Nursing Transitions in Portugal. Second half of 20TH century

Conferência proferida no âmbito International Perspectives in the History of Nursing Conference. London 14 – 16 September 2010Aim of the Study: to contextualize nursing transitions in the second half of the 20th century, in the dimensions: context, curricula and actors. Purpose: As far as nursing education is concerned, in the Portuguese case for many years we can not talk about the existence of a discipline of nursing. The construction of the discipline seems to have happened between the process of the nurses’ professionalization and the social construction of the curriculum, essentially since the 50’s of the 20th century. Methodology: The historic method allowed formulating connections between ideas, events, institutions and people in the past enlightening the socio-historic discourse throughout this period. The stories of life assumed a particular effect, connecting them to the formation of trajectories to understand the mechanisms and processes used by participants in managing the situations they were in, with the resource of the ethno-biographic interview. The Unique Case Study, with qualitative characteristics, allowed us to know individual, organizational, social and political phenomena. Findings: We have analized the data under three dimensions - Contexts, Curricula and Actors – along the decades from year 50’ to the beginning of XXI Century. About Contexts , until 1965 the School for Nurses was within the hospital, and without autonomy. After the national evaluation of the state of the schools of nursing about their pedagogic conditions to teach, recommended by WHO in 1963, the Schools started , in 1965, a process of autonomy with the creation of the first Nursing School, independent of hospitals – School of Education and Management in Nursing. One of the most important fact occurred in 1988 with the Integration of Nursing in Higher Education, and the conversion of the schools in Higher Nursing Schools, in 1989. From Curricula, a dimension we can emphasize is that in 1947 were established two levels of nursing education. The Introduction of the contents “medical nursing techniques” and “chirurgic nursing techniques” in 1952, can be considered as the emergence of nursing as a discipline, because of the official participation of nurses in the education of pairs, and the beginning of conceptualization of nursing care. Because of this in 1964, occurred a Curricula reformation. The Discipline of Nursing (with biomedical orientation) structuring the education, among biomedical disciplines and inclusion of social and human sciences. In the year of 1967 we assist the beginning of the education on Investigation. After The Carnation revolution, many things have changed and we have assisted one of the most important transitions, the unification of pre-graduate education (1975). The integration in higher education with bachelor degree (1988) and with Degree in 1999, are also considered two important transitions. Considering the Actors in this transitional analysis, in 1947 the State has begun to control of the legal exercise of nursing and with the conditions promoted by the transitions in contexts and curricula, after 1965 we assisted a very important evolution and social recognition, with responsibility of education and the Direction of the Schools by nurses and the promotion of similar access conditions as required for other courses in higher education. Since 1975 we have in Portugal a unique Professional – Nurse, a transition that contributed to the Regulation of the Professional Exercise of Nursing, in 1996. In 1998, the Portuguese State as regulated the possibility to the Establishment of the Nurses Order. Conclusions: Contexts - Nursing Higher Schools are autonomous organizations, in different scenarios of the higher education network: Not integrated Schools; Schools integrated in Polytechnics Institutes and schools integrated in Universities, but all of them in the polytechnic subsystem. Curricula - From the unique curriculum to curricular diversity, the conception and curricular development occurs from Nursing, discipline and profession, along the three cycles of Bologna studies . Actors - The qualifications for the skills that enhance to deal with the complexity in health suggest the debate on nursing education about professionalism and multidisciplinarity. The professionalization process is going on, but we still assist to a lack of social and professional identity