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Professional caregivers

Importance of the nursing profession grows with increasing life expectancy and aging population

One of the main responsibilities of a nurse has always been to help people recover from illness and maintain good health. While in past centuries, professional nursing consisted of empirical and largely intuitive practices, today it is based on broad scientific knowledge and involves increasingly specialized procedures across a range of health fields. “Nurses are responsible for ensuring patients receive quality healthcare,” says Regina Szylit, dean of the Nursing School at the University of São Paulo (EE-USP).

The Pan American Health Organization (PAHO) and the World Health Organization (WHO) designated 2020 as the International Year of the Nurse and Midwife, to recognize the work carried out by professionals in these sectors, as well as to highlight the need to increase investment. The idea is that stimulating professional development helps improve patient care.

“This is an area that is expected to grow substantially in Brazil in the coming years, because of the aging population and increasing life expectancy, which will create a greater demand for specialized care,” says Maria Helena Baena de Moraes Lopes, dean of the Nursing School at the University of Campinas (UNICAMP). The education and training of these professionals is subject to continuous improvement due to their crucial role in providing essential services and healthcare, as well as disease prevention. “Nursing is also growing in terms of knowledge production, with more scientific research being conducted by undergraduate and graduate students,” notes Lopes.

In Brazil, Law No. 7,498 of 1986, which regulates the nursing profession, establishes four roles performed at health institutions: nurses, technicians, nursing assistants, and midwives. According to data from the Brazilian Federal Nursing Council (COFEN), an estimated 2,245,000 such professionals are registered in the country.

Nurses are responsible for leading the teams, as well as evaluating nursing diagnoses and preparing and prescribing healthcare strategies for each patient. They are also responsible for making decisions that require scientific knowledge. Their training through higher education can take up to five years.

Technicians are qualified to deal with health problems of varying complexities. They are directed by nurses and work under their supervision. The role requires a high-school education and a nursing course. Nursing assistants, meanwhile, are responsible for simpler duties, such as ensuring patient hygiene and comfort.

Rising demand

• Preventive guidance
• General and emergency healthcare
• Home and pre-hospital care
• Rescue teams

Fields of expertise
• Obstetrics
• Pediatrics
• Geriatrics
• Oncology

• Hospitals, clinics, and health centers
• Emergency services
• Psychosocial care centers
• Companies (occupational nursing)
• Home care

Midwives require a higher education—the courses follow a curriculum established by the Brazilian Health Agency (ANS) to promote vaginal childbirth and reduce the number of cesarean sections, the latter of which accounts for 84% of births in the country, according to ANS data. The School of Arts, Sciences, and Humanities at the University of São Paulo (EACH-USP) was a pioneer in this field, and since 2005 has offered a bachelor’s degree in obstetrics for professionals who intend to become midwives.

Undergraduate nurses qualify with a broad skillset that includes biochemistry, anatomy, physiology, immunology, nutrition, sociology, and psychology, among other disciplines. “Many specialize in a specific field by taking graduate courses and residencies,” explains Torcata Amorim, from the Department of Maternal and Child Nursing and Public Health at the Nursing School of the Federal University of Minas Gerais (EE-UFMG). This is the case, for example, for nurses who work in obstetrics, pediatrics, ophthalmology, cardiology, psychiatry, gerontology, and intensive care units (ICUs). “But they are all trained to care for and improve the patient’s quality of life, and to prevent diseases and injuries,” she adds.

As well as a bachelor’s degree, nurses can choose to graduate with a teaching degree, enabling them to give classes on technical courses. “There are also great incentives for students to commit to research activities,” says Vanessa Pellegrino Toledo, who runs the undergraduate nursing course at UNICAMP. As well as leading to potential careers in academia, studying a master’s or PhD allows nurses to conduct clinical research, such as evaluating the efficacy and safety of drugs for human use. “Because this is a field that uses extremely rigorous methods, labs are often looking for graduate researchers,” says Toledo.

Health professionals have to constantly update their knowledge due to the advancement of technologies used in the sector, such as applications that offer patient advice, monitor patients with chronic diseases, and use artificial intelligence to give nurses new perspectives on their work. In 2003, the UNICAMP teaching hospital (HC-UNICAMP) inaugurated its Health Technology Assessment Center, with the aim of more efficiently raising and using funds in clinical research. The center studies the efficiency of equipment and technologies to avoid unnecessary expenses, for example.

Activities carried out in partnership with doctors and other health professionals have allowed nurses to participate in more collaborative work processes—collective discussions on diagnoses and care strategies have now become common. “The idea that nurses function simply as doctors’ assistants is outdated. Today, an interdisciplinary approach combines the work of these different professionals,” says Lopes, from UNICAMP.

Nursing remains an overwhelmingly female professional field. According to a 2016 survey conducted by the Oswaldo Cruz Foundation in partnership with COFEN, just 15% of nurses are men. “The emergence of modern, scientific nursing in the Victorian era gave the profession a certain femininity,” says Osnir Claudiano da Silva Júnior, a researcher at the Nursing History Laboratory at USP’s Ribeirão Preto Nursing School. “Nursing, however, has no gender. It is purely a social construct,” he concludes.