ORIGINAL RESEARCH

Lúcia Esther Duque Moliterno: knowing the life story of a militant nurse

Deybson Borba de Almeida^I; Gilberto Tadeu Reis da Silva ^II; Paulo Joaquim Pina Queiros^III; Genival Fernandes de Freitas^IV; Igor Ferreira Borba de Almeida ^V

^I Nurse. PhD. Professor at the State University of Feira de Santana - Bahia. Bahia, Brazil. E-mail: deybsonborba@yahoo.com.br
^II Nurse. PhD. Full Professor, Federal University of Bahia. Brazil. E-mail: gtadeuccreis@uol.com.br
^III Nurse. PhD. Adjunct Professor, School of Nursing. Coimbra, Portugal. E-mail: pauloqueiros@esenfc.pt
^IV Nurse. PhD. Full Professor. University of São Paulo. Brazil. E-mail: genivalf@usp.br
^V Dental surgeon. Graduated. Federal University of Bahia. Bahia, Brazil. E-mail: igfecr@hotmail.com

DOI: http://dx.doi.org/10.12957/reuerj.2017.13345

ABSTRACT

Objective: to analyze the life trajectory of a militant nurse. Method: this is a historical research, with qualitative approach, approved by the Ethics Research Committee, CAAE: 28775614.2.0000.5531. Data were collected through a semi-structured interview to an exponent of Brazilian nursing. Data were analysed by content thematic analysis. Results: from the 80's to the present her life trajectory is permeated by engagement in several fields: student, professional and union, mobilized by professional identity. It is understood that professional unions are a way of professional representation, understood as important social bodies. Conclusion: this study highlighted that the centrality of political militancy and the importance of studies that address the alienation and the nursing professional's identity, are essential for professional's valorization and recognition, which has as consequences a more ethical and autonomous nursing care.

Keywords: Nursing; leadership; history; policy.

INTRODUCTION

Nursing is understood here as a social practice that responds to the demands established by organizations of economic, political, social and ideological practices. It is carried out predominantly by women and is based on knowledge coming from other sciences and from the synthesis produced by themselves to apprehend their object of work - the field of nursing care, with the aim of meeting the social and health needs of the Brazilian population¹.

It is worth mentioning that nursing was slow find its identity and organize itself as a category of workers. It has its history marked by technical and social division of work and preservation of differences until the middle of the 1980's, when it began to discuss and implement a project of revision of the profession².

Another aspect that gives relevance to the present study to the scientific field is the existence of a gap on the theme. A search carried out in the Virtual Health Library with the search terms political militancy resulted in 48 studies; and with the active search of the theme political militancy in nursing, nothing was found. In turn, with the terms political militancy of nurses, two studies were identified.

Therefore, this article had as objective to analyze the life trajectory of Lúcia Esther Duque Moliterno, with emphasis on her engagement with the Brazilian Nursing.

LITERATURE REVIEW

Militancy arises in the life of people as a possible way to exercise their role as subjects, to be what they are. The stories of militants show that they do not find space in the world to be who they are, which leads them to seek, in the social movement and militancy, a territory where this may be possible³.

This concept is amplified by considering that militancy is a form of engaged and critical political participation in which actions are aimed at the political awareness of the population, seeking to develop new values ​​that enable people to organize and fight for a fair and dignified society ⁴.

From a historical perspective, in the decade of the 1980, the political militancy in Brazil was practiced through syndical movements of workers and of the working class. That was a period of democratic openness, the reorganization of civil society and of specific minority groups to fight for their individual and collective rights.

However, in the twenty-first century, social movements ceased to be headed by specific groups and categories and involved broader segments of organized civil society, addressing specific and punctual issues linked to the birth of a new conception of democracy.

However, a decline in political militancy has taken place in recent years, especially in the forms of political representation in trade unions and parties. This has been a result of the individualization of society, the strengthening of neoliberalism and the scandals in these entities when they fail to represent and fight for collective interests, or due to oligarchic groups that create a crisis of confidence in these entities⁵.

METHODOLOGY

This is a qualitative study, a method that applies to the study of history, relationships, representations, beliefs, perceptions and opinions, the products of human interpretations of how they live, construct their artifacts and themselves, feel and think⁶.

This is a historical research based on the biography of the nurse and unionist Lúcia Esther Duque Moliterno, born in São Paulo on February 5, 1960, who has been in the lead of the Nurses' Union of the State of Bahia since 1996.

She graduated in Nursing from the State University of Feira de Santana (1984), holds a postgraduate degree in Public Administration from São Camilo College, Residency in Medical-Surgical Nursing and a Master's Degree in Nursing from the Federal University of Bahia, obtained in 1987.

Worked in the emergency field for 32 years, in the public and private sectors of the Health Care Network, is currently a nurse of the Municipality of Camaçari, Bahia, and works in the area of worker's health.

A semi-structured interview was applied for collection of primary data. It consisted of a series of open questions made orally in a planned order, but so that the interviewer has the possibility of add questions of clarification⁷. The interview was recorded on July 13, 2014 (lasting 2h and 35 minutes) and was transcribed and analyzed afterwards. The interviewee was identified by the initial letters of her name - LEDM, after each transcribed statement.

The content analysis method was used as a basis. This comprises a set of communication techniques to treat data aiming to obtain, through systematic and objective procedures of description of the content of messages, indicators (quantitative or otherwise) that allow the inference of knowledge of the conditions of production/reception (inferred variables) of these messages⁸.

Data analysis included the following steps: cut outs of record units, enumeration based on frequency, treatment of results and interpretations.

The categorization of the data was based on the record units and on the manifested content. Three movements of political militancy of the militant were identified: student, professional and union engagement. Regarding latent content, the following category raised: professional identity.

Latent content is understood as the one that opens perspectives to discover new ideologies and tendencies of the characteristics of social phenomena and, manifested content is the one that guides to conclusions based on the objectives and pertinence of the study⁹.

The scientific research respected the ethical precepts of research proposed by Resolution 466/2012 and its project was approved by the Research Ethics Committee, CAAE: 28775614.2.0000.5531, through Opinion number 663,359.

RESULTS AND DISCUSSION

Four categories emerged from the analysis of the discourse; three were related to the manifested content and one referred to the latent content, which are dealt with below.

Student engagement

[...] my class for example, it was a very contentious group [...] we went to find out if there was an academic directory in the UEFS [...] it was my class that implemented it [...]. (LEDM)

[About the gathering of students in the city of Sorocaba] [...] the police entered the room and said that whoever was seen in the next day distributing leaflets, tagging, would be arrested [...] we left at 5:00 in the morning [...] the police caught us, put us in the paddy wagon [...] and went all around Sorocaba. [...] the chief police officer was of DECOE and then he told us: do you want to live? [...] you will receive mental torture, which is worse than physical torture [...]. (LEDM)

[...] the student movement, I think it was the great incentive [on the reasons that led to militancy], then I began to look at nursing with different eyes[...]. (LEDM)

The understanding that student engagement increases the awareness and political skills of students and future professionals has been evidenced in some studies that consider social movements as sources of innovation and generating arenas of knowledge^10-12.

The way in which the experiences in the student movement collaborated towards a new view of nursing as a field of knowledge and as a profession was evident in the speeches highlighted in this category. They are experiences of contestation and even of psychological torture, which contributed to a citizen professional practice and in defense of life.

In this sense, political militancy favors personal and professional growth, learning and knowledge acquisition. Several studies have shown that, when experiencing militancy, individuals can learn about themselves, about personal relationships, broaden their view of the world and help to better understand society. This stance benefits changes in behavior and opens perspectives of personal fulfillment^2,10.

Professional engagement

[...] the relationship of the director of a public hospital at that time with the nurses, especially with me, was terrible. [...]. For leading the strike of the health area [...] And then political persecution began, in the case [...]. He had an audit started. [...] this director opened a case against me and then he invented several things against me.[...] They transferred me to Barreiras [...].(LEDM)

About the complaint I made about a private hospital that practiced undue reuse of a catheter [...] the doctors of the unit, when they knew about it... they would do a procedure and they would assault me [...] I would just say [...] 'respect the patient, he is lucid. I'm not going to argue with you now, when you're done we discuss the matter.' [...] they put me out of hemodynamics! Out! [....]. (LEDM)

Regarding the professional engagement, the conflicts between the medical and nursing categories are evident in both experiences, in the public and private network, especially when it comes to the biomedical model focused on specialties, which fragments the person in parts, centered on the notion of profit, with a hierarchical health care and dominated by medical knowledge.

In this analytical category, professional engagement and the fight against the biomedical model, the confrontations and the consequences of the engagement and of the political action of the subject stand out not only for the identity issue, but also for involvement with a more just society, as various studies have reported ^13-15.

It is worth mentioning that the biomedical model still guides professional health practices, both in the care and in the management aspect, based on the cartesian paradigm, focused on profit, so that users of health services are treated as objects, bodies to be cured¹¹.

The narrated conflicts go through the struggle for better working conditions, respect in the relationships between doctors and nurses and the right of the user of health services to receive an ethical and humane care. In this sense, in societies whose social relations are capitalist, medicine follows the dominant logic, guided by the individualization and domination of people, a process that makes class relations obscure¹².

Union engagement

About the invitation to be vice president of the union [...] a colleague said [...] but Lucinha, how can we allow our union to be closed? [...] Forget that, oh, I do not want that happen, for God's sake! (LEDM)

About the political militancy of the nurse [...] I say this, 'the political issue, of the understanding of the nurse, he has to give his counterpart... [...] otherwise we won't advance politically. (LEDM)

Thus, the worker is the one who politically advances within his entity, by participating. [...] Today, there are 600, but for a universe of 30 thousand nurses in the State of Bahia, this is nothing. (LEDM)

Another aspect revealed was union engagement. Although she initially did not want direct involvement with the trade union, she assumed the Union of Nurses of the State of Bahia (SEEB) as one of the meanings of her life. Finally, she identifies advances and difficulties in the history of the union, as well as the fragile political awareness of nurses.

It is understood that professional unions are a form of professional representation, important social organisms, since they are intended to defend the economic and social interests of the components of their respective occupational categories, individually or collectively. They have, as main objectives, to fight for salary improvements and for living and working conditions of its associates. And precisely because they represent a professional category or class, all those who practice the profession, regardless of individual, social and political issues are included ^13,14.

The importance of the trade union movement for a working class composed mainly of women coming from an essentially proletarian class, a phenomenon defined as proletarianization of nursing, is acknowledged ¹³. They have a little empowered professional notion and practice ¹⁵ .

In this sense, the main impasses observed by the trade union movement in nursing are the fragile political awareness of nurses, the existence of several unions that affiliate these professionals, as well as the difficulty of finding people who actively militate in favor of the profession¹⁶.

It is also worth noting that nursing has become an activity that is not socially valued, besides suffering the burden of being basically a female profession. There is also the problem of poor compensation which, coupled with daily difficulties, leads professionals to the need to dedicate themselves to two concomitant jobs¹⁷.

Professional identity

[...] few nursing students go to college to become nurses. And those who enter to become nurses [...] They do not have political awareness that they are hardworking. (LEDM).

I remember as if it were today [...] a patient with high digestive hemorrhage [...]In crisis [...] With hematemesis, bleeding, everything was messed up [...] the other day, when I arrived, I saw that he was well. So, something that is like that, professionally and even as a student, at the time, caused me much satisfaction. There, I think, at that moment, I said, 'No! I want to be a nurse.' (LEDM)

If you do not go to the patient and say, 'look, I'm a nurse', he will not ever know that you're a nurse [...]I think the nurse still has [...] to find personal identification [...]. (LEDM)

Reference to the lack or fragility of the nurses' identity regarding their profession was observed in this category.

A professional choice is often mediated by external factors, and the importance of this identity for the professional exercise with ethical-political conscience was also emphasized. ^13-15,17. According to the interviewee, this lack of professional identity is expressed in the social representation of nursing, especially in the category of nurses.

It is likely, therefore, that interpretations related to the professional image arise from the lack of knowledge about the importance of nursing. This imposes the need to discuss such image in so as to favor the construction of professional identity, that is, to allow recognition of its relevance in the context of health teams ¹⁸.

CONCLUSION

Considering the objective of the study - to analyze the life trajectory of Lúcia Esther Duque Moliterno, with emphasis on the engagement with Brazilian Nursing, it was possible to identify that her life course was marked, in fact, by militancy, represented by her student, professional and union engagement.

The importance of student engagement in the political formation of Lúcia Ester Duque Moliterno was notable and signaled as a catalyst for empowerment, citizenship and political awareness.

As for professional engagement, the life trajectory of the militant was often marked by conflicts contrary to the biomedical model, but in favor of the defense of life, not allowing herself to be dominated by hegemonic issues determined by the capitalist system.

Another important and very significant engagement was with the union. This had the aim to contribute to improve the reality of nurses, who still experience precarious working conditions, lack of social recognition and professional invisibility.

Finally, the category 'professional identity', highlighted as latent content in the data analysis, made it possible to verify the fragility of nurses in recognizing themselves as workers that have repercussions in terms of professional status. In view of the above, the implementation of actions to promote political awareness among professionals, as well as to strengthen the professional identity, favoring a more ethical and citizen nursing care, is considered fundamental.

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