Neoliberalist influences on nursing hospital work process and organization

Abstract

Objectives: To describe and analyze the infl uence of the neoliberal economic and political model on the nursing hospital work process and organization. Method: Qualitative descriptive research, having as its scenery a university hospital. The subjects were 34 nursing workers. The data collection took place from March to July 2013, through semi-structured interview. The data treatment technique used was content analysis, which brought up the following category: working conditions precariousness and its consequences to the hospital work process and organization in the neoliberal context. Results: The consequences of neoliberalism on hospital work process and organization were highlighted, being observed physical structure, human resources and material inadequacies that harms the assistance quality. In addition to wage decrease that cause the need of second jobs and work overload. Final considerations: There is a signifi cant infl uence of the neoliberal model on hospital work, resulting on working conditions precariousness. Descriptors: Work; Nursing; Politics; Working Conditions; Worker Health. RESUMO Objetivos: Descrever e analisar a infl uência do modelo econômico e político neoliberal na organização e no processo de trabalho hospitalar de enfermagem. Método: Pesquisa qualitativa e descritiva, tendo como cenário um hospital universitário. Os participantes foram 34 trabalhadores de enfermagem. A coleta ocorreu de março a julho de 2013, por meio de entrevista semiestruturada. A técnica de tratamento dos dados foi a análise de conteúdo, que fez emergir a seguinte categoria: precarização das condições laborais e suas repercussões para organização e processo de trabalho hospitalar no contexto neoliberal. Resultados: Evidenciaram-se repercussões do neoliberalismo na organização e no processo de trabalho hospitalar, verifi candose inadequações na estrutura física, nos recursos humanos e materiais, que afetavam a qualidade da assistência. Além de perdas salariais que levam à necessidade de outros empregos e sobrecarga de trabalho. Considerações fi nais: Há forte infl uência do modelo neoliberal no trabalho hospitalar, resultando na precarização das condições laborais. Descritores: Trabalho; Enfermagem; Política; Condições de Trabalho; Saúde do Trabalhador. RESUMENObjetivos: Describir y evaluar la infl uencia del modelo económico y político neoliberal sobre la organización y el proceso del trabajo hospitalario en enfermería. Método: Estudio cualitativo y descriptivo en un hospital universitario. Participaron 34 personales de enfermería. Se recolectaron los datos mediante entrevista semiestructurada en el periodo de marzo a julio de 2013. La técnica de análisis de datos empleada fue el análisis de contenido, del cual surgió la categoría: precariedad de las condiciones laborales y repercusión en la organización y el proceso de trabajo hospitalario en el ámbito neoliberal. Resultados: El neoliberalismo infl uye en la organización y el proceso de trabajo hospitalario, sea en la inadecuada estructura física o en los...

Contributive factors for the consolidation of patient safety culture in the hospital environment

“…Inadequate physical space for care activities causes discontent and psychological distress in workers, leaves them vulnerable to work-related accidents and alters the work process. 29 In this sense, the model of an organization that contemplates the specificity of health work and considers the subjectivity of workers, which enables pleasurable work on a larger scale than suffering, builds a positive individual and collective identity, which it possible to provide safe and excellent care. 29 The certification guaranteed improvements in the physical environment, brought more comfort and safety for professionals, who feel the results of collective work and the satisfaction of performing daily work with favorable conditions.…”

Condições de saúde e características do trabalho de enfermeiros de um hospital universitário

“…Nesse sentido, os enfermeiros pesquisados podem ter aderido a um novo vínculo empregatício devido à flexibilidade apresentada pelo trabalho em turnos e/ou plantões, o que permite a dedicação a outras atividades produtivas e a manutenção de elevado padrão de vida (1,15) . No entanto, a sobrecarga gerada pela presença de múltiplos trabalhos pode representar risco à saúde do profissional e à segurança do paciente, haja vista que, em decorrência do elevado número de horas semanais de trabalho, esses indivíduos se tornam mais cansados e estão vulneráveis ao desenvolvimento de intenso desgaste físico e mental (16)(17) .…”

Diagnóstico de cultura de segurança do paciente

“…James Reason developed in the late twentieth century the theory of human error as an unintended consequence of executing an incorrect or inadequate plan of a planned action, ie the plan may be appropriate, but the actions do not occur as planned or not sufficient to achieve the proposed objectives. 24 It is assumed by reason that human errors can be dealt with in two ways: one centered on people with a personal, punitive approach, emerging in this model the culture of fear, where human error is assumed as a moral issue, that the cause of the error stems from incorrect mental processes, inattention and caution. 24 On the other hand, this is the systemic approach, that is, the systemic and error-leading model, contradicting the first strand in the system-centered approach, assuming that human beings fail and errors are predicted and are systemic models, which allow failures in the process and procedure development chain.…”

“…24 It is assumed by reason that human errors can be dealt with in two ways: one centered on people with a personal, punitive approach, emerging in this model the culture of fear, where human error is assumed as a moral issue, that the cause of the error stems from incorrect mental processes, inattention and caution. 24 On the other hand, this is the systemic approach, that is, the systemic and error-leading model, contradicting the first strand in the system-centered approach, assuming that human beings fail and errors are predicted and are systemic models, which allow failures in the process and procedure development chain. In this model, we work with the just culture, that is, the culture of learning from mistakes.…”