Condições de trabalho em enfermagem no enfrentamento da Covid-19 sob o prisma da precarização

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Abstract

RESUMO Objetivo: Investigar as condições de trabalho em enfermagem no enfrentamento da pandemia de Covid-19, à luz de aspectos da precarização do trabalho. Métodos: Estudo transversal, com 131 trabalhadoras(es) da enfermagem que atuaram contra a Covid-19 em hospitais alagoanos, no Nordeste brasileiro. Os dados foram coletados online, por questionário de avaliação da saúde dos trabalhadores. Utilizaram-se o teste do Qui-Quadrado ou Exato de Fisher e a regressão logística. Resultados: Entre as(os) trabalhadoras(es), 71% tiveram contratos precários, 33,6% referiram ao prolongamento da jornada e 23,7% eram sindicalizadas(os). Na análise multivariável, ter pouca experiência hospitalar foi preditor para o vínculo precário (OR= 2,408; IC95%= 1,051-5,518). As variáveis preditoras para o prolongamento da jornada foram: ser enfermeira(o) (OR= 3,824; IC95%= 1,274-11,483), horas extras (OR= 3,668; IC95%=1,009-13,333) e número inadequado de trabalhadoras(es) (OR= 10,872; IC95%= 3,409-34,675). Ser técnica(o) de enfermagem foi preditor para ser sindicalizada(o) (OR= 8,967; IC95%=2,560-31,410). Conclusões: A pandemia acentuou a precarização das condições de trabalho em enfermagem, principalmente entre as(os) enfermeiras(os).

Abstract

ABSTRACT Objective: To investigate working conditions in nursing when facing the Covid-19 pandemic, in light of aspects of precarious work. Methods: Cross-sectional study, with 131 nursing workers who worked against Covid-19 in hospitals in Alagoas State, Northeast Brazil. Data were collected online, using a workers’ health assessment questionnaire. The Chi -Square or Fisher’s Exact test and logistic regression were used. Results: among nursing workers, 71% had precarious contracts, 33.6% reported extended working hours and 23.7% were union members. In the multivariable analysis, having little hospital experience was a predictor for poor employment (OR= 2.408; 95%CI= 1.051-5.518). The predictor variables for lengthening the working day were being a nurse (OR= 3.824; 95%CI= 1.274-11.483); overtime (OR= 3.668; 95%CI= 1.009-13.333) and inadequate number of workers (OR= 10.872; 95%CI= 3.409-34.675). Being a nursing technician was a predictor of being a union member (OR= 8.967; 95%CI=2.560-31.410). Conclusions: The pandemic has accentuated the precariousness of working conditions in nursing professionals, especially among nurses.

Abstract

RESUMEN Objetivo: Investigar las condiciones de trabajo de la enfermería para el afrontamiento del Covid-19, según la visión de la precarización del trabajo. Métodos: Es un estudio transversal realizado entre 131 trabajadoras(es) de enfermería que actuaron contra el Covid-19 en hospitales de Alagoas, Brasil. Los datos se recogieron online mediante un cuestionario de la salud de los trabajadores, con la Prueba X2 o Exacto de Fisher y regresión logística. Resultados: El 71% tenía contratos precarios, 33,6% declaró jornadas laborales prolongadas y 23,7% estaba sindicado. En el análisis multivariado, tener poca experiencia hospitalaria fue un factor predictivo del empleo precario (OR= 2,408; IC95%= 1,051-5,518). Las variables predictoras de jornadas laborales extendidas fueron: ser enfermera(o) (OR= 3,824; IC95%=1,274-11,483); horas extraordinarias (OR= 3,668; IC95%= 1,009-13,333) y número inadecuado de trabajadores (OR= 10,872; IC95% =3,409-34,675). Ser técnica(o) de enfermería fue un factor predictivo de estar sindicado (OR= 8,967; IC 95%= 2,560-31,410). Conclusiones: La pandemia acentuó la precarización de las condiciones de trabajo en la enfermería, principalmente entre las(os) enfermeras(os).

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Employment and working conditions of nurses: where and how health inequalities have increased during the COVID-19 pandemic?

Alba Llop-Gironés, Ana Vračar, Gisela Llop-Gironés … (2021)

Background Nurses and midwives play a critical role in the provision of care and the optimization of health services resources worldwide, which is particularly relevant during the current COVID-19 pandemic. However, they can only provide quality services if their work environment provides adequate conditions to support them. Today the employment and working conditions of many nurses worldwide are precarious, and the current pandemic has prompted more visibility to the vulnerability to health-damaging factors of nurses’ globally. This desk review explores how employment relations, and employment and working conditions may be negatively affecting the health of nurses in countries such as Brazil, Croatia, India, Ireland, Italy, México, Nepal, Spain, and the United Kingdom. Main body Nurses’ health is influenced by the broader social, economic, and political system and the redistribution of power relations that creates new policies regarding the labour market and the welfare state. The vulnerability faced by nurses is heightened by gender inequalities, in addition to social class, ethnicity/race (and caste), age and migrant status, that are inequality axes that explain why nurses’ workers, and often their families, are exposed to multiple risks and/or poorer health. Before the COVID-19 pandemic, informalization of nurses’ employment and working conditions were unfair and harmed their health. During COVID-19 pandemic, there is evidence that the employment and working conditions of nurses are associated to poor physical and mental health. Conclusion The protection of nurses’ health is paramount. International and national enforceable standards are needed, along with economic and health policies designed to substantially improve employment and working conditions for nurses and work–life balance. More knowledge is needed to understand the pathways and mechanisms on how precariousness might affect nurses’ health and monitor the progress towards nurses’ health equity.

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How long and how much are nurses now working?

Jane Lipscomb, Barbara Brady-Fryer, Xochiquetzal Geiger … (2006)

Extended work schedules-those that vary from the standard eight hours per day, 35 to 40 hours per week-are common in nursing and contribute to problems with nursing recruitment and retention, in addition to compromising patient safety and the health and well-being of nurses. This study describes the nature and prevalence of such schedules across nursing settings. Quantitative survey data collected as part of the Nurses Worklife and Health Study were analyzed. The sample consisted of 2,273 RNs. Demographic data, information about respondents' primary jobs (position, workplace, and specialty), and specific work schedule variables were analyzed, including data on off-shifts, breaks, overtime and on-call requirements, time off between shifts, and how often respondents worked more than 13 hours per day and on scheduled days off and vacation days. Respondents were also asked about activities outside of work, commuting time, and other non-nursing activities and chores. More than a quarter of the sample reported that they typically worked 12 or more hours per day, as did more than half of hospital staff nurses and more than a third of those with more than one job. A third of the total sample worked more than 40 hours per week, and more than a third worked six or more days in a row at least once in the preceding six months. Nearly a quarter rotated shifts. Almost one-quarter of nurses with more than one job worked 50 or more hours per week, and they were more likely to work many days consecutively, without sufficient rest between shifts, and during scheduled time off. Single parents were as likely as those with more than one job to work 13 to 15 hours per day, 50 to 60 hours or more per week, and many days consecutively. Seventeen percent of all nurses worked mandatory overtime, as did almost a quarter of the single parents. Nearly 40% of the total sample and more than 40% of hospital staff nurses had jobs with on-call requirements. The proportion of nurses who reported working schedules that exceed the recommendations of the Institute of Medicine should raise industry-wide concerns about fatigue and health risks to nurses as well as the safety of patients in their care.

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Nurses' exposure to violence and their professional commitment during the COVID‐19 pandemic

Sultan Özkan Şat, Pınar Akbaş, Şengül Yaman Sözbir (2021)

Aims and Objectives This study aimed to determine the relationship between nurses' exposure to violence and their professional commitment during the COVID‐19 pandemic. Background Violence against nurses is a common problem that persists worldwide. Design This was a descriptive cross‐sectional study. Methods An online questionnaire form and the Nursing Professional Commitment Scale were used to collect the data. The study was carried out online during the COVID‐19 pandemic between October–December 2020. A total of 263 nurses agreed to participate in the study. The STROBE checklist was followed for observational studies. Results During the COVID‐19 pandemic, 8.4% of the nurses stated that they were exposed to physical violence, 57.8% to verbal violence, 0.8% to sexual violence and 61.6% to mobbing. 52.1% of the nurses stated that they thought of quitting the profession during the COVID‐19 pandemic. The mean total Nursing Professional Commitment Scale score was 71.33 ± 15.05. Conclusions This study revealed that nurses' exposure to physical, verbal and sexual violence during the COVID‐19 pandemic decreased compared to before the pandemic. Nurses' exposure to mobbing during the pandemic was found to increase. A statistically significant difference was found between the status of the nurses' exposure to physical violence, verbal violence, and mobbing, working hours, number of patients given care, and their thoughts of quitting the profession. It was found that the status of exposure to physical violence, thinking of quitting the profession and working hours decreased professional commitment. Relevance to clinical practice In the light of these results, it is recommended that measures to prevent violence should be addressed in a multifaceted way. In managing the pandemic process, the decisions and practices should not be left to the managers' initiative to prevent mobbing. Initiatives that will increase nurses' professional commitment during the pandemic process should be planned and implemented.