UPDATE ARTICLES

 

Meaning of the regulation of working hours in the nursing scope

 

Tatiane Araújo dos SantosI; Orlaneide Santos da SilvaII; Cristina Maria Meira de MeloIII; Heloniza Oliveira Gonçalves CostaIV

INurse. Master in Nursing. Professor at the School of Nursing /Department of Community Nursing from the Federal University of Bahia. Member of the Research Group Gerir.  Salvador, Bahia, Brazil. E-mail: tatianearaujosantos@yahoo.com.br
IINurse.Technician at the Edgard Santos University Complex. Member of the Research Group Gerir. Salvador, Bahia, Brazil. E-mail: orlaneide@gmail.com
IIINurse. PHD in Public Health from the University of São Paulo. Associated Professor I at the School of Nursing /Department of Community Nursing from the Federal University of Bahia. Head of the Research Group Gerir. Salvador, Bahia, Brazil. E-mail: cmmelo@uol.com.br
IVNurse. PHD in Administration Federal University of Bahia. Director at the School of Nursing from the Federal University of Bahia (managerial period 2013-2016). Member of the Research Group Gerir. Salvador, Bahia, Brazil. E-mail: helo.gon@terra.com.br


ABSTRACT: The aim of this paper was to reflect on the meaning of the regulation of working hours for nursing workers. Currently, with the elaboration of the Bill nº 2295/2000, the goal is to ensure the working time of 6 hours daily and 30 hours weekly. We question throughout this essay on what implications the regulation of this journey will bring for nursing workers. The possibility of further free time will be used for the cultural, political and technical growing of workers or will serve only for the accumulation of more employment links and more time dedicated to consumption? At the end, the authors show possible answers to these questions and their consequences.

Keywords: Nursing; Nursing Legislation; Working Hours; Work.


 

INTRODUCTION

 

The aim of this paper was to reflect on the meaning of the regulation of working hours for nursing workers. We understand that the struggle to reduce the workload has managed to politically mobilize nurses and nursing technicians, which generates opportunities for the political strengthening of the profession at stake. Nonetheless, the debate on the regulation of working hours is not capable to incite other issues that permeate the work routine of nursing professionals, such as the worsening of employment links and increased intensity of work, we task a risk of having an sterile achievement; because the law of a right does not ensure beforehand its effectiveness, given that the latter is the result of permanent mobilization of workers against exploitation conditions of their workforce.

The nursing professionals hold a weekly workload that varies between 30 and 44 hours, and the daily working hours might vary among 6, 8, 12 or 24 hours, or working systems of four days with 6 hours, or one day with 12 hours, according to what is established in their employment contract1. Nursing employees working in public services already work in the regime of 30 hours a week², but the nurses who perform their duties in private health services have their workload defined in line with the interests of the institution. In both cases, although the situation in the public sector is the desired, there is a lack of regulation of working hours by means of legislation.

The struggle for the regulation of working hours in the field of nursing already exceeds half a century. During the 80s and 90s, the mobilization of the category of nurses in favor of regulation of working hours was intensified, thereby obtaining the approval of the Bill nº 407/1991, which regulated the working hours at 30 hours a week. Such a draft law was vetoed by the President of the Brazilian Republic in December 19962. Currently, the Brazilian National Congress deals with the Bill nº 2295/2000, which fixes the workload of nursing professionals in six hours daily and 30 hours weekly. In 2013, this project awaits further steps to go to the full House of Representatives, after being approved by the Committee for Constitution and Justice.

The regulation of working hours of health workers in 30 hours a week was one of the guidelines approved in the 12th National Conference on Health. Among the categories that comprise the nursing scope, it is observed that, because of work overload, there is no sufficient time to relax, to be with the relatives or to develop learning activities, which leads many professionals to clinical pictures of physical and emotional wear and, consequently, the care quality is hampered2. Nevertheless, will the regulation of working hours for nursing categories mean the abandonment of this condition?

THE WORKING HOURS

The working hours mean the period in which the employee make available to the employer its workforce3. The changes occurred in the mode of production in the last twenty years indicate the conformation of increasingly flexible working systems, which is a situation found when workers, under the illusion of having control of their working time, exercise it in their homes or in other places that are not the traditional spaces of the factories or offices.

Moreover, currently, the worker has to prepare itself all the time for the labor market, which leads him/her to use all his/her ability and skills to the world of work, including those that the worker acquires out of the market. Accordingly, in addition to working at work, he/she also works out of it, by making available all the rest of time to get skills that will be used in the work and for the work4.

However, it should be highlighted that the capitalism of the XXI century is multifaceted. This implies that the changes that take place faster in some segments, such as the example of flexible working days for the computer science and communication industries, are not transferred to other sectors in the same proportion. For example, for the labor market related to the health scope, it seems that the idea of a ​​flexible working hours is still far away, given that one of the characteristics of this market is that the work is carried out within the institutional framework, so that one can have control over workers and to enable them to exercise control over the users, as well as the nature of healthcare work, which is produced and consumed in act and, therefore, is essentially relational.

Nevertheless, even with these particularities of the health-related work, one point connects the health workers to the others with regard to working hours: even if it is bounded for the health work and more flexible in other sectors, everyone is subjected to intensification of the working hours, regardless of where they exercise their working activities.

This is because, in the XXI century, the entire working time was meticulously controlled by employers and this also means control over work breaks. Thus, a worker of our century, even remaining eight hours a day at its workplace, exerts its activity more heavily than a worker of the early XIX century, when control over work time was in its beginning and charges for productivity were still incipient, although they both were already exercised.

Before this multiplicity of shapes, where, for some workers, working time is flexible and, for others, is delimited, how could we determine such a working time? We should not forget that the basis of the capitalism is the exploitation of the workforce, by reducing it to a commodity, and, in such a way, it is determined by the labor time required for its production³.

The working day is comprised of two stages: the time required for the worker to produce its means of subsistence and a second stage in which the worker produces capital gains for the capitalist. Due to it is a doubly determined magnitude, the working day is variable and its entire time will be changed according to the length of time of the overwork3. Thus, it is easy to realize that the capitalist will always try to keep the workload on its ceiling, since this implies an increase in the production of absolute capital gains.

The variation of working hours is established by the physical limits of the worker and the moral boundaries of society3. After all, in addition to feed itself and sleep, among other biological needs, the worker needs time to devote to its family and to the activities that are pleasant and enable it to socialize outside the world of work.

In this scenario, the working day has been the fruit of the historical struggle of the working class for the conservation of the only good that it has been kept in the capitalist society - its workforce. Under this viewpoint, the determination of the working hours is the result of the struggle of the working class against the capitalist class, given that the worker individually, from a certain development of productive forces, is unable to resist the onslaught of capital to increase the production of further values3.

Nonetheless, as the capitalist has in its favor the employment contract, an instrument that legally grants it the right of usufruct of the workforce, through the payment of a wage, workers should also pursuit for legal mechanisms to protect them from the abuses of the capitalism on behalf of the generation of further values.

Thus, the struggle for recognition and regulation of the workload, on the part of the State, is crucial for the working class, since the appears as “a social barrier, which prevents them from selling themselves and their offspring, by means of a voluntary contract with the capital”3:414  and thus it stays legally enlightened” when time is over to the worker sells and when it begins the time that belongs to this worker”3:415.

30 WORKING HOURS A WEEK

As noted in the first section of this essay, a working day is consisted of the necessary labor time and by the labor time for producing capital gains. In order to continue generating capital gains, even with the reduction of working hours, the capitalism might proceed to contrivances, such as reducing the necessary labor time, so that the time of production of capital gains might be enhanced. One of the ways for using such a contrivance is to increase the intensity of work to be performed5,6.

The intensity of work is related to the way in which the work is conducted, which reflects on the amount of energy that is expended by the worker, whether it is physical or emotional, in carrying out its labor activities7. This expenditure of human energy is demonstrated in the outcomes of the work:

When it comes to physical labor, the outcomes appear in measures, such as the number of vehicles assembled per person a day, etc. When work is not physical, but emotional or intellectual, the outcomes might be found in the improvement of the quality and quantity of services7:69.

At this point, we have a first reflection point: will the reduction of working hours mean the reduction of the intensity of work? For us, this will only be possible if the working conditions also change7. It becomes necessary to remember that nurses manage the work process of other nursing workers and they are subjected to the management of numerically and qualitatively insufficient teams, being that is a fact that forces them to also assume the direct patient care, thus performing a dual function. Furthermore, it is not uncommon to perceive the accumulation of the managerial function of more than one ward, by the nursing professional, which takes place in a single work shift.

In addition, nurses are the professionals who commonly provide several consulting shares to the health service to which they are linked, such as the purchase of equipment, supplies, deployment of a given service or assessment of a certain technology, without receiving wages or even recognition because of such activities. The increased intensity of work for nurses associated to poor working conditions is a reality, both in Brazil8-10 and abroad11-13.

Thus, even with a reduced workload, if the above mentioned working conditions do not change, the intensity tends to increase. Thus, the reduction of the working hours has to come associated to the improvement of working conditions in the health scope in a general manner, which means for all healthcare workers the reduction of the “oppressive labor time”6:111. Hence, it should be emphasized that, given the immateriality of the performed work, the subjectivity and the relational effort needed in the health assistance, as well as the poor working conditions, submit workers and users to tensions that are materialized in the deterioration in the relationship between them and in the inadequate care.

Another aspect that should not be forgotten is that the reduction of working hours is one of the mechanisms to minimize the structural unemployment among workers6. Thus, does the reduction of journey mean the opening of further field of work for the nurses? Immediately, yes! But, it might be an artificial creation of vacancies, if it involves, on the part of nurses, the accumulation of a growing number of employment links. The first justification for such accumulation would be low wages, which would not allow the nursing professional to practice its profession in a single link. Based on the analysis of these two last assertions, we already have the solution of the problem: the working hours should be linked to the struggle for decent wages, which are capable of providing sustenance without having to accumulate links that bring as consequence the physical and emotional exhaustion.

Furthermore, it is important to pay attention to the scientific and artistic development of the profession at stake. It is not possible that the entire time that one intend to be free is be used only for the acquisition of skills to be used in the workplace, such as the uncontrolled search for several specializations, or filled with more work or even aimed only for consumption. After all, one of the ways used by the capitalism to the dislocation of workers is the encouragement for competitions, which make them to seek during the whole time to qualify themselves5 in order to keep their employability.
In short, when we use the spare time to the development of other values ​​that go beyond than those imposed by the labor market - competitiveness, flexibility and individualism - we can start to think of a society that is not guided by the production of further values. Therefore, we can give more sense to the things that we perform as healthcare workers, mothers, daughters, women and citizens.

FINAL CONSIDERATIONS

Finally, it is noteworthy to raise the attempt to answer the central question of this essay: will the regulation of working hours for nurses, technicians and assistants mean more time to working activities or time to live? At this background, we present an important point for the answer to this question: time to live and working time is actually an artificial division. There is no meaningful life outside of work and meaningless inside it or inversely.

For nurses, this means to give a meaning to what is done. The act of caring of people should not be the mixing of other professions and neither means the subordination of those who exercise it. But, for that, it will be necessary to take the fight by means of a way of health assistance that enables the integration of health-related professions, where the user is the link among all these professions and where the attributes that are expensive to the capitalist system - demand for procedures and technologies - are secondary to the of care process. Therefore, for the accomplishment of a care action that promotes health, nurses need to retrieve another dimension of their profession: the political dimension. The truly free time should also be used for political engagement in the profession itself and in emancipatory movements of society.

By using the free time in a truly free manner, we can dedicate ourselves to our families and to activities and cultural leisure, which are disconnected from consumption, given that this freedom completes us and enables us to develop our skills and abilities. The options are exposed. We should only make the choices.

REFERENCES

1. Freitas GF, Fugulin FMT, Fernandes MFP. A regulação das relações de trabalho e o gerenciamento de recursos humanos em enfermagem. Rev esc enferm USP. 2006; 40:434-8.

2. Associação Brasileira de Enfermagem. Jornada de trinta horas para a enfermagem: luta da enfermagem e regulação social. Jornal da ABEn. 2005;47 (3): 14-5.

3. Marx K. O capital: crítica da economia política. O primeiro, o processo de produção do capital. São Paulo: Editora Nova Cultural Ltda;1996.

4. Gorz A. O imaterial: conhecimento, valor e capital. Tradução de Celso Azzan Júnior. São Paulo: Annablume; 2005.

5. Gorz A. Metamorfoses do trabalho: crítica da razão econômica. Tradução de Ana Montoia. 2ª ed. São Paulo: Annablume; 2007.

6. Antunes R. Adeus ao trabalho? ensaio sobre as metamorfoses e a centralidade do mundo do trabalho.14ª ed. São Paulo: Cortez;2010.

7. Rosso DS. Intensidade e imaterialidade do trabalho e saúde. Trab., Educ.Saúde. 2006; 4: 65-91.

8. Mandu ENT, Peduzzi M, Silva AMN. Análise da produção científica nacional sobre o trabalho de enfermagem. Rev enferm UERJ. 2012; 20: 118-23.

9. Robazzi MLCC; Mauro MYC; Secco IAO; Dalril RCMB; Freitas FCT; Terra FS et al. Alterações na saúde decorrentes do excesso de trabalho entre trabalhadores da área da saúde. Rev enferm UERJ.2012; 20: 526-32.

10. Silva AA, Rotenberg L, Fischer FM. Jornada de trabalho na enfermagem: entre necessidades individuais e condições de trabalho. Rev Saúde Pública. 2011; 45: 1117-26.

11. Wallin AO, Jakobsson U, Edberg AK. Job satisfaction and associated variables among nurse assistants working in residential care. Int Psychogeriatr.2012; 24: 1904-18.

12. Arsalani N et al. Iranian nursing staff´s self-reported general and mental health related to working conditions and family situation. Int Nurs Rev. 2012; 59: 416-23.

13. Estrym-Behar M; Van der Heijden BI; Fry C; Hasselhorn. Longitudinal analysis of personal and work-related factors associated with turnover among nurses. Nurse Rev.2010; 59 (3): 166-77.