Regulación de la enfermería en México: actores, procesos y resultados

Abstract

Resumen El objetivo de este artículo es analizar la estructura regulatoria de la enfermería en México, a través de la normatividad y los actores involucrados. Se desarrolló un estudio de caso con uso de fuentes de información cualitativa, cuantitativa y revisión de documentación oficial. El análisis integró los datos obtenidos de las fuentes de acuerdo con cuatro dimensiones propuestas por Moran & Wood (1993). La dimensión con mayores avances es el ingreso al mercado ya que el Estado regula el ingreso a través de una licencia de práctica. La regulación de la competencia es débil y muestra áreas aisladas de práctica autónoma. El mercado laboral ofrece condiciones variadas de inserción con muestras claras de deterioro. El mecanismo de pago dominante es el salario de las instituciones públicas mostrando una estructura que incorpora un componente que no cotiza para la pensión al término del ciclo laboral. La regulación de la enfermería es un componente de su profesionalización y como tal se distingue como un proceso en marcha en vías de consolidación, particularmente aquellas dimensiones relacionadas con la regulación de la competencia, la estructura del mercado y los mecanismos de pago en el cual la enfermería y sus representantes deben jugar un papel más activo.

Nursing practice environment and missed care at highly specialised hospitals in Mexico: A cross‐sectional observational study

“…The link between organizational factors and missed nursing care reflects the multifactorial problems confronting the micro and macro management of public health institutions in Mexico. Salient among them are an inadequate allocation of human and physical resources and, more specifically, limited availability, accessibility and quality of services, together with a dearth of assessments 48 . The preceding factors are consistent with those cited by the WHO and PAHO.…”

Violence against female health workers is tip of iceberg of gender power imbalances

“…Nurses and midwives tend to lack professional autonomy within the health workforce 24 because their capacities and skills are generally not recognised or valued by medical and institutional hierarchies. 15 29 30 …”

“…At a broader level, the discourse around many female dominated health occupations, such as nursing and midwifery, as a caring versus curing profession, has historically justified its subordination to medicine and ignores the importance of caring for physical and emotional healing. Nurses and midwives tend to lack professional autonomy within the health workforce24 because their capacities and skills are generally not recognised or valued by medical and institutional hierarchies 152930…”

Advanced Practice Nursing Roles: A Comparison Between Mexico and the United Kingdom

“…The Mexican Government has control over the registry and licensing of all professionals. The General Law of Professions, passed in 1945, included the creation of the General Direction of Professions (DGP in Spanish), which is responsible for conducting the registry and granting practice licenses to all university graduates, including licenses for nursing and obstetric nursing graduates ( Aristizabal et al, 2020 ). This process has been maintained under government control since its inception.…”

“…Certification, which is valid for 5 years, neither substitutes licensing nor implies that the lack of certification could lead to license withdrawal. Instead, certification is a voluntary process taken by graduate nurses periodically to obtain a new credential that can be used to enhance their qualifications and increase their labor opportunities ( Aristizabal et al, 2020 ). Just after the turn of the century, the Mexican Council for the Certification of Nursing was created to certify graduate and specialist nurses.…”