The Work of Nurses in Primary Health Care: Crossings of the New Public Management

Abstract

The literature in the field of health management mentions a concept called new public management (NPM), introduced in Brazil and France at the end of the 20th century. The objective of the study was to analyze the repercussions of the work of nurses in primary health care in Brazil and France under the influence of NPM. This is an excerpt of a double-titled thesis, which is a research intervention with nurses from two Brazilian states and five French departments. Data were produced between February 2019 and July 2021. The public policy Health on the Hour acted as an institutional transducer, provoking a reduction in access and producing effects on professional practices. In both countries, NPM amplified the predominance of technical and quantifiable acts, the focus on individual care, and the loss of autonomy. Nurses reported insurmountable situations, using the metaphor “Sophie’s choice”. The results showed that making dilemmatic decisions has been the daily routine of nurses, which has not resulted in debureaucratization and higher quality of care.

Violence in the Nursing Workplace in the Context of Primary Health Care: A Qualitative Study

“…Nursing has been strictly placed under the authority and orders of priests and doctors [23]. Similarly, a study shows that, from the perspective of other professionals, nursing is still hierarchically submissive to other professions, with its aspects linked to care and the feminine and linked to the conception of domination between men (medicine) and women (nursing) [56].…”

“…The theoretical-methodological framework of Institutional Analysis (IA) guided this study; it has previously been used in other studies in the primary health care setting [23]. The concepts: institution, analyzer, subject-group, and subject [20,24], in articulation with the data collection devices, allowed participants to reflect on their workplace context and the violence against health professionals, especially nursing professionals.…”