Organização do trabalho em enfermagem: implicações no fazer e viver dos trabalhadores de nível médio

Abstract

Este artigo reflete acerca da organização do trabalho da enfermagem no contexto do trabalho em saúde. Sustenta-se teoricamente nas formulações do materialismo histórico-dialético sobre o processo de trabalho humano, em uma abordagem crítica do conceito de profissão elaborado pela sociologia das profissões e em algumas teorias do campo da administração que vêm influenciando o trabalho da enfermagem. Teve por base os dados obtidos em 6 (seis) pesquisas de campo que resultaram em 3 (três) dissertações de mestrado e 3 (três) teses de doutorado que trataram do tema, utilizando a abordagem da pesquisa qualitativa e envolvendo a participação de representantes dos diversos grupos que compõe a equipe de enfermagem. Conceitua organização do trabalho incluindo a perspectiva da vivência nos locais de trabalho e das relações macrossociais. Ressalta que as transformações que vêm ocorrendo no mundo do trabalho têm influenciado o trabalho em saúde, mas que o modelo de organização continua influenciado pela lógica taylorista. Conclui que a realidade da organização do trabalho da enfermagem pode ser mudada pela ação coletiva dos profissionais de enfermagem, em aliança com os demais setores organizados da sociedade e atendendo as necessidades dos usuários dos serviços.

The nurses' work process in different countries: an integrative review

“…Actually, these "tendencies" help reduce labor expenses in the health sector and aim at maintaining the mode of production and capital accumulation in the health industry (35,37) .…”

Work organization in hospital nursing: literature review approach

“…Current macro policies in society influence and affect the organization of work. 1 Hospitals and health institutions in general can be considered as "professional bureaucracy" type organizations, according to Mintzberg's Organizational Theory. 8 In these organizations, the "operating core" consists of well-educated and trained professionals who hold considerable control over their work and enjoy relative autonomy due to their specialized knowledge and the complexity of the work.…”

“…Although centered in the medical work, in organization and the management of work and care practice, each professional category holds a certain autonomy in assessment and decision making. 1 In nursing, in general, the organizational principles based on Taylorism and Fordism prevail, such as a rigid hierarchy, division of work tasks, doing to the detriment of thinking, a strong concern with manual procedures, routines, standards and task distribution scales, providing, among other things, the fragmentation of care to users. 1 Nursing is strongly influenced by the management sector and by physicians, and the nurses work is still primarily administrative.…”

“…1 In nursing, in general, the organizational principles based on Taylorism and Fordism prevail, such as a rigid hierarchy, division of work tasks, doing to the detriment of thinking, a strong concern with manual procedures, routines, standards and task distribution scales, providing, among other things, the fragmentation of care to users. 1 Nursing is strongly influenced by the management sector and by physicians, and the nurses work is still primarily administrative. Thus, the nursing work in the hospital is performed both in the "operational core" and in the "advisory support" areas.…”

“…During these more than 150 years, the organization of the therapeutic environment has been an important part of the nursing work, being grounded on the technical and social division of the work since its conception. 1 More recently, there has been a consolidation of the understanding that the professional role of the nurse is identified by the dimensions of the service in health care, education, research and management, and that these articulated dimensions directly influence the quality of care.…”