Seeding a Profession: The Intersection of the State, International Interests, and the Early Development of Brazilian Nursing

Abstract

State and international entities can have profound effects on the development of a country's nursing profession. Through a global health governance lens, this paper explores the development of nursing in Brazil during the early twentieth century, and its intersections with national and international interests. Accordingly, we will show how state policies established an environment that fostered the institutionalization of nursing as a profession in Brazil and supported it as a means to increase the presence of females in nation building processes. The State focused on recruiting elite women for nursing, in part due to the Rockefeller Foundation's involvement in the country. Nurses who worked for Rockefeller came from well-educated classes within US society with specific ideas about who should be a nurse and the roles of nurses in a healthcare system. These women served as the primary vehicles for interacting with Brazilian health authorities responsible for health system development. Their early efforts did not, however, ensure a system capable of producing nursing human resources at a rate that, in present day Brazil, could meet the health needs of the country. Findings from this paCultura de los Cuidados Historia

Nursing professionalization and welfare state policies: A critical review of structural factors influencing the development of nursing and the nursing workforce

“…While nursing has gained professional status in some countries, in others, it is still considered a semiprofession and for this reason, the debate about the status of nursing as a profession is ongoing (Liu, ). Further, given that the educational system for healthcare professionals is intricately linked to both local and global contexts (Frenk et al., ), the process of professionalization is invariably affected by international trends (Oguisso et al., ). For instance, the Bologna process , fast‐tracked the integration of nursing education into higher education, accelerating and harmonizing the process of nursing professionalization among European Union member countries (Davies, ).…”

“…The expansion and/or retrenchment of welfare services affects the occupational groups involved in the provision of those services that are either in high demand or become obsolete. Related, it has been noted that state initiatives to expand/improve the provision of healthcare services (Oguisso et al., ) and the provision of health care during civil (Hermann, ) and military conflicts (Choperena & Fairman, ) are generally associated with strengthening of the nursing profession because they increase the demand both for more nurses and more highly skilled nurses. The following examples attest to it.…”

“…Relatively fewer nursing studies considered the role of national policies in influencing nursing professionalization (Oguisso, de Freitas, Squires, & Bonini, 2016;Squires, 2007;Squires & Beltran-Sanchez, 2011). Insightful work has been done to investigate the links between policy and particular aspects related to professionalization such as regulation (Benton, Pérez-Raya, González-Jurado, & Rodríguez-López, 2015;Duncan, Thorne, & Rodney, 2015), education (Aiken, Cheung, & Olds, 2009;Blaauw, Ditlopo, & Rispel, 2015;Duncan, Thorne, Van Neste-Kenny, & Tate, 2011), practice guidelines (Bail, Cook, Gardner, & Grealish, 2009), professional development (Pavolini & Kuhlmann, 2016), and density of practitioners and staffing levels (Lane, Antunes, Kingma, & Weller, 2010;Tourangeau, Cranley, & Jeffs, 2006).…”

The influence of welfare state factors on nursing professionalization and nursing human resources: A time‐series cross‐sectional analysis, 2000–2015

“…Next, WS generosity and underlying principles influence financing models, service provision, accessibility and the overall development of a healthcare system (Bahle, Kohl, & Wendt, ; Freeman & Rothgang, ), all of which, in turn, influence the demand for HHRs. For example, periods of system expansion, followed by increases in the reach and diversity of services, boost the demand for nurses (Kaasalainen et al, ; Oguisso, de Freitas, Squires, & Bonini, ; Siles, Solano‐Ruiz, Fernández de Freitas, & Oguisso, ). Meanwhile, the provision of health care through either public or private organizations has an impact on employment circumstances, including job security (Brannon, ), work conditions, education requirements, and salaries (Squires, ).…”

Primeiro concurso público para enfermeiros do Departamento Administrativo do Serviço Público

“…There was an expansion of professional nursing schools at the same time when conflicts for the legitimation and regulation of the profession occurred. With the foundation of public undergraduate nursing schools reference-model such as the São Paulo Hospital School of Nursing, in 1939, and the University of São Paulo School of Nursing, in 1942, the requirement to equate the new schools to the standard institution-Anna Nery, as defined by Decree 20,109 of 1931, began to lose momentum (10) .…”