Nurses graduated from Escola de Enfermagem Carlos Chagas: Work areas. 1936-1948

Abstracts

Objective:

To analyze the spread out Nurses Graduated, during the period of 1936-1948, from Carlos Chagas School of Nursing (EECC), several fieldwork areas.

Methods:

Social-historical study was based on documental analysis of the "List of 1936-1948 graduated", from Memory Center School of Nursing (CEMENF), UFMG. It has followed the steps recommended by the historical method.

Results:

About half of them were worked on public health. The hospital field was not a choice for former Nurse graduated from EECC, except for graduated Sisters of Charity. The work of Nurses was well accepted by the companies, starting the first forays into the world of Occupational Health Nursing. Teaching in nursing schools were the choice for Nurses who wanted to study and work.

Conclusion:

Historically, EECC confirms the tendency for professionals aimed at the needs of the healthcare market regulated by the state.

Nursing; History of Nursing; Schools, Nursing

Objetivo:

Analisar a distribuição das egressas da Escola de Enfermagem Carlos Chagas (EECC) em seus campos de trabalho no período de 1936 a 1948.

Métodos:

Estudo histórico-social, fundado na análise do documento "Relação de diplomadas 1936-1948", do Centro de Memória da Escola de Enfermagem da UFMG (CEMENF). Seguiu os passos preconizados pelo método histórico.

Resultados:

Cerca de metade de suas egressas foi atuar na saúde pública. O campo hospitalar não foi dominado pelas ex-alunas da EECC, excetuando-se as Irmãs diplomadas. O trabalho da enfermeira foi bem aceito pelas empresas, iniciando as primeiras incursões no universo da Enfermagem do Trabalho. A docência nas escolas de enfermagem tornou-se um atrativo à mulher que desejava estudar e trabalhar.

Conclusão:

A EECC confirma historicamente a tendência de formação de profissionais voltadas para as necessidades do mercado de saúde reguladas pelo Estado.

Enfermagem; História da Enfermagem; Escolas de Enfermagem

Objetivo:

Analizar la distribución de enfermeras egresas de la Escola de Enfermagem Carlos Chagas (EECC) en sus campos de actividad en el período 1936-1948.

Métodos:

Estudio histórico y social, basado en el análisis del documento "Relação de diplomadas 1936-1948", del Centro de Memoria de la Escola de Enfermagem UFMG (CEMENF). Siguieron los pasos recomendados por el método histórico.

Resultados:

Mitad de las graduadas actuó en salud pública. El campo hospitalario no fue dominado por ex-alumnas de la EECC, exceptuándose las Hermanas diplomadas. El trabajo del enfermero fue bien aceptado por las empresas, a partir de las primeras incursiones en el universo de la Enfermería del Trabajo. La enseñanza en las escuelas de enfermería se ha convertido en un atractivo a la mujer que deseaba estudiar y trabajar.

Conclusión:

La EECC confirma históricamente la tendencia de los profesionales orientados a las necesidades del mercado de la salud regulados por el Estado.

Enfermería; Historia de la Enfermería; Escuelas de Enfermería

INTRODUCTION

The Nursing School Carlos Chagas (NSCC) was responsible for the creation of the current Federal University of Nursing of Minas Gerais (FUNMG). It was created on July 7, 1933, by Decree Nº 10,952. The name given was a tribute to the sanitarian physician Carlos Chagas. Its creation was a result from an agreement between the Health Board of the state of Minas Gerais and the Faculty of Medicine in the University of Minas Gerais. Its purpose was to meet the growing public health demands of the mining state, country and also the hospital field¹.

The NSCC was the first nursing school in Brazil located outside of Rio de Janeiro and also the first state nursing school established in the country. It followed the pattern of the oficial school, the current Nursing School Anna Nery (NSAN), matching it in 1942, by holding the banner of Modern Nursing¹.

It is worth remembering that the first 15 years of operation of the NSCC (1933-1948) are in the national context that included the first government of Getúlio Vargas (1930-1945). From the 1930s, the government increased the commitment to public health and various strategies were designed to improve health in Brazil, among them, the various international agreements signed, the various educational institutions and consolidated assistance². It can be pointed out in this sense, the works of the Public Health Special Service (PHSS), created in July 1942 as a result of an agreement between the United States and Brazil, establishing the following: sanitation of the Amazon valley, the preparation of professionals for public health work and collaboration with the then National Service of Leprosy³.

Considering that the NSCC was an institution within the Department of Public Health of Minas Gerais, it was understood that there was an investment by the mining state in nursing education. It emerged then the need to know whether the graduates from NSCC could met the state desires. This idea came forth from the assumption that the school should meet investors needs in their demands once it was financed by the state and, therefore, the students, after graduation should fill the gaps in the health market, especially the public health field.

This study aimed at analyzing the distribution of the alumni of the NSCC in their work fields from 1936 to 1948, considering that 1936 was the year of graduation of the first class of nurses from the Nursing School Carlos Chagas and that1948 was the last year that the record of the alumni of the acting in the fields in the can be found in the analyzed documentation.

It is believed that this study will contribute to the greater visibility of the Center for Memory UFMG School of the Nursing of the UFMG (MCSN), as a place for the construction and production of knowledge and that it will bring new facts to the history of the NSFMGNS, the mining community health and the history of Brazilian nursing.

METHOD

This is a study of social-historical nature where one of the results was found in the Master thesis entitled "Nursing Carlos Chagas: design, change and resistance 1933-1950"¹ in which data collection was carried out in the period from August 2012 to June 2013. The findings presented in this article were founded in the analysis of the document "List of Diplomee 1936-1948"⁴ available in the archives of MCSN. This source brings the work of each one of the students from the first class of graduates in 1936, until 1948, allowing to reveal the areas where former students of the Carlos Chagas Nursing went to work. Other documentary sources from the MCSN such as the periodic "Nursing in Minas"^5-7, produced by the students and teachers of the NSCC, and the transcript of an oral source⁸ belonging to the collection of NSAN Documentation Centre, whose copy was transferred to MCSN, were used for the discussion and documentary confrontation for internal criticism, as proposed for use of the method of historical research in Nursing⁹. In regards to ethical aspects, it is worth mentioning that because it is a study using documentary sources available for public consultation, the project was exempted of a Research Ethics Committee.

RESULTS AND DISCUSSION

In the first 15 years (1933-1948), the NSCC graduated a total of 111 nurses in the general nursing program that lasted three years. From that group, seven of them never worked in the nursing field: Five left the profession, one went to a convent and another became ill and was hospitalized in a sanatory. Thus 104 nurses remained available and active in the health sector⁴.

Below is a compiled chart of the destination of the alumni of the Carlos Chagas Nursing School in the period 1936-1948:

The most significant fields of activity during this period are public health, nursing education and hospital field. Even though the nursing curriculum of the NSCC be predominantly towards the hospital teaching, the heritage of Anna Nery's¹ teaching pattern, the Brazilian's health market opened to work possibilities in public health, which shows a mismatch between the market needs of the country and nursing training offered in the period¹⁰.

The field of Public Health

Figure 1 makes it clear that most of the NSCC former students turned to the fields of the public health, which was one of the biggest demands of state and federal governments. Graduate Nurses held jobs as sanitary or public health fiscals. The sanitary, health educator (in schools), responsible for nursing services in anti-tuberculosis dispensary in Santa Izabel Leper center, prenatal service, thoracic registration and BCG service (Bacillus Calmette-Guerin - vaccine against TB).

Graphic 1
Nursing Graduate 1936-1948 and their Work Areas.

As for the nurse duties in public health care, a study on the image of the public health nurse, issued in a magazine in 1929, showed that it was the public health nurse responsibility, in particular, to provide care to patients and guide them towards preventing diseases, in favor of the quality of public health development in Brazil¹¹. In fact, the being/doing of the nurse that historic time met what was placed as one of the political investment priorities on health in the country in the 1920s and 1930s¹⁰.

The health visitation was the largest field of operation of the alumni of the NSCC, both in relation to public health regarding other fields. The sanitary visit performed by a qualified nurse, was one of the greatest needs of the state government in relation to public health. The work of those graduates was concentrated in Belo Horizonte.

The demands for the visits of the nurses were so expressive in the country that a historical study on the public health nursing, in São Paulo, showed that, due to the lack of graduate nurses in that state until approximately the second half of the 1940s, health authorities gave preference to the training educators or satirists, in courses with shorter duration than the general nursing course. The sanitary educators course in Sao Paulo lost its strength only in 1942 with the implementation of the Nursing School at the University of São Paulo¹². In Minas Gerais, however, the investment in nurses who were not graduated, took place after the creation of the NSCC. The state government, in the late 1940s, with unsatisfactory numbers of graduates by nursing schools, invested in the creation of the School of Public Health of Minas Gerais, with the offer of shorter courses than those offered by standard nursing schools¹.

The process of bringing of the health visiting services with registered the NSCC to the country side took place at a slow pace and gained strength only from 1946, with the SESP. That year, 13 nurses got graduated. Among those, eight went to the field of public health. Among those eight, four of them chose to act serving health visitation to the country side of Minas Gerais, one in Diamantina, one in Teófilo Otoni and two in Divinópolis.

The acceleration of the process of occupation and modernization of mining region of Rio Doce is linked to the performance of SESP Sanitation Program Vale do Rio Doce, the Rio Doce Projects and Mica, in the 1940s, and the Minas Gerais program, in the 1950s. Such association resulted from the Washington Agreements between Brazil and the United States (1942). The preventive actions in aimed at improving human habitability in those conditions and the maintenance of health¹³, justifying the need for the graduates of the NSCC to move to the mining country side.

Under the guidance of the visiting nurse, Lais Moura Netto dos Reys, first director of the NSCC, from 1933 to 1938, the Nursing in Minas, scientific periodic produced by the Nursing School Carlos Chagas, affirmed that:

And in this current and tireless work the nurse for public health, commonly called visiting nurse, runs and insole the city streets and roads in their daily visits, warning the community at the first sign of danger, ready to protect life and health of people, which devoted guardian, health educator, which teaches how to train, raise and educate for the country and for God healthy men, entire, body and soul. It is your duty to improve, raise for his attitude and influence the level of life in society⁵.

In this speech, Lais Netto dos Reyes shows that calling a "registered nurse" of "Visiting nurse" was the common way to name it, and one should use "public health nurse”. This is probably due to the fact that nurses who did the general course of NSCC and worked in health visit before the creation of the school in Minas Gerais were also called visiting nurses.

The nursing school was another field explored and occupied by the former students from NSCC in this period. It is worth mentioning that the school groups were all from Belo Horizonte, which allows to conclude that the school care in Minas Gerais, brought to the country side did not occur through the NSCC former students until 1950. It is necessary to consider that the school care in the country side did not occur in this period by registered nurses, but may have occurred through a school teacher who was prepared in a course offered also by the NSCC, even though this course lasted less than the regular course. This course was known a branch course¹ of the Red Cross course.

On the work routine of the school nurse, it is recorded:

The nurse of an institution [school group] examines every morning the health and cleanliness of the children upon their arrival. If the boy is sick or shows symptoms of communicable disease, he will be immediately sent home, being readmitted after curing. The board of the institution and the nurse help mothers with advice and try to correct the bad influences and hygiene defects in the family environment⁶.

Before some of the duties of the school nurse, one realizes that this was more a position of public health that favored the basic notions of hygiene. The concern of improving hygiene habits of the population would help in reducing the incidence of infectious diseases, which was also part of the mining state government plans.

The school nursing service already existed before the creation of the NSCC. Thus, it seems that it was from the NSCC creation that this field had then registered nurses. This shows the expansion of the registered nurses' action field in the public health and simultaneously the consolidation of their role. The same applies to the nurse positions at Leper discharge department, the nurse at the Leper department Santa Izabel, the nurse at the prenatal service, at the chest registration and the nurse at the BCG service.

At the clinics, their work was "monitoring those who are or have been in contact with tuberculosis", "consultation", "diagnostics", "referral to sanatoriums," "statistics of deaths”. Laboratory tests were run, such as "BK sputum examination", "urinalysis", "further analysis" and radiological tests such as "X-rays and radiocopies". The treatments applied were "pneumothorax, frenicectomias and injections (gold, calcium, etc.)". There was a service of visiting nurses at the central dispensary and home visits, referral, lectures and home injections were also carried out⁷.

Moreover, a journal of the Federal District, which circulated in 1929, pointed out that it was for the nurse to identify and track the ones affected by the symptoms of tuberculosis, directing them where necessary, to medical appointments or dispensary provinces of tuberculosis closer to their homes. They were also supposed to examine and ask the people, especially children, who had had direct or indirect contact with TB patients who were examined every three months by the family doctor or¹¹ dispensary. This factor also points o the nurse trend to work in health visiting and dispensaries.

The field of teaching the art of caring

Among the graduates from the Nursing School Carlos Chagas there is the group who directed their career to teaching, continuing, therefore the teaching the art of caring. This can be understood by the fact that nursing, following the official education standard in Brazil since 1931, was at that time a young profession, with a small number of nurses in the country. So it was natural that part of the alumni went to become professors in existing institutions, and were expected to be help creating other nursing schools. This happened to sister Matilde Nina, the first religious to graduate in nursing in Brazil. She was the founder of Nursing School Luiza de Marillac, in Rio de Janeiro in 1939. The same happened to sister Josefa Luno, who ran the Nursing School of Recife and Celina Viegas, who organized and directed the Nursing School Hermantina Beraldo (NSHB), in Juiz de Fora⁴.

At the time of the creation of the NSHB in 1946, Minas Gerais had only two nursing schools, the NSCC and the Nursing School Hugo Werneck, both in the capital of the state. As the number of nurses graduated from those schools year was not enough to meet the needs for expansion and amplification of various health services yet to be created in the state, the city of Juiz de Fora was chosen to become the school's headquarters, once it was the second biggest city in number of population in Minas Gerais and also by the remote location of Belo Horizonte, so it could meet the needs of another micro-region, the prosperous Zona da Mata¹⁴.

An important historical personality in the nursing field, who studied nursing at the School Carlos Chagas, was Waleska Paixão. She was friends with Laís Netto dos Reys and was invited to assist her at NSCC by teaching the discipline Drugs and Solutions. It was then that Waleska Paixão went to live with the duality of being a student and teacher of the NSCC, where she finally graduated in 1938. With the resignation of Laís Netto do Reys from of the NSCC board to take over the NSAN in Rio de Janeiro, Waleska Paixão became director of the NSCC and was its director for 10 years, when he went to NSAN¹⁵.

The hospital field

In the hospital field, Belo Horizonte, which was born in the late nineteenth century, symbol of the hygienic-sanitary proposal and the status of "healthy city", had a poor network. Certain of the advantages of good weather and good city water, positivists engineers who planned the city did not see the construction of a hospital as a priority and institutions were popping up by initiatives mainly of society, represented by doctors, by the ladies of society and the Sisters of Charity¹⁶.

The hospital network remained precarious until the mid-1940s, when it was increased with new institutions such as the Municipal Hospital, currently knows as Hospital Odilon Behrens and the construction of the current Hospital da Baleia¹⁷.

It should be noted that the growth of the hospital network in the 1940s did not occur only in Belo Horizonte, but in the whole country, as there was a decline in the sanitary model along with the expansion of the importance of social security. Thus, there was an increase in the number of hospitals due to the expansion of private medicine geared to individual healing care. With the expansion of the Brazilian social security system, the production of private services was privileged and favored the healing hospital care¹⁸, which increased the job offer demands for nurses in the hospital field.

Even with the growth of the hospital field, in the 1940s, in Belo Horizonte and in the country, this one was slightly occupied by the NSCC graduates. In João Monlevade, a town 120 kilometers from Belo Horizonte, two former students from the NSCC became directors at Hospital Margarida, and one of them also worked at Belgo Mineira, a big metal company. Only one nurse went to work at the Hospital São Vincent de Paulo, currently Hospital of the Federal University of Minas Gerais, this one being a sister of charity. It is essential to mention that this hospital was run by sisters of charity and served as a training field for the NSCC. No other graduate from the NSCC worked at the St. Vincent Hospital until 1948.

At Santa Casa de Belo Horizonte, there are no records of former students from the NSCC until 1948. The Santa Casa was run by charity sisters, since its inception (1901) and served as a training field for students from the Nursing School Carlos Chagas. The internship model started in the early 1935 and in November of that same year, the director Laís Netto dos Reys received a letter from the Santa Casa provider stating that a rule of the agreement made with the NSCC had been infringed. A first-year student of the school’s general course entered a gynecologic ward for measuring vital data and the Sister in charge of the services, impugned the entry of that student. The director Laís Netto dos Reyes explained that that case was not related to a specific specialty care and so the student could performer it, but still, the Santa Casa da Misericórida banned the internships of the NSCC at the institution¹.

The Sociedade Anônima Metalúrgia Santo Antônio Hospital, in Rio Acima, was also used as a training field in the NSCC, and was considered by Waleska Paixão as the best school training field during 1938-1948, because of the wide governance to implement the Modern Nursing⁸. In 1942, one graduate from the NSCC took over as head nurse of that institution, but then moved to public health, assuming the post of visiting nurse.

The Municipal Hospital of Belo Horizonte was opened in 1945 and served as a training field for the NSCC since its inception and it was up to the school's director, Waleska Passion, to head the nursing services¹. The Hospital only hired its first registered nurse in 1947. The hired nurse was a charity sister and had graduated from the NSCC (Sister Aparecida de Cristo Rei)⁴. The absence of lay graduates at the St. Vincent Hospital and the Santa Casa and the hiring of a religious nurse to the Municipal Hospital show that the hospital field in Belo Horizonte was still dominated by the religious, especially in institutions linked to the Catholic Church.

The hospital was the place where the former students from the NSCC, except the seven charity sisters graduated from that school, struggled to occupy in Minas Gerais, especially in Belo Horizonte. In the small group of graduates that were not sisters and that took positions in hospitals are those who went to work in other states and started to work at the Police Emergency Aid, Maternidade São Lucas Hospital and the Hospital São Francisco, all in Belo Horizonte. However, the documentation revealed that one of the alumni who had started to work the Police Emergency aid soon left it for a position in the public health service, and from the three remaining who were acting in maternity wards, only one continued because another one went to the public health service and the other abandoned the profession because she got married⁴.

The presence of these recent former students in maternities, although not significant, points to the further consolidation of the role of maternal nurse and child health, to a greater independence of women and also to the growth of the market; after all, so far, the most common, even for the ladies of high society, was to have children at home with the help of a midwife¹⁶.

Companies open their doors to nurses from the NSCC

According to the documents consulted, even if the nursing labour had not rocketed at that time, it was during Vargas government that the graduate mining nurse began her work in companies. Although it was found in the sources, clues that point the duties of those former students in the field of business, there are no question as for the work of the nurse should include curative actions, resulting from accidents in companies and also preventive actions, working notions of hygiene to maintain the good health of workers and minimize infectious diseases. Companies that hired the graduates from NSCC were: Standard Oil (Esso Brasileira de Petróleo), in Rio de Janeiro, Banco do Brasil in Belo Horizonte, and Companhia Siderúrgica Belgo Mineira⁴.

Companhia Siderúrgica Belgo Mineira, in João Monlevade, currently named Arcelor Mittal, was inaugurated by Getúlio Vargas in the 1930s, and had its first blast furnace in 1937. Along with its expansion in 1942 the company operated with three blast furnaces. That must have grown rapidly on the number of employees, requiring curative and preventive nurse cares¹.

Abandons in the nursing profession

For the modern woman to enter the world of education and moreover in the professions world, there was a short range of alternatives. To be exercised by women, the profession needed to bring together elements justifying the permission of the parents of the good society girls to perform it, as well as the authorization of their religious congregations so that they could embrace the profession. Nursing could be, therefore, a good option for women who did not want to devote themselves to teaching in regular schools¹.

Even though nursing was a new proposal for women who wanted to work, abandoning the profession occurred, in part, by ignorance on the part of the population as for the performance of the registered nurse, and also because it was common for the culture at that time that women did not work. The nurse could come to marry her husband and request not work any longer outside her home, or she could consider that the nurse's job was no longer of her interest, or it was too heavy physically and mentally.

FINAL CONSIDERATIONS

Given the presented, some considerations must be made. The Nursing School Carlos Chagas historically confirms the trend of professional training focused on the needs of the health market regulated by the state government. However, despite the recent graduates have been directed mainly to meet demands of the public health, the institution graduated a lower number of nurses compared to the great need for professionals in the country in this period, and few were discharged to act in the country side. This helps us to understand the creation of another school in Minas Gerais focused on public health, the School of Public Health of Minas Gerais, for the training of sanitary health educators, in a faster course when compared to the general course of the graduated nurse in end of the 1940s.

The hospital field was not dominated by former students of the NSCC from 1936 to 1948, except for the charity’s sisters who were graduated. This indicates that the care tradition of religious women and their power in the mining field hospital continued reigning in that period. On the other hand, the work of the nurse was seen as attractive by the companies that opened doors to them, starting the first incursions in the universe of what would be the Occupational Health Nursing in Minas Gerais.

Finally, teaching in nursing schools has become attractive to nurses once the nursing field has been consolidating itself as an alternative career for women who wanted to study and work, helping to keep alive the current Federal University School of Nursing Minas Gerais and its history.

REFERÊNCIAS

• ¹
  Santos FBO. Escola de Enfermagem Carlos Chagas: projeto, mudanças e resistência - 1933-1950 [dissertação]. Belo Horizonte (MG): Escola de Enfermagem, Universidade Federal de Minas Gerais; 2014.
• ²
  Pava AM, Neves EB. A arte de ensinar enfermagem: uma história de sucesso. Rev. Bras. Enferm. 2011; 64(1):145-51.
• ³
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• ⁴
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• ⁵
  Reys, LN. Entrevista. A Enfermagem em Minas. Belo Horizonte, MG. 1936; I(IV): 22. (Centro de Memória da Escola de Enfermagem/UFMG).
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• ⁸
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  Campos PFDS. The academic dossier of Maria de Lourdes Almeida: history and nursing in post-1930s Brazil. História, Ciências, Saúde-Manguinhos. 2013;20(2):609-25.
• ¹¹
  Deslandes AKM, Aguiar S, Neto M, Porto FR. The image of care delivery by Public Health Nurses as disseminated in Revista da Semana (1929). Rev. Latino-Am. Enfermagem. 2013; 21(1):412-8.
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  Faria L. Educadoras sanitárias e enfermeiras de saúde pública: identidades profissionais em construção. Cadernos Pagu. 2006;27:173-212.
• ¹³
  Genovez PF, Vilarino, MTB. Entre práticas sanitárias e saberes tradicionais: a territorialização do saneamento no Médio Rio Doce. Território, Sociedade e Modernização. 2010: 119.
• ¹⁴
  Costa LDMC, Santos RM, Trezza MCFS, Rozendo CA. Produção de pesquisa histórica Relativa a criação de cursos de graduação em enfermagem: uma revisão integrativa. Hist. Enf. Rev. Eletr (HERE). 2012;3(1):1-16.
• ¹⁵
  Santos GF, Caldeira VP, Moreira SA. A inserção de Waleska paixão na enfermagem. Esc Anna Nery. 2010;14(2):268-74.
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  Marques RC. A caridade criando hospitais em Minas Gerais (Brasil) - séculos XVIII-XX. Dynamis [Granada, Barcelona, ESP]. 2011;1(1):107-129.
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  Maques RC, Silveira AJT, Figueiredo BG, organizadoras. História da saúde em Minas Gerais: instituições e patrimônio arquitetônico (1808-1958). Barueri (SP), Rio de Janeiro: Manole; Ed. Fiocruz; 2011.
• ¹⁸
  Silva KL, Sena RR, Tavares TS, Martins ACS. Oferta dos cursos de graduação em enfermagem no estado de Minas Gerais. Texto & contexto enferm. 2011;20:124-130.

Publication Dates

• Publication in this collection
  Apr-Jun 2015

History

• Received
  05 June 2014
• Accepted
  18 Mar 2015