RESEARCH ARTICLES

The work of college health sciences faculty: situations that cause pleasure and pain

Ana Sofia Resque Gonçalves^I; Denise Elvira Pires de Pires^II

^I PhD in Nursing, Assistant Professor of the Federal University of Para, Institute of Health Sciences, School of Nursing. Belem, Para, Brazil. E-mail:sofiares@ufpa.br, sofiaresque@hotmail.com, sofiaresque@gmail.com
^II Post-PhD, Professor of the Federal University of Santa Catarina, Health Sciences Center, Department of Nursing. Florianopolis, Santa Catarina, Brazil. E-mail: piresdp@yahoo.com
^III Work derived from the doctoral thesis in nursing entitled: Pleasure and suffering in the health teachers working in public university in the Amazon region – Inter-institution Doctorate -University Federal of Para/Federal University of Santa Catarina. Presented in December 2010.

DOI: http://dx.doi.org/10.12957/reuerj.2015.6179

ABSTRACT

This qualitative, descriptive study examined situations that cause pleasure and suffering in the work of health studies faculty at a university in northern Brazil. Data were collected between November 2009 and February 2010, through semi-structured interviews of 25 teachers from five departments of the Institute of Health Sciences, Pará Federal University, Belém, and analyzed using thematic content analysis. The results showed that teachers' pleasure at work derived from: enjoying teaching, gaining recognition for their work, and good results. Suffering at work stemmed from: inadequate pay, lack of equipment, and difficult interpersonal relationships. It was concluded that the situations that lead to pleasure and suffering are expressed dialectically in the work process of healthcare teachers, and that enjoying the profession provides satisfaction even though working conditions may cause suffering. Keywords: Faculty; pleasure-suffering; job satisfaction; occupational health.

INTRODUCTION

The work world has undergone changes and the characteristics of activities in education have also changed. The new demands of the educational work processes have required from teachers adaptations to technological innovations, to the constant updates and professional excellence. This requirement has reflected in the personal life, in the quality of health and in the satisfaction of these workers¹.

The educational work, especially in health, in adverse conditions or excessively can damage the teacher's health, causing illness. Distress/dissatisfaction and risks are also associated to the teacher's work, as well as different degrees of pleasure, according to the environment and the way the activity is performed. Teachers seek alternatives to make sense to work in a dialectical relationship of pleasure and pain².

However, the study of situations that cause pleasure and suffering in the work of university teachers is a complex theme that still needs to be further investigated. Thus, our objective was to analyze the situations that cause pleasure and suffering in the work of university health teachers.

LITERATURE REVIEW

The teaching activity as showed an increasing depreciation due to the reduction of investment in higher education, whether of the work environment, salary, or even of social recognition. The result of this situation invariably emphasizes negative effects of physical and psychological stress, absenteeism and even abandonment of the teaching profession³.

The tendency of job satisfaction level of teachers is related to the emotions that the teacher experiences when developing their work⁴.

The teaching practice as a work endowed with intensification of interpersonal relationships mobilizes suffering that is intrinsic to the construction of the teaching relationship, driven by the teaching situation. The teacher's work entails an exposure at the relational level. Affective demand with students can be intense, which may trigger a large tension⁵.

Scientific works^3-5 show that the number of cases of stress and the Burnout syndrome among teachers, with or without other conditions, has grown significantly.

METHODOLOGY

This is a qualitative, descriptive study conducted in the Northern region of Brazil, in the city of Belem, State of Para, with 25 professors from five faculties of the Institute of Health Sciences of a Federal Public University.

The semi-structured interviews took place from November 2009 to February 2010 with seven teachers of nursing faculty (Ng), three of medicine (M), five of pharmacy (P), five of nutrition (Nt) and five of dentistry (D), selected by intentionality and convenience criteria. The reports were identified with the initial letter of the profession and the order of occurrence of each interview. The data were sufficient for the saturation criterion. The study met the criteria of Research with Humans⁶ and was submitted to the Ethics Committee of Federal University of Para and approved under Opinion No. 222/08.

The thematic content analysis technique⁷ composed two categories: situations that cause pleasure in teaching work and situations that cause suffering in teaching work.

RESULTS AND DISCUSSION

Characterization of participants

The descriptive analysis allowed finding the following results: among 25 teachers, the clear predominance of women (19 / 76%) reveals that women have excelled in university teaching, which is against data from the Censo da Educação Superior (Higher Education Census)⁸ that points more men teaching in higher education in Brazil.

Regarding the age group, the average was between 41 and 60 years of age, composing one of the oldest occupational groups. In the Censo⁸ the average was 35 years old. This result can be explained by the amount of time of preparation to entry into the occupation (PhD), as well as the maintenance of work until an age, on average, more advanced than in other categories⁹.

Working time ranged from 1 to 36 years with various teachers close to retirement. Around 24 (96%) of teachers were effective, 12 (48%) worked in graduate courses and 13 (52%) in graduate and post-graduate courses. All had attended some type of post-graduate course, consisting of 12 (48%) masters, 9 (36%) doctors and 4 (16%) specialists. The predominance of master teachers contradicts the Censo⁸, which points to 51.4% of the teachers working in public higher education in Brazil with doctorate.

Situations that cause pleasure in teaching work

The most significant situations enabled the development of four subcategories, which are explained in order of importance, as follows.

Enjoying teaching

The health teacher's work is endowed with positive components, laden with meanings, which can lead to pleasure at work. The teacher, by enjoying the profession, feels satisfied.

The pleasure of doing something I like to do, for me this is very important. (P2)

I like what I do! I have always identified myself with this area [...], so I work in the area that I like. (Ng1)

The personal and professional satisfaction, the identification with the teaching activity and the time of experience in teaching activity can mean greater state of empowerment. The nature of work and even the experience of each individual to the labor are factors that influence job satisfaction¹⁰.

Enjoying what you do is so important that overcomes the overload, over-activity and work demands.

I have a very heavy workload. But, I am not dissatisfied, no [...]. Because I like what I do. [...] If it were in another situation that I did not like, because this work here is difficult. But since I like what I do, it does not become a reason for dissatisfaction. So I feel like this [satisfied]. (P3)

The enjoying what you do is presented as a refreshing point in teaching process, since the teachers feel responsible for carrying out the task and take charge for it, even considering this work difficult.

The dimensions that structure the teaching work context also benefit body, mind and social relations. Pleasure demonstrations are recognized by gratification, achievement, recognition, freedom and appreciation at work, which become health indicators at work¹.

The peculiarities of health education require a complex relationship between teacher and student and the patient. This conformation causes that satisfaction with teaching is attributed to the feeling that they are contributing to train professionals that will be useful to society.

I can see them in the future; they can be great professionals, [...] within what they intend to do. I notice [...] a student excited and dedicated to the course he wants. (P3)

The teacher's role in the formation of new citizens and professionals is a socially recognized contribution. The teacher, recognizing their central role in society, feels responsible for preparing the citizen for life. This training, in fact, should be carried out with joy, hope, and belief that change is possible¹¹.

Satisfactory relationships between teacher and student

The teacher-student interaction was described as healthy and generated high level of satisfaction.

I have a great satisfaction in the relationship with students, it is very good, very pleasant, [...] a lot of satisfaction, really. (Ng3)

With students in general it is very good relationship. [...] They arrive here very young, and somehow, [...] they look for advice, for such things [...] the student esteems us a lot . (P2)

The student-teacher relationship is presented as a factor influencing the beneficial aspects of the work, in which pleasure is evidenced not only in the commitment, in the construction of knowledge, but in the interest and learning demonstrated by students.

I see a positive response from students, that is, when they understand what I'm talking about and they are interested, they are learning, it makes me very happy. (P5)

The teacher is "the social subject that, by exercising the profession, builds links between education and the world, life and school, knowledge experienced by the student and knowledge to be learned in time and space of the educational institution"^12:1.

The student-teacher relationship is influenced by the culture that delineates the everyday living, the individual and collective practices. Teaching, as a function directed for social change,¹³ requires something more than the feeling of social usefulness, perhaps it needs the promotion of essential aspects that create pleasure in the work ².

Recognition of the work performed

It is a factor that influences satisfaction in the teaching/learning process, where pleasure is evidenced by gratitude, by respect to the creative ability they carry out, and especially by the recognition by students.

Satisfaction with the student we see reciprocating. [...] at the end of each semester there are classes that honor us, that appreciate our work. It is a satisfaction that is priceless. It means that we are within an institution that, in a way, believes us. (P1)

What makes me very happy is the thankfulness of the students. It is the response to my actions . (Nt1)

Recognition of work by students, by peers. (D4)

Teachers feel fulfilled when they have the recognition of the people to whom they provide their services^14,15. Recognition is essential and decisive for people "who mobilize their subjectivity at work"^16:34. Recognition of work can then be reappointed by the "subject to the scope of construction of their identity and this is translated affectively by a sense of relief, pleasure, and sometimes lightness of soul or even rise. The work is thus inscribed in the dynamics of realization of the ego"^16:34.

When there was recognition of the work by the academic community (students, colleagues) and also by the institution and users, positive feelings, vitality and job satisfaction were generated, that is, the recognition contributes to the sense of fulfillment of workers and to the production of health ¹.

The relationship between teachers and students and colleagues in the institution in which they carry out their activities is important as it is in that space that the factors that interact directly in feelings of pleasure are established.

Visualization of the work product

The pleasure in the work process can also result from the visualization of the work product, from noticing the good results obtained. Participants indicated that performing a work that is useful to society, contributes to workers' satisfaction.

The research that I developed gave me great personal satisfaction, because I made good publications, I have national recognition thanks to the dedication to these researches. (P4)

It gives me satisfaction when I see the result of work. (Ng2)

When I see something being produced, when give guidance for a Course Conclusion Paper, which probably we will publish as a book, so I think it's the greatest satisfaction. (Nt5)

These results led to the realization that the work is a dynamic process, which has a subjective dimension and involves macro-structural determinations and constraints that are reflected in the pleasure and health of the worker/teacher^2,3.

The greatest source of satisfaction in the health teacher's work focuses on the fact that their interventions help in maintaining human life ^17,18.

Teaching is the opportunity to participate in the life of a human being, it is not only about teaching, [...]. To perform the care you have to be concerned about keeping that life [...]. (Ng7)

I can see the recovery of the nutritional status of the patient; for me, this is amazing [...] it is very painful when you lose a patient. [...] The great satisfaction is when I see that nutrition is critical for the individual's quality of life. (Nt3)

The university health teacher's work entails respect and responsibility for maintaining life of the other¹⁸ and it is not limited only in production, as dictated by the professional qualification requirements and productivity goals in publications, guidance and participation in the scientific community.⁵ Those working invest efforts in every possible ways, so "it is fair that this contribution is recognized"^16:34.

The results of the work, once visualized and recognized, can create opportunities for teachers to reach the sense of their relationship with work and then enjoy the benefits of this recognition experiencing pleasure in teaching activity.

Situations that cause suffering at work

The most significant situations allowed formulating three subcategories, discussed below.

Insufficient remuneration

This subcategory appears as an important factor in the work process, capable of causing suffering, since the teacher is engaged in the construction of the future health professional and feels devalued in this regard. Teachers in almost all faculties approached by this study were dissatisfied with the devaluation in salary.

It is satisfactory in all items, except the salary issue. [...] we are an ED [exclusive dedication worker] burden and keep limited to an X salary, whereas when we are not ED, we can have multiple alternatives, [...] [more financial gain and everything else]. (P1)

[...] the teacher is very poorly paid for what he does. [...] We are ED, we do research, teaching and extension, in a very high workload, [...] running the research projects [...] taking several students under guidance. (M3)

The doctor of the university hospital working 40 hours weekly, with master, earns more than a teacher with my profile, who holds a doctorate and is ED. [...] Not that I think that the professional… the technician has to earn well, really, to hold on, we have to hold on…with a lagged salary....this discourages us. (M3)

The salary contains numerous meanings: concrete meanings (support the family, pay off debts, etc.), but also abstract meanings, inasmuch as "the salary comprises dreams, fantasies and possible accomplishments projects. In the opposite case, the salary can project all the negative meanings involving the material limitations it imposes"^19:50.

Certain statements showed feelings of injustice, when reporting to the wage inequality in relation to other areas and between teachers (effective and temporary) and outrage at the salary. The injustice was the most significant aspect of suffering with the salary, according to frequency and intensity criteria adopted in the discourse analysis of the participants:

[...] it is very bad, the salary of a substitute teacher at the Federal University working 40 hours is pitiful; a bricklayer earns more. (Ng3)

[...] health and education areas have the lowest wages. [...] See the comparison with the salaries of the legal sector, wages are beautiful! (D2)

The salary [...] makes me very unhappy [...], I compare the teacher's salary, Ministry of Education, with the salary of health area, Evandro Chagas and others, they have nearly a quarter of our work and earn more than we! (M1)

I think it's a requirement and great responsibility where we work; health and education. [...] are the two priority areas, but the least valued; education even more than health, so it makes me very unhappy. (M1)

Some participants said they could not survive only on the salary of teacher or health professional and that hardly the teacher would be only a teacher:

[...] my main source of income is not here at the university. [...] I have another source of income. If I lived only with the salary of the university, [...] it would be difficult, complicated. [...] There is a lag in earnings; it should be a little better. (P5)

The negative aspects present in the work organization act as important components in the grieving process of university health teachers, causing wear, aging and somatic diseases².

Inadequate infrastructure

The difficulties inherent to infrastructure are also important in the suffering of university health teachers. Deficits and inadequacies hinder the implementation of educational activities and increase workloads. It is highlighted, in this subcategory, lack of materials, lack of laboratories and the lack of support by the institution as suffering reports:

It is [...] [lack of] infrastructure and support for various activities. (M2)

It is [...] not having an appropriate laboratory [...] to do all that I imagine. (Nt4)

For us, the microscope is very important. [...] There are very few and there is nobody to do maintenance. [...]. If an air conditioning breaks [...] we have to take from our money to fix it, there is no money available for it. (F5)

However, it [the University] needs help on the issue of [...] textbook. When we really need that bibliographic support, we have to have an extra expense. And this complicates [...] our dissatisfaction. (Ng7)

The scarcity of material resources, excessive bureaucracy and lack of pedagogical and technical support by the higher authorities of the educational system act as a source of suffering for teachers²⁰.

Regarding the organization of work at the university, there are problems with the security of buildings, especially against fires, robberies and others, and deficiencies in toilets, which had repercussions on the health of teachers.

The physical facilities, for example, I am hypertensive, I teach at night here, and there is no water for me to take [...] if I want to take medicine [...] I cannot take the medicine [... ] if you want to pee, I have to hold it until I return home. We even use these facilities but they are deplorable, [...] very shameful. (Ng2)

What distresses me and hurts me most is when I go to the classroom; it is a totally unhealthy environment [...]. So I already arrive here upset. (Ng6)

The neglect with education on the national scene is reflected in the working conditions of teachers ⁵ and therefore, they tend to develop strategies to deal with the unpredictability, with the precarious conditions in which they perform the teaching activity at the university and with the suffering.

If I want to [...] make a more differentiated dynamics I have to invest in this process and lead this academic out of the academy, which I think it is much more productive for them to insert into reality. (Ng6)

And there [at the university] is not even chalk available, I have to buy my pen, the overhead projector does not exist, we do not have classrooms, we have to share them with medicine, with dentistry and pharmacy teachers [...]. (N6)

Workers use their initiative, originality and cooperation to meet and overcome the inconveniences, inconsistencies and practical impossibilities of the environment and the prescribed work organization².

Buying teaching materials, to assume the teaching obligations, highlights the struggle for social rights marked until our days by the indifference of the State ¹.

For an enriching and enjoyable work, it is essential that teachers have freedom to create and conditions to carry out their work. When this does not occur, there is the possibility of suffering with physical and/or mental illness.

Problems in interpersonal relationships

There is highlight for the superficiality, competitiveness and the lack of dialogue.

The relationship that we have ends up being [...] cold. [...] It does not deepen, it is superficial. The meetings are to make academic calendar: [...] who is going to teach such day and such time, without much progress towards discussion of that content, [...] [There is no working towards] adjusting content with another other discipline, a real integration. (Ng7)

The biggest problem is the competitiveness that exists among teachers; unfortunately this is true [...]. People want to take the place of another who is ready. People who already have years, then a new one arrives, already thinking he can stay there, when he has to climb the position. So I'm very unsatisfied. (Nt3)

The conflicting social relationships can affect health, increasing both workloads as the physical and mental wear ^3,5.

The situations of suffering were expressed by feelings of anxiety, stress and hopelessness. We also identified managerial and administrative problems, shortage of teachers and overwork, lack of qualifications to the demands of work and exhausting journeys interfering with the performance of work, personal life, well-being and health^3,5, making the work tiring and exhausting.

Suffering experiences did not necessarily mean getting sick, but they can contribute to illness. Participants complained about the devaluation of the teaching activity, reflected in insufficient salary, in the lack of human and material resources and in the conditions in which the teaching work at the university is currently being performed²¹.

The work context influences the pleasure and suffering, in three dimensions: organization, conditions and socio-economic relations, in which the teacher experiences objectively and subjectively the sense of work¹.

CONCLUSION

The situations that generate pleasure in health teachers' work revealed that enjoying what they do, interacting with students and feeling that their work contributes to prepare citizens and professionals needed to society were important elements as they allowed social recognition in the activity.

Situations that generated suffering showed that the organization, working conditions and problems in interpersonal relationships interfere in personal life, well-being and health of teachers.

The situations that cause pleasure and suffering are expressed dialectically in the work process, and the enjoying what you do promotes satisfaction, although the working conditions cause suffering to health academics. It was shown that they recognize a conflicting duality between suffering and pleasure in work and show concern in finding reasons and seek proposals to minimize the suffering and increase pleasure.

Limitations of this study consisted in the refusal of physicians to participate due to lack of time, which reduced the number of participants of this category and in the use of a single research field.

It is expected that the adequacy of conditions and organization of teachers' work prove primordial in the scenario of Brazilian universities and thus promote health, quality of life and pleasure to university health teachers.

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