Percepção de docentes enfermeiros sobre a problemática ambiental: subsídios para a formação profissional em enfermagem

4Mestranda do Programa de Pos-Graduacao em Enfermagem da UFSM. Rio Grande do Sul, Brasil. E-mail: gracieleerthal@ gmail.com RESUMO: O estudo objetiva compreender a percepcao de docentes enfermeiros sobre a atual problematica ambiental, no intuito de obter subsidios para reflexoes sobre a formacao profissional em enfermagem. Trata-se de uma pesquisa com abordagem qualitativa, do tipo descritivo-exploratoria, realizada com docentes enfermeiros de um curso de enfermagem. Os dados foram coletados por meio de entrevista semiestruturada e analisados de acordo com as etapas da analise de conteudo. Os docentes possuem uma concepcao de meio ambiente como espaco de interacao e local para existencia humana. Tambem tem clareza acerca dos impactos da atual problematica ambiental sobre a vida humana, e suas consequencias, inclusive para a saude das pessoas. Compreendem que sua responsabilidade, no que tange as demandas ambientais e grande, havendo um entrelacamento entre a esfera individual e profissional. Conclui-se que essas questoes devem fazer parte da pratica educativa, na formacao de enfermeiros, no sentido de possibilitar a conscientizacao dos futuros profissionais. DESCRITORES: Enfermagem. Educacao em enfermagem. Docentes de enfermagem. Ecologia. Meio ambiente. PERCEPTION OF NURSES-PROFESSORS ABOUT ENVIRONMENTAL PROBLEMS: GRANTS TO THE PROFESSIONAL TRAINING ON NURSING


INTRODUCTION
For some decades, debates about economic, social, cultural and ecological impacts, among others, have intensified worldwide due to an environmental crisis of global proportions.Thus, the expected and unexpected consequences of that crisis bring important changes on people´s lifestyle.This context has been subject of reflections by various scholars.
According to some contemporary sociologists, [1][2] we live in a period of reflexive modernity in which we feel the negative impacts from the project of economic and scientific-technical advance that was propagated in the era of modernity.In this sense, we are in the midst of a risk society and such thoughts are scattered throughout the social tissue.They are affecting everyone, without any distinction, and they cannot be controlled.Environmental risks, which are called high consequence risks, are widely addressed as representatives of that thought.
The concept of reflexivity is central in the discourse of these authors, and according to them, we suffer from negative impacts of technical-scientific progress in the condition of contemporary subjects.2] This subject is presented as fundamental in relation to a debate on the environmental matter, given that, as part of a risk society, we need to reflect on this topic in order to establish actions in the collective and individual level that result in measures to contain the crisis.
It is a fact that the environmental issue is an emergency, and it is reflected in a crisis of being in the world, with demonstrations in the internal spaces of the subject, in the self-destructive social behaviors, in the process of nature degradation and life quality of the people.Uncertainty is the essence and it calls the attention to the prevalence of cognitive-instrumental rationality, which aggravated the current situation on the planet, by spreading the idea of nature domination and its use in a compartmentalizing process of knowledge and social practices. 3ccordingly, it is important to define that before the tangle of information disseminated through the media, books, movies and many political speeches, the conception of environment has been directed either to a purely biologicist bias and representing a scientific paradigm still dominant in the West or it has been understood very recently in broader terms, assuming ideas of complexity and global interaction.
Going into that world of meanings and concepts, it seems that being aware of environmental issues requires more than simply offering visibility and legitimacy to the problem itself, rather than merely "feel its effects".It requires "to think and act about that", in other words, to be guided by principles related to ecological ideas, consistent with what is known as ecological subjects, those people with beliefs and values that point to an ecological way of being. 4t is about recognizing and assuming that in order to apprehend the environmental problem, it becomes imperative to take a look at the environment in which nature integrates a network of relationships, not only natural relations but also social and cultural ones.That is why all learning, as dialogic act, requires the understanding of mutual relations between nature and human world. 4efore this problem, it is realized the need for involvement of a range of social agents, including the educational universe at all levels, searching for the potentialization of other rationalities.In the scope of the professional training at the university setting, this issue is of paramount importance in order to create an interface between various aspects involving the educational process, including those ones linked to social and environmental demands.This involves adopting interdisciplinary methodological approaches based on values and sustainable practices.They are essential to stimulate the interest and engagement of citizens into action and accountability. 3owever, although this issue must be discussed at various levels of education, formal or informal, it is known that the training process is still somewhat debated, even if it has great importance, particularly in terms of professional training on health.And, considering that the negative impacts of destruction and environmental imbalance affect, directly and indirectly, the condition of health and illness of the populations, they also bring new demands to the practice of care for which professionals need to be prepared.
Recent studies [5][6] point out there is insufficient approach to the environmental issues, especially by researchers-nurses.The national scientific production on the subject is quite modest.It is guided by a biologicist bias, which is based on epidemiological studies, persisting significant gaps on the matter under the point of view of professional training and health work.
Perception of nurses-professors about environmental problems... Thus, the construction of knowledge promoting a similar discussion in the scenario of nurses´ professional training is extremely important, especially for the possibility of subsidizing a debate broadening on the important relationship between health and environment.So, this undoubtedly favors the reflective process and scope, by future professionals, of an ecological conscience, giving opportunity to the construction of values that guide the proactive thinking and acting with regard to current demands imposed by the environmental crisis.
Therefore, it is responsibility of the health sector not only prevent environmental hazards providing answers to the impacts caused by environmental problems, but also act to reduce social vulnerabilities through changes on individual, social and political behavior for a healthier and fairer world. 7Based on these assumptions, this study was developed in order to understand the perception of professors-nurses about current environmental problems, with the aim of obtaining subsidies to reflect on the professional training in nursing.

METHODOLOGY
This research has a qualitative approach, and it is characterized as a descriptive-exploratory study.It was developed with professors-nurses from a Nursing Course at a Federal University in the South of the country.
Data collection was conducted from August to September 2010.Considering the subjectivity character of that search, it was chosen the use of semi-structured interview consisting of questions elaborated by the researchers, in the intended thematic area and favoring the achievement of the established goals.The closure of these interviews took place due to data saturation, and the collection ended with the sixth interviewed professor.
Data analysis began during the collection period and lasted until the month of November 2010.It was actualized soon after the interviews transcription and findings organization.Since it is a qualitative study, it was adopted the content analysis referential 8 as a way of assessing the collected material.
The research proposal was submitted to the approval of the institutional direction where data were collected, the Ethics Committee on Research with Human Beings (CEP) and the Federal University constituted as the research scenery.The research was approved through a Letter of Ap-proval (CAAE 0129.0.243.000-10).The selected subjects participated in the study only after reading, accepting and signing the Free and Informed Consent Form, in accordance with the proposal of the Resolution 196/96 from the National Board of Health.The anonymity of those participants was assured through the use of alphanumeric codes to designate each respondent.

RESULTS AND DISCUSSION
For a better understanding of this study, the obtained reports and reflections that followed were subdivided into categories of analysis, with interrelationships among them.To the composition of this manuscript, three of the originated categories were selected, namely: the environment as space for interaction and place for human existence, the current environmental issues: impacts on human life, and environmental responsibility: entanglement between individual and professional spheres.The others, which aimed at analyzing the curricular structure of the studied Nursing Course, are included in another scientific publication.
In the initial stage and opening the process of interpretation, it is important to highlight as the first category of analysis, the one that is produced from the statements related to the conception of environment.This understanding, which was revealed and discussed under the professors´ point of view, provokes the appearance of two meanings when considering the environment, namely: 'the environment as interaction space and place for human existence'.
The following statement reveals this way of thinking: [.

..] I understand the environment not only as if you are there and I am here, I am inside this environment, I am part of the environment. I cannot be separated or else I will be within a Cartesian view, even fragmented. I am here in this environment, I am part of this environment, and I am able to add good things in this environment or not, it depends on how I act and interact with this medium (D1).
After that, another teacher expresses his perception, adding a vision of bigger interaction to the idea of environment: [...] I think the environment cannot be restricted to the forest and wetland, we have an environmentalist vision towards flora and fauna.I think the environment is everything, where we are and how we live.So are relationships, working place and my house.Anyway, everything, where I am living, where I live in familiar terms, where I relate to other persons.For me, that is also environment (D4).
In an attempt to interpret these statements, it is possible to notice a concept that goes beyond the present reductionism in the naturalized perception of environment (result generated by a positivist aspect), which is often found in scientific researches.The systematic review on the topic showed, in the health area, a predominance of publications with epidemiological and biologicist focus, in which there are conceptualizations of the environment as nature itself and as etiologic or predominant factor for some pathologies, in the narrow sense of a notion of cause and consequence. 6t should be noted that, very often, this attempt of environment conceptualization soon evokes the words nature, biological life, flora and fauna.Such notion is confirmed and propagated in many textbooks and telecommunications, reinforcing a fragmented and reductionist ideology.These meanings are far from representing an objective and neutral portrait, rather, they constitute "naturalized" lens featured by the author, which tend to see the nature as a world of biological order, essentially good, peaceful, balanced, stable in its ecosystemic interactions, autonomous and independent from the human world.Or else, when this interaction human-environment is focused, the presence of man seems to be always problematic and fatal to the medium. 4t is a fact that the study results, which were brought in prior testimonies, come against this bias when considering a human being no longer an intruder of a wild and unspoiled nature, but on the contrary, he acquires a relation of belonging to it, because such medium is a space to his interdependent existence since he is part of it.By demonstrating such understanding, the professors are close to an approach that brings out a sense of relations web type that integrates and makes to interact social, cultural and natural aspects, in the same formalized notion.
This logic, albeit incipient, finds justification in the works of authors who seek to demarcate the interrelationship between different elements that make up the human existence.
For example, Fritjof Capra 9-10 , who was based on modern physics, expresses a holistic and ecological vision of the planet.It is related to the concept of a world globally interconnected, in which biological, psychological, social and environmental phenomena are interdependent.
His way of thinking demands an ecological perspective, which is not obviously embraced by the mechanism still in force.So, he is challenging coherences historically established by the science.The environment, in a systematic vision, is no longer seen as a machine composed of a multitude of parts, and it is now described as dynamic, indivisible and interrelated whole.
Moreover, it is important to add that when the environment is addressed under complexities and an interrelational optic, it opens up pathways that drive the experiences brought by the professors to a socio-environmental perspective. 4Then, since they gestate an ideology of environment not only as a place for human existence, but also with this space to the interrelationship among culture, society, physical and biological basis of vital processes.
Thus, this environment is no longer strange to the human social life, but it is fully penetrated and reordered by it.Currently, what is natural is so imbricated and confused with what is social to the point it is not possible to state one or the other, but as if they were the same. 2 That is, it is propagated an idea of socio-biodiversity as an attempt to apprehend the complex interaction between society and nature, combining biodiversity (biological diversity of the natural life) and social diversity (social diversity formed by different social and cultural groups that inhabit the planet).
Therefore, a notion of socialized environment means much more than being in the natural world and marked by humanity.It is beyond the idea that nature is independent of the human (personified nature).Rather, it means this medium is also a product of human decision.It influences and it is influenced by it. 2It is a dip in the dialogue between society and nature; it is considered as a continuous interaction in which the parties mutually modify. 4ccordingly, it is possible to say that among the surveyed professors there is a concept that seeks to overcome the Cartesian mechanism on the definition of environment, by appropriating more magnified and systemic discourses.Obviously, concepts do not exhaust the world and they never cover the entire reality either.Instead, they are like lenses in our view of reality and they do not represent the only translation of this world.
They constitute in modes to cut it, frame it, and thus, they try to understand it. 4That is why the existence of a broader definition does not imply necessarily a practical capability in that proportion, but it represents on itself points that direct to the mutations.Different from social, systemic and more opened logics to see and comprehend Perception of nurses-professors about environmental problems... the environment, demanding little by little, actions that go beyond the abstractionism in order to become concrete.
Following this line of thought, it emerged from teachers´ testimonies another category related 'to the current environmental matters: the impacts on human life'.This category includes statements that refer to the professors' confrontation with the current environmental crisis, the posterior occurrence of a confrontation with its consequences and peoples´ difficulty on becoming aware of it.
Certainly, humanity faces today a serious environmental crisis of enormous proportions and capable of affecting the whole planet.It is not limited to isolated spots on earth.A crisis that has been evidenced, in recent years, by showing daily information about expected and unexpected disasters along with ecological, social and health impacts.
Such disclosure ultimately leads the community to feel impacted and even fearful, because everyone understands that such disasters do not represent mere evidence or "probabilities", but real and potential threats to life.So, it is necessary to have discussions, debates and questions about the environmental topic, and also enter in the scope of health.
In this sense, there is a growing emphasis on environmental problems by various sectors of modern society.This is logical, since there is evidence that life on Earth and the Earth itself are threatened by a number of factors related to the process of environmental degradation, among them: global warming, the extinction of animals and plants and the increase in the number of catastrophic climatic events.There is even the risk of a planetary collapse. 11t first glance, all these ecological dangers we face in modernity may appear similar to the vicissitudes of nature that were found in pre-modern times.However, the contrast is very clear.Today, ecological threats result from a socially organized knowledge (i.e. from the human action itself), mediated by the impact of industrialism on natural resources and setting a new risk profile introduced by the advent of modernity. 12his crisis and the risks deriving from it cannot be solved by simple and localized measures, because its consequences are not specific or restricted.They affect the whole planet and they are also very harmful.Therefore, it is imperative to construct a conception of ecology and environment in order to exceed the biological world, and move into philosophical, social, cultural and economic dimensions.
Considering these risks are part of the interviewed teachers' experience, the environmental issue is felt or captured by those individuals in their daily lives, as it is expressed below: [...] I think it is a delicate situation and I guess most people are not aware of it.We think this happens with others, elsewhere, and it is not our problem (D3).The surveyed subjects seem to be aware (in the sense of seeing and understanding) of the complexity that encompasses the environmental crisis, and how they are affected by its impacts day by day.[...] our inclusion in that space, when it is modified, also produces side effects [...] we can verify an over consumption of our energy reserves like water, oil, air, noise pollution, pollution is ... ultimately, all kinds of pollution (D6).
Therefore, teachers demonstrate to comprehend the severity and multidimensionality of the environmental problems, and they point out some strategies (although they are timid) to face them, electing the sensitization and reflective process on the topic as essential steps to implement changes.Those statements are proven through their testimonies: [...] the environment is everything and it is being affected as a whole, the air we breathe, the siltation of rivers, the torrential rains that did not happen before and windstorms.These are responses the environment is giving to the misuse performed by the men.There is no awareness of the people who are also part of that environment, because for me, they are part of the environment.If there is no critical awareness, more ecological acts, since each person has its role in the conservation of this environment, the Earth actually will end (D1).
Thereby, there is recognition from the complexity of this situation and how much awareness is required from individuals and communities in order to promote actions that can mitigate or reverse its harmful effects.Nature is already showing us that there is a very serious problem, precisely in relation to climate, rainfalls and droughts; these things did not use to happen in our country.Today, there are tornadoes, heavy rains and drought regions.Nature is already showing that the problem is quite sharp and we need to do something about it.We have many things to do in relation to the environment (D2).
Yet, this confrontation with the current environmental issues and the identification of situations that are threatening the life of the planet and people does not mean contemporary subjects promote a reordering of their social practices to the point of causing changes (on lifestyle, for example) to the development of actions in order to minimize the environmental impact.
Modern life is better understood as a matter of routine contemplation.Risks are supposed to be accurately measured and estimated in a way that the "future and its risks" are nothing more than things that will come, although they are reflexively organized in the present, in terms of knowledge from their possibilities. 12The point is that being continually "reminding" the risk does not make it an act of reflection, but a "reflection" of what might happen and with the tendency to become simply a routine.
Besides all this, it is necessary to reflect on the historical conception of the environment that has guided the course of humanity.Since it was focused on biological aspects, it keeps a gap between natural and social, between human being and nature.It is also possible to add the idea that when there is an interactive process, it happens with emphasis in the notion of natural world ownership.Hence nature is just extension and motion; it is passive, eternal and reversible.And, it is up to the human being to know and unveil it in order to dominate and control it. 13hereby, it is necessary that new assumptions guide the look or the looks on this complex environment, in order to enhance its social and systemic complexity, integrating human being and nature.All this leads to realize that the environmental problems must be understood according to the context in which they operate, through the eyes of multiple actors who interact with them, looking through various knowledge to build a new rationality that conceive the environment as part of life, as the very human existence. 11n that sense and direction, it is deduced from the teachers´ placements the attempt to "do things differently", to act differently.That exists in some specific aspects (albeit in a very limited manner), and it surpasses the mere speech.In this regard, it is noteworthy that when the subjects were asked about environmental actions they had carried out on their daily lives, they were unanimous in relation to disposal and separation of garbage at their homes, according to the report: [...] I separate my garbage, when there is some stuff that is possible to give to the garbage collectors who make the recycling I do it in my home space (D6).
It is important to consider that due to the fact household waste, in general, do not contain hazardous components, the most widespread method for final disposal, once it was deprived of its recyclable components, is its placing in landfills.Nevertheless, it is necessary to say that the efficiency of its recycling depends a lot on the selective waste collection (which, unfortunately, is not very common in Brazil), and also, it is needed more society awareness about recycling indispensability. 14Without any doubts, there is still much to be done on technical improvements in relation to the litter, and that requires great commitment from society and government agencies due to the seriousness of this matter.
Another category that emerged refers to the 'environmental responsibility: interweaving among individual, social and professional spheres'.To the professors, it seems to be of great importance even in the professional training, as it is expressed below: as teacher, citizen, nurse, mother or any other social role we play.The environmental responsibility is collective; we need to think about it, and we have in our hands, as opinion makers, the potential to spread this responsibility (D4).
As it was said before, the professors expressed during the interviews an interweaving between their responsibilities as citizens and professionals.Their concern with the education of future nurses, and their commitment to the ecological cause through a critical-reflective look is quite evident: I have a lot of responsibilities, not only as a teacher but also as a human being [...].As a teacher, my responsibility would be greater due to the training.Now, it is important what we say and teach to the students, because in the future they will be the trainers [...] it is essential the whole issue on preservation, we need to make the students think about the environment in critic and reflexive ways, so, they will become future preservers (D5).
In relation to the environmental responsibility, whether in the area of ethics, morality and education, all of the processes and human-educational activities show and propose knowledge for actions and duties of citizenship.The awakening to this responsibility refers to the interconnection of educational paradigms, based on philosophical and critical thoughts in order to address values, concepts, beliefs and knowledge for environmental, social and human development, at the same time. 15nder this view, each teacher may contribute to the construction of this entanglement between health and environment within her own discipline, taking into account the current environmental problem and the urgency on training a sensitive conscience to ensure the survival of mankind. 16erception of nurses-professors about environmental problems... Thereby, there is an attempt for reflections on the professional responsibility and educational process, within a logic interrelating healthenvironment, to extend the thinking, the ability to know the world, make decisions, make choices and transform all the people involved.This sense of responsibility, which permeates the conduct of the individual as a citizen and produces an inner reflection, together with the teaching practice nurture an expansion-transformation process in the professional training on nursing, with the aim of building environmental awareness.This is intended and desired for the necessary social transformation and construction of environmental sustainability.
Obviously, it is important to highlight that this matter´s demarcation, as an explicit institutional policy, is also a prerequisite to the achievement of educational practices combined with the pursuit of socio-environmental responsibility development, in the professional training process.The concern on this issue is evident among teachers: I think that, as professors, we have the responsibility to incite our students to widen their vision of the world, and this expansion needs to include the environmental problems (D6).
In general, it is possible to learn from the speeches that the notion of environmental responsibility must pervade the spheres of "human being-citizen" and "the professional", so that the educational practices, in the process of nursing training, are consistent with the conception of environment as space for interrelation among society, nature and nursing practice with potential to the environmental sustainability of the planet.Then, it is necessary that educational practices integrate social actions of a collaborative nature, built with subjects and not for them, combining knowledge and daily social practices to the intervention of local reality.Furthermore, they must be grounded in the students' criticality in order to change behaviors and attitudes towards the environment. 3is implies a shift of paradigm, perceptions and values in order to generate more sympathetic knowledge and complex thought, opened to indeterminacies, diversity, possibility to construct and reconstruct in a continuous process of new readings and interpretations, and setting up new action possibilities.:67 In this aspect, the training practice will only find adequate expression in the educational process if students and teachers have conditions to discover and conquer themselves as subjects of their own historical destination (including social, cultural and environmental aspects).Thereupon, the discussion with the students about the ecological impact in everyday actions, as citizens and health professionals, is extremely beneficial for the academic training in a sense of starting a movement to make people more aware of themselves and more responsible with the environment, allowing the Earth to remain habitable and sustainable for present and future generations. 17:71 This is based on the idea of education as a way of having more qualified teachers and students, through the development of the learning capacity and learning how to think.These actions allow people involved in the process of making decisions, people committed to the society they are part of and also contribute to build that society. 18n general, the idea is that environmental responsibility, when it is truly imbued in the educational practice during the training process, can boost the discussion of new ways to understand the relations between man and environment, and promote new behavioral actions. 19:77 The educational practice must also emphasize the importance of sustainable living ethics that should be part of higher education institutions in order to reach the fundamental change of human beings attitudes and behavior. 20o, by rethinking the debate on environment and health interface in nursing education, it is essential to discuss about this environmental responsibility, and considering it a primary value for professional and environmentally correct practices.The environmental responsibility, since it generates a change of posture, must be part not only in the professional practice, but also on people´s daily lives.Therefore, the professors´ role, which is environmentally responsible and committed to their practice, is linked to the proposition of reflections, new habits and attitudes that enable the student and future nurse to learn essential values to the promotion of health, better life quality to the people and preservation of the planet.
Therefore, it is quite appropriate to mention the important legacy of Florence Nightingale, nursing precursor who showed in her practice the interaction relevance between the human being and nature, as a way of promoting the process of healing and rehabilitation.The recommencement of her assumptions may be the strategy for debate solidification about environment and health interface, in the context of nursing education.It might increase the reflection on the topic and subsidize care for human beings more attached to sustainable and humanistic assumptions.

FINAL CONSIDERATIONS
This study helped to understand the perception fostered by teachers-nurses in relation to the current environmental problems in order to obtain subsidies to the reflection about the professional training in nursing.It appears the conception found goes beyond the reductionism present in the naturalized perception of the environment.It gets close to an approach that brings up a web of relations that integrates and makes social, cultural and natural subjects interact.Then, it is possible to say that among the surveyed teachers there is a transpose of the Cartesian mechanism on the environment definition, by appropriating more magnified and systemic discourses.
Regarding the environmental matters, the professors demonstrated to understand its seriousness and pointed out some strategies, albeit timid, to confront this issue.They elected awareness and reflective process as essential steps to implement changes.Thereby, it is necessary to deal with health-environment relation in the process of professional training because, without any doubts, mankind survival and health depend on a paradigm shift and the way of relating to the environment.
The internalization of the environmental responsibility concept as citizen and teacher, which was also observed among the subjects, is crucial to the development of educational practices on nursing education.Those practices might enable a critical reflection on the problem and also prompt the awakening of values and attitudes directed to act in an environmentally correct way.Studies to deepen this reflective process, particularly regarding the development of educational methodologies on nursing and provoking the awareness of future nurses in relation to environmental issues, are fundamental to combine the profession with the important task of promoting environmental sustainability.