PERSPECTIVES OF NURSING GRADUATES FROM STRICTO SENSU COURSES ON THE WORLD OF WORK

ABSTRACT

Objective:

to identify the point of view of egresses from stricto sensu postgraduate courses about the contributions of such qualification for acting in the world of work; and discuss difficulties and facilities experienced by egresses in the labor context, considering the qualification process in stricto sensu postgraduate courses.

Method:

qualitative study, conducted in three universities in Rio de Janeiro, Brazil, carried out with 25 nurses, whose collection occurred from April to June 2019. Semi-structured interview was used, and data treatment occurred through thematic content analysis.

Results:

qualification had positive repercussions, providing diversified job opportunities, and conferring greater professional recognition. The configuration of the work organization and interpersonal relationships are elements that hinder or facilitate the work, resulting in pleasure or suffering.

Conclusion:

the contribution of this study was to analyze the perception of graduates about the importance given to professional qualification, presenting a differentiated point of view.

DESCRIPTORS
Nursing; Education; Professional Qualification; Graduate Nursing Education; Work

RESUMO

Objetivo:

identificar o ponto de vista de egressos de cursos de pós-graduação stricto sensu sobre as contribuições de tal qualificação para a atuação no mundo do trabalho; e discutir dificuldades e facilidades vivenciadas pelos egressos no contexto laboral, considerando o processo de qualificação nos cursos de pós-graduação stricto sensu.

Método:

estudo qualitativo, realizado em três universidades fluminenses no Brasil, realizado com 25 enfermeiros, cuja coleta ocorreu de abril a junho de 2019. Utilizou-se a entrevista semiestruturada e o tratamento dos dados ocorreu por meio da análise temática de conteúdo.

Resultados:

a qualificação repercutiu positivamente, proporcionando diversificadas oportunidades de empregos e conferindo maior reconhecimento profissional. A configuração da organização laboral e das relações interpessoais são elementos que dificultam ou facilitam o trabalho, resultando em prazer ou sofrimento.

Conclusão:

a contribuição deste estudo foi analisar a percepção de egressos sobre a importância conferida à qualificação profissional, apresentado um ponto de vista diferenciado.

DESCRITORES
Enfermagem; Educação; Qualificação Profissional; Educação de pós-graduação em enfermagem; Trabalho

RESUMEN

Objetivo:

identificar el punto de vista de los egresados de los cursos de postgrado stricto sensu sobre los aportes de dicha calificación para actuar en el mundo del trabajo; y discutir las dificultades y facilidades experimentadas por los egresados en el contexto laboral, considerando el proceso de calificación en los cursos de postgrado stricto sensu.

Método:

estudio cualitativo, realizado en tres universidades fluminenses en Brasil, realizado con 25 enfermeros, cuya coleta ocurrió de abril a junio de 2019. Se utilizó la entrevista semiestructurada y el tratamiento de los datos se realizó mediante el análisis temático del contenido.

Resultados:

la cualificación repercutió positivamente, proporcionando diversas oportunidades de empleo y confiriendo un mayor reconocimiento profesional. La configuración de la organización laboral y las relaciones interpersonales son elementos que dificultan o facilitan el trabajo, dando lugar a la práctica o al sufrimiento.

Conclusión:

la contribución de este estudio fue analizar la percepción de los egresados sobre la importancia conferida a la cualificación profesional, presentando un punto de vista diferenciado.

DESCRIPTORES
Enfermería; Educación; Habilitación profesional; Educación de Postgrado en Enfermería; Trabajo

INTRODUCTION

Nursing is both a specific field of knowledge and a social practice that is structured and consolidated as science, technology, and innovation. Thus, it contributes to good practices applied to health services directly or indirectly to users, especially of the Brazilian Unified Health System (SUS)⁽¹⁾.

These good practices are recommended by the Ministry of Health and aim, among other guidelines, for excellence of care, humanization of care and management, and reduction and control of risks to users and the environment. Therefore, it is important to have a qualified nursing team that contributes to the production of knowledge to meet the demands of the formation and training of human resources, with potential impact on care, management, teaching and research⁽²⁾. In this sense, stricto sensu graduate studies are considered a promoter of positive results in the various instances of work in health and nursing⁽³⁾.

On the other hand, nursing faces many challenges in its daily work, both in the development of the best care, in the case of care nurses, and in the process of training future professionals, experienced by teaching nurses. To face these challenges, these professionals are required to have high psychophysical and cognitive capacity, to ensure quality in the service provided⁽⁴⁾.

It is known that the world of work in contemporary times is permeated by adverse situations, many of which are related to the neoliberal ideology that underlies the organizations of work in health. Thus, polyvalent, and multifunctional workers are verified, pressured to reach increasingly high production goals, with growing unemployment and underemployment, generating competitiveness among peers and constant need for training and qualification to remain in the labor market⁽⁵⁾.

This work context brings up a dynamic of feelings that oscillates between suffering and pleasure, impacting on the subjectivity and health of workers. The Psychodynamics of Work presents an outstanding contribution to the understanding of the dialectic and dynamics of negative and positive feelings that permeate the workers’ experience. For Psychodynamics, work is never neutral in relation to health and subjectivation processes of individuals, and it can lead to health or illness, depending on the configuration of the organization of work in comparison with the biopsychosocial specificities of the worker⁽⁶⁾.

Therefore, it is emphasized that both the process of professional qualification and the experience in the world of work are complex phenomena. Both are characterized as multifaceted, complex, and dynamic; also indicating a close relationship and interpenetration of situations. In this sense, the object of this study is the perception of nursing graduates from stricto sensu graduate courses on the contributions of qualification for working in the world of work in health and nursing.

In view of the above, the following objectives were set: to identify the point of view of graduates from sensu stricto postgraduate courses on the contributions of such qualification for acting in the world of work in health and nursing; and to discuss difficulties and facilities experienced by graduates in the health work context, considering the qualification process in sensu stricto postgraduate courses.

METHOD

This is a qualitative, descriptive-exploratory study, carried out in three higher education institutions in Rio de Janeiro (two federal public and one state public), which develop master’s and doctoral programs. The institutions were named University A, University B, and University C, to respect the confidentiality and anonymity recommended in research with human beings.

The participants were 25 nurses graduated from the stricto sensu post-graduation programs of these three institutions, of which eight were from University A, 10 from University B and seven from University C. The invitation to the possible participants was made through electronic mail, whose virtual addresses were made available by the three universities, after consent and clearance for the development of the research by the ethics committee.

There were three inclusion criteria for participants, of which one was that they were nurses, because two programs linked to the investigated institutions admit other health professionals. This criterion was since one of the most significant interests of this research was the nursing work and the understanding of these professionals about this context.

Another inclusion criterion was that they had worked in the profession for at least one year, which was considered enough time to acquire an approximate view of the labor reality as masters and doctors. It was also listed as an inclusion criterion to collect data with qualified nurses from 2009, the year chosen because it was when the Social Organizations and the neoliberal model were consolidated in the health services of Rio de Janeiro, bringing significant changes in the world of work in health⁽⁷⁾.

The exclusion criterion was graduates who worked outside Brazil, because the focus of the study was the national labor market; therefore, the reality of other countries was not the center of interest of this research.

Data were collected with graduates who graduated between 2009 and 2016. Those who accepted the invitation responded to a semi-structured interview script, composed of open questions, for example: Talk about the contributions of the stricto sensu post-graduation for your performance in the world of work; Comment on the difficulties and facilities experienced in your work practice after completing the stricto sensu post-graduation. The collection period occurred between April and June 2019.

The content of the interviews was recorded using cell phones, lasting an average of 30 minutes. The transcriptions were made by the researchers themselves soon after the interviews were held.

To ensure the anonymity of the participants, each interview had a codification, consisting of the letter E referring to the word interview and a cardinal number related to the chronological order of completion. The number of participants was guided by the criterion of data recurrence, meaning, when the content of the interviews started to be repeated, it was an indication to end the collection⁽⁸⁾.

The Thematic Content Analysis technique was used to treat the information collected, in the light of Bardin’s analysis⁽⁹⁾. To apply this technique, the following steps are performed: i) pre-analysis; ii) exploration of the material and iii) treatment of results, interference, and interpretation. Thus, initially, the selection of relevant documents for analysis is made, objectives and hypotheses are elaborated, pointing out reference factors for clarifying the object (pre-analysis). Then, after the data is obtained, it is explored, scrutinized, and transformed into results (material exploration). The last step is elaborated from the results that were significant for the research⁽⁹⁾. Thus, the results are classified and analyzed in line with the theoretical framework of the research, which dealt with nursing education, worker health and critical education.

The application of this technique brought up three categories: I) qualification repercussions on professional performance; II) obstacles and opportunities experienced in the world of work; III) pleasure and suffering arising from the work experience.

The study was submitted for evaluation to the Research Ethics Committee under opinion number n. 3,043,442.

RESULTS

Repercussions of the qualification in the professional performance

The qualification obtained with the master’s and doctorate course was fundamental for the improvement of the working conditions, as well as it broadened the critical perspective on the world of work, besides providing greater personal and professional fulfillment.

Obtaining a doctorate was a watershed. For example, the financial issue, because the salary is better as an adjunct professor; there is the fact that the opportunities increase, you get more invitations for various jobs.

(E 04)

Besides the degree that allows you to be in renowned institutions, it allows you productions to improve your practice. My master’s degree improved my practice and I multiply this to the students and patients.

(E 08)

My qualification helped me to face this daily work, because it gave me a broader world view, made me a more critical person, to see the reality of the facts and understand it better.

(E 09)

The qualification allowed me to enter a public higher education institution as a teacher, which is a great personal and professional achievement. So, it gave me greater opportunities in the job market.

(E 10)

Obstacles and opportunities experienced in the world of work

It is known that the work of nurses, whether in care or in teaching, is permeated with challenges and complexities. And the configuration of the work organization has great interference on the difficulties and facilities for the execution of the work tasks.

One difficulty of our work is its organization, because we are often short of personnel and material, which in turn increases the pace and demand of our work. So, you want to perform something you have learned, but because of these shortages you can’t do it.

(E 08)

The precarious structures of public universities, especially the care units used as practical field by the students, lead the professionals to the need for improvisations and adaptations, which can negatively influence the development of teaching-learning and the quality of the service.

The structure of a public university, of public hospitals that we go through, is bad. And you must improvise. You teach the student one way and when you get there you must adapt within aseptic techniques, not hurting any concept. Improvisation is sometimes difficult for the student to understand. I think that the main difficulty is the very structure of the public system.

(E 13)

As we work in two problematic areas, which are education and health, we have a shortage of human and material resources, we work with obsolete materials, our equipment is not maintained, so this hinders you in your work.

(E 02)

The participants mentioned the multiple tasks that need to be performed, which captures leisure time and family time, as it is necessary to cope with the intense labor demands. They also mentioned the salary that falls short of the teachers’ needs, especially considering the responsibilities and work activities they must perform.

The difficulty is the overbooked schedule, and this ends up hindering the time with the family and for fun. It is necessary to have the product of the extension program, published articles, and teach a good class. In short, this is an exhausting dynamic, not to mention the administrative processes we go through. It is all very intense.

(E 11)

We have a series of requirements to maintain ourselves at the level that the university demands, that is, training, publication, participation in congresses. And, unfortunately, we live an economic degradation. We earn a small salary which is not enough to pay for all these activities.

(E 09)

Some factors that provide work opportunities and contribute to the smooth running of the work process were verified. The good interpersonal relationship, solidarity among professionals, and cooperativity in work activities stand out.

The clinical area where I work has a group that is very supportive, and with this we have a very healthy working relationship. So, this solidarity of colleagues is fundamental, it is the main facilitating element.

(E 14)

The decision-making process, which will directly affect the lives of the workers, is democratic. So, I think that this is the easiness of the job. We have mature discussions to decide things, and there is a collaborative environment.

(E 19)

Pleasure and suffering arising from the work experience

Work has the characteristic of being dialectical, that is, while it results in pleasure, it can generate suffering. The emergence of such feelings depends on the configuration of the work organization and the specificities of the labor process, in confrontation with the biopsychosocial peculiarities of the worker.

From this perspective, the participants highlighted some situations that result in suffering from their work experience, with emphasis on the extensive workload, demands, and high productivity goals.

There is a discomfort related to stress, to the wear and tear of working in a regime that leads you to this intensification of work. You go home and the work doesn’t end, the stress and psychological suffering are great.

(E 09)

Another condition that causes suffering is the lack of human and material resources, which leads to the need for improvisation in care practice and teaching, making it difficult to perform procedures.

This question of improvisation, sometimes you suffer too. Having to improvise something important or not having something essential to do a procedure the way you learned it. This is too bad.

(E 13)

Some participants mentioned as a source of suffering the interpersonal relationship with coworkers, as they highlight competitiveness as a generator of conflicts in the work collective, especially for those who work as professors, who need academic production to maintain themselves in stricto sensu graduate programs.

The academic environment is very competitive. CNPq and CAPES make demands and create rankings in which people end up comparing themselves, and this is not positive. This situation causes suffering because you see people with wonderful potential, but who do not have the same opportunities, and people feel belittled within the academic environment.

(E 18)

On the other hand, the world of work promotes pleasurable situations for professionals, pushing them to continue seeking new knowledge and improving their practice. Factors such as teaching classes and accompanying the students’ growth were mentioned as important elements that provide pleasure.

It gives me great pleasure to accompany the students, to see their evolution, to see how they arrived at the practice trembling with fear and when they arrive at the internship, they gain independence. It gives me pleasure in the sense that I like teaching, I like being in the classroom.

(E 05)

It gives me pleasure to feel useful in-patient care, to see it improve, to apply the knowledge I acquired in my master’s degree in the care practice, making it excellent and relevant to the user.

(E 25)

Other sources of pleasure are working with the desired profession, the autonomy to develop research, and to contribute to the advancement of nursing education and care.

I take pleasure in developing clinical research that will contribute to nursing education and nursing care.

(E 08)

You graduate, choose a profession, invest in qualification, and get a return on what you have invested is very pleasurable. It is the return on your investment.

(E 05)

DISCUSSION

Stricto sensu post-graduation contributes significantly to the advancement of science, technology, and care, and is a watershed in the lives of students, as it qualifies them for the labor market, enables greater job opportunities, and creates an interface between knowledge production and the demands of the agencies that foster education and research.⁽¹⁰⁾ The courses aim to qualify human resources to act and transform the world of work, with holistic and innovative health actions⁽¹¹⁾.

In this context, it is necessary to be aware of the insertion of graduates in the labor market and support them to monitor and encourage their theoretical, methodological, and technological progress, so that they can solve the adversities of labor scenarios. The graduates’ approval in public positions and the changes they make in society demonstrate the social impact generated by academic qualification⁽¹²⁾.

It was found that the graduates emphasized the intense academic productivity, which leads to an excessive workload, as well as the demands and adversities of the labor context in the respective institutions to which they are linked, in a reality that makes them face the shortage of personnel and material, as well as the extensive workload to which they are subjected. Thus, a fine line is created between work and rest/leisure, often putting adequate rest in second place, which can facilitate the occurrence of work accidents, medication errors, exhaustion, and lack of leisure^(12-13).

The participants thus expressed that the extensive workload dedicated to work can lead to sick leave and/or lack of motivation, since the fulfillment of all work assignments becomes a priority before leisure. Thus, the wear and tear can cause damage to the physical and mental integrity of professionals as well as the quality of service⁽¹⁴⁾.

From this perspective, the nursing category fights, on a national level, for the regulation of up to 30 hours of weekly working hours, to minimize the harmful consequences of the extensive workloads to which the profession is subjected. It seeks a working day more appropriate to the specificity of the task, considering the safety and biopsychosocial needs of these workers⁽¹³⁾.

The psychodynamics of work studies the relationship between work organization and the subjectivity of the worker, including the way he/she experiences the work practice, and the organization is an element that can generate both suffering and pleasure. Insofar as it provides the worker with freedom and autonomy to control his or her work activities, this organization has the potential to arouse pleasure in the worker. On the other hand, depending on the configuration of the work organization, if it is authoritarian, plastered, whose prescribed work is distanced from reality, then there is suffering at work⁽¹⁵⁾.

Pleasure and suffering are influenced by a triad that consists of work organization, working conditions, and interpersonal relationships. The way the worker deals with the adversities of the work context, besides this triad, is intimately related to his or her experiences and perspectives, external and internal. In this logic, suffering can be a mobilizer of changes: the individual uses it as a means to re-signify his experiences, or it can lead to falling ill and staying away from work^(15-16).

The structure of hospitals, mentioned by graduates, is an element that hinders the progress in assistance and in the teaching-learning process. The work in public hospitals has been marked by a high insufficiency of supplies, leading to situations that require adaptation and improvisation to make possible the continuity of care, a situation that is a source of suffering for the worker⁽¹⁷⁾.

Adaptation is understood as conformation, adjustment, modulation, and appropriation, a process that allows a living being to become more capable of surviving in the environment in which it lives. Improvisation, on the other hand, can be understood as doing, preparing, or inventing in a hurry, without a plan or previous organization⁽¹⁸⁾.

In this context, the hospital improvisation arises from an urgent need in care, however, it is not always convenient for the execution of the work if we consider the respect for the scientific principles of nursing. Thus, due to flaws in work organization and public management, the constant adaptations and improvisations may be harmful to patient safety, to the worker’s health, and to the students’ teaching-learning process. From this angle, the art of improvisation, although it awakens creativity and mastery of adversities, can prove to be difficult to assimilate for future nurses, and as an impasse for the professional who wishes to apply new knowledge obtained through scientific research⁽¹⁷⁾.

Satisfaction and pleasure with work can be understood as a sum of favorable feelings that the worker has in relation to it. The greater the result of this sum, the greater the motivations for the professional to provide quality care to the user, his family and community⁽¹³⁾.

Following the perceptions of the participants regarding situations of pleasure, acting in the profession desired by the worker consists of one of the factors that provides the basis for satisfaction in the work context, since, inserted in the professional exercise of interest, there are greater chances of pleasure and professional identification⁽¹⁹⁾.

The teacher’s pleasure is intertwined with the dynamic relationship and exchange between students and the educational institution to which he/she is linked, with student satisfaction awakening in the teacher the pleasure of teaching and strengthening his/her identification with the profession⁽²⁰⁾.

Furthermore, when analyzing the factors responsible for the emission of pleasure, the recognition of the work by the patient is essential for professional satisfaction and identification. This recognition can be perceived from the moment the user and his family are welcomed into the health unit, where the professional is dedicated to creating a bond, until a procedure is performed. Thus, through a horizontal relationship, the patient trusts the professional and shows affection in the form of gratitude, leading the nurse to identify with the profession and encouraging him to increasingly improve his practice⁽¹³⁾.

It is understood that the study’s limitation lies in the impossibility of generalizing the results, given that the context of data collection focused only on the reality of the state of Rio de Janeiro. However, it is pondered that the present study may encourage other researchers to explore other realities, expanding the knowledge on the theme.

CONCLUSION

Based on the results apprehended, it is considered that the master’s and doctor’s degrees had a positive effect on the lives of the participants, highlighting the importance of qualification as a provider of greater recognition and professional appreciation. Furthermore, it has provided more and diversified employment opportunities with more attractive salaries; it has made it possible to expand and deepen one’s area of expertise; it has encouraged creativity and entrepreneurship in work activities, and a critical view of the work context.

It is noteworthy that, with the acquisition of titles, responsibilities increase, resulting in a greater workload and overbooked schedules. From this perspective, it caused a decrease in the time dedicated to rest and leisure, leading to psychological suffering and weariness of the participants. Moreover, it is considered that work organization, working conditions, and interpersonal relationships can be facilitating or hindering factors for the exercise of the profession, according to how they are configured and conducted.

The results also pointed to the need to look at the subjectivity of the graduates, to transform the aspects that cause suffering at work and enhance the factors of satisfaction and pleasure at work. In this way, health is promoted, and the risk of work-related illness is minimized.

The contribution of this study is to analyze the perception of graduates about the importance given to professional qualification, presenting a differentiated point of view. It also contributes to the programs of stricto sensu courses, in the sense of evaluating the pertinence of the contents developed in the courses, to qualify the students to account for the dynamic and unusual transformations in the world of work.

ACKNOWLEDGMENTS

This research had the financial support of the National Council for Scientific and Technological Development (CNPq) obtained through the call nº 12/2017, process 306014/2017-3. In addition, we thank CNPq and the State University of Rio de Janeiro for the technical incentive related to the Institutional Program of Scientific Initiation Scholarships.

HOW TO REFERENCE THIS ARTICLE:

• Souza NVD de O, Silva M de S, Roque ABM, Costa CCP da, Andrade KBS de, Carvalho EC, et al. Perspectives of nursing graduates from stricto sensu courses on the world of work. Cogitare Enferm. [Internet]. 2022 [accessed “insert day, monh and year”]; 27. Available from: http://dx.doi.org/10.5380/ce.v27i0.75756.

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Edited by

Associate editor: Susanne Elero Betiolli

Publication Dates

• Publication in this collection
  11 Mar 2022
• Date of issue
  2022

History

• Received
  28 Aug 2020
• Accepted
  15 Oct 2021