to Rachel's portrait (a special place in the ceremony), at the same time it gave visibility to the leadership of the Brazilian nurse in the direction of the school that was considered the standard at the time, it also made clear the resistance to the foreign leadership.
These strategies that reflect the fight for legitimate monopoly of power of Brazilian nurses through the use of collective capital of "prestigious" nurses, determined by their "position in the objective structure of the authority relations, that is, of authority and force that they have achieved during their fight" (5) .

FINAL CONSIDERATIONS
Both tenures from Bertha Pullen (1928-1931)   and (1934-1938) The present study aims at reinforcing the American leadership in the education of Brazilian nurses, through the second tenure of Bertha Pullen(1934-1938) as the principal at Anna Nery Nursing School.To deal with the issue presented, the following objectives have been designed: describe the circumstances in which Bertha Pullen takes on the management of Anna Nery Nursing School; to assess the strategies used by her to ensure her position of power and prestige in the school and in Brazilian Nursing, and to discuss the resistance to her presence and authority by graduated nurses and students struggling for a national identity.METHODSThe present study, performed through the social history perspective called "Emblemas e rituais na formação da identidade da enfermeira brasileira" (Symbols and rituals in the formation of the Brazilian Nursing Identity), has been approved by the Ethical Research Committee at Anna Nery Nursing School / Hospital Escola São Francisco de Assis.Data were assessed at the light of Pierre Bourdieu's theory of the social world, when he studies the setting of the different social spaces, the hierarchies and the interior struggles of these spaces, assessing dialectic relationships among the agents in these spaces(1) return of American leadership expressed by Bertha Pullen managing Anna Nery Nursing School: strategies to fix space Bertha Pullen takes in the management of Anna Nery Nursing School, on a second tenure on April 2 nd 1934, and chose as her assistant the Brazilian nurse Maria de Castro Pamphiro, graduated by the first class and with post graduation in the United States.It is worth mentioning that after Rachel Haddock Lobo's death, Maria de Castro Pamphiro ran the School as a deputy principal for seven months.Bertha Pullen, on her first monthly report on activities, in the end of April 1934, recorded that she was taking over the management of Anna Nery Nursing School again, after being away for precisely two years and nine months.This statement indicates the understanding of the principal that the management of Rachel Haddock Lobo, interrupted by her death, was only a short break in the American leadership in the management of school and, at the same time, she mentioned the services she had done in her first management.Bertha Pullen also made a brief diagnosis of the school situation, saying that it was in poor conditions, however, highlighting that the general organization principles have remained the same.She pointed out the need for reviewing the theoretical contents and the practical experiences.To keep her authority and control of professors and students, the principal tried to establish direct communication with students, adopting the strategy of holding informal events where professors would attend.Thus, in the second month of her tenure, the "Social Hour" was established every Mondays at the principal's office.This situation, although apparently made the principal and the students closer, reinforced the social distance, since social reality is characterized by situations that reflect having a set of features given to the socially valued and at the same time make people realize their limits, when they internalize external determinations, in the sense that they either admit or accept what was given to them, according to their habitus.

Figure 2 -
Figure 2 -Ritual to Inaugurate Rachel Haddock Lobo's portrait , separated by the brief management of the Brazilian nurse, Rachel Haddock Lobo, are the reiteration of the American presence running Anna Nery Nursing School, despite resistance of graduated people and students.The concern of the principal in keeping rituals started due to the inauguration of Anna Nery Nursing School is justified by the possibility of legitimating a nursing model for the Brazilian society, since

LIDERANÇA NORTE-AMERICANA NA FORMAÇÃO DA ENFERMEIRA BRASILEIRA (1934-1938)
las enfermeras y alumnas.De este modo, se concluye que su segunda gestión en la Escuela de Anna Nery no representó una necesidad real o sentida por la misma escuela.DESCRIPTORES: historia de la enfermería; escuelas de enfermería; emblemas e insigniasRESISTÊNCIA ÀEstudo histórico-social teve como objetivos: descrever as circunstâncias em que Bertha Pullen assume a direção da Escola de Enfermagem Anna Nery; analisar as estratégias empreendidas por Pullen para assegurar sua posição de poder e prestígio no espaço da escola e da enfermagem brasileira e discutir as resistências à presença e autoridade da diretora americana, pelas enfermeiras diplomadas e alunas, na luta pela identidade nacional.A análise do corpus documental se fez a partir da contextualização das fotografias, com base nos documentos escritos e fontes secundárias.O estudo evidenciou que a segunda gestão de Bertha Pullen se configurou como a reiteração da presença americana na liderança da Escola de Enfermagem Anna Nery, apesar da resistência das enfermeiras e alunas.Desse modo, pode-se concluir que a segunda gestão de Bertha Pullen na Escola de Enfermagem Anna Nery não representou necessidade real ou sentida pela própria escola.DESCRITORES: história da enfermagem; escolas de enfermagem; emblemas e insígniasThe introduction of a new Nursing model in Brazil, under the influence of the Nursing Mission, was concrete after the creation of the Nursing School and a Nursing Service, both ran by American nurses.With the creation of the Nursing School of the National Department on Public Health, in 1922, the American nurses brought to Brazil a nursing model that added to the traditional features of the Nightingale Department on Public Health already had 125 students graduated at Anna Nery Nursing School, and 17 had post graduation in the United States, the final decision was that Bertha Pullen came back to Brazil to be in charge of the school in a second tenure (1934-1938).