Regulación de la enfermería en México: actores, procesos y resultados / Regulation of nursing in Mexico: actors, processes and outcomes

Resumen El objetivo de este artículo es analizar la estructura regulatoria de la enfermería en México, a través de la normatividad y los actores involucrados. Se desarrolló un estudio de caso con uso de fuentes de información cualitativa, cuantitativa y revisión de documentación oficial. El análisis integró los datos obtenidos de las fuentes de acuerdo con cuatro dimensiones propuestas por Moran & Wood (1993). La dimensión con mayores avances es el ingreso al mercado ya que el Estado regula el ingreso a través de una licencia de práctica. La regulación de la competencia es débil y muestra áreas aisladas de práctica autónoma. El mercado laboral ofrece condiciones variadas de inserción con muestras claras de deterioro. El mecanismo de pago dominante es el salario de las instituciones públicas mostrando una estructura que incorpora un componente que no cotiza para la pensión al término del ciclo laboral. La regulación de la enfermería es un componente de su profesionalización y como tal se distingue como un proceso en marcha en vías de consolidación, particularmente aquellas dimensiones relacionadas con la regulación de la competencia, la estructura del mercado y los mecanismos de pago en el cual la enfermería y sus representantes deben jugar un papel más activo.

Abstract This paper aims to analyze the regulatory structure of nursing in Mexico through its legislation and perspectives of participant stakeholders. A case study was undertaken using qualitative and quantitative data sources, as well as from the review of official documents. The analysis included data from the sources according to the four realms proposed by the Moran & Wood (1993) model. The more advanced realm was the market entry since the state regulates entry through a license of practice. The regulation of competition is weak, showing very reduced areas of autonomous practice. The labor market is offering a wide variety of entry options with clear signs of deterioration. The dominant payment mechanism is salary, showing a structure that incorporates a component that does not impact on pensions at the end of the labor cycle. The regulation of nursing is a component of its professionalization, and as such, it is understood as a multidimensional consolidating process, particularly realms related to the regulation of competition, market structure, and payment mechanisms, in which nursing representatives should play a more active role in the future.

Regulation of nursing in Mexico: actors, processes and outcomes. / Regulación de la enfermería en México: actores, procesos y resultados.

This paper aims to analyze the regulatory structure of nursing in Mexico through its legislation and perspectives of participant stakeholders. A case study was undertaken using qualitative and quantitative data sources, as well as from the review of official documents. The analysis included data from the sources according to the four realms proposed by the Moran & Wood (1993) model. The more advanced realm was the market entry since the state regulates entry through a license of practice. The regulation of competition is weak, showing very reduced areas of autonomous practice. The labor market is offering a wide variety of entry options with clear signs of deterioration. The dominant payment mechanism is salary, showing a structure that incorporates a component that does not impact on pensions at the end of the labor cycle. The regulation of nursing is a component of its professionalization, and as such, it is understood as a multidimensional consolidating process, particularly realms related to the regulation of competition, market structure, and payment mechanisms, in which nursing representatives should play a more active role in the future.

El objetivo de este artículo es analizar la estructura regulatoria de la enfermería en México, a través de la normatividad y los actores involucrados. Se desarrolló un estudio de caso con uso de fuentes de información cualitativa, cuantitativa y revisión de documentación oficial. El análisis integró los datos obtenidos de las fuentes de acuerdo con cuatro dimensiones propuestas por Moran & Wood (1993). La dimensión con mayores avances es el ingreso al mercado ya que el Estado regula el ingreso a través de una licencia de práctica. La regulación de la competencia es débil y muestra áreas aisladas de práctica autónoma. El mercado laboral ofrece condiciones variadas de inserción con muestras claras de deterioro. El mecanismo de pago dominante es el salario de las instituciones públicas mostrando una estructura que incorpora un componente que no cotiza para la pensión al término del ciclo laboral. La regulación de la enfermería es un componente de su profesionalización y como tal se distingue como un proceso en marcha en vías de consolidación, particularmente aquellas dimensiones relacionadas con la regulación de la competencia, la estructura del mercado y los mecanismos de pago en el cual la enfermería y sus representantes deben jugar un papel más activo.

Challenging Authority: The Impact of Practicing Nursing in the Legislature.

How does challenging authority look? This article describes two steps taken to prepare for and engage in challenges to existing laws. The first step is use of the nursing process to help structure deliberations about when to pursue, justify, and target a challenge to existing law to create desired outcomes. The second step is the important process of building the case for change and the broad base of support needed to push against resistance to change. The article details two examples of specific legislative successes the author accomplished using these two steps.

The slippery slope of nursing regulation: challenging issues for contemporary nursing practice in Canada.

This paper provides readers with an overview of some contemporary issues associated with nursing regulation and scope of practice in Canada. Issues with the current organizational structure of nursing regulation and its impact on nursing advocacy in Canada are explored. An argument is presented that nursing regulation needs more consistency and collaboration in Canada. Several examples are used to illustrate this. Fragmentation of regulation is explored and regulatory disciplinary processes are examined in relation to some countries with similar professional structures. The impact of changes in the regulatory status of complementary and alternative health practitioners on nursing is also critiqued. We provide recommendations for future policy and practice to better pave the way for nursing scope and regulatory clarity.

La gestión del cuidado en la legislación profesional: algunas consideraciones para su regulación / Professional legislation and care management: considerations for regulation

Uruguay cuenta hoy con una ley de ejercicio profesional, la cual ha sido un esfuerzo del colectivo profesional que hoy es una realidad expresada en la Ley 18.815. En la actualidad se está recorriendo un camino con el fin de reglamentar dicha legislación y se torna de relevancia reflexionar algunos aspectos que tienen que ver con el rol profesional, el cual se distingue en gran medida por la gestión del cuidado. El objetivo de este artículo es abordar algunos aspectos claves que permitan iluminar el proceso de reglamentación de la ley en el país, presentando algunas consideraciones sobre los desafíos que supone para el colectivo este proceso para empoderar el cuidado, la gestión del mismo y el rol profesional. El profesional de enfermería tiene muchas fortalezas que pueden ser abordadas como oportunidad única en el momento de reglamentación de la ley. El acrecentar las habilidades en la gestión de cuidados encuentra hoy un terreno especial que ofrece oportunidades para que las necesidades de las personas sean satisfechas con humanidad, calidad y seguridad, acordes al nuevo modelo de atención en la salud, fortaleciendo la interacción enfermera/paciente. Ante los escenarios poco favorecedores para el desarrollo del rol profesional de Enfermería, la reglamentación de la ley de ejercicio en el país ofrece hoy una posibilidad para fortalecer la autonomía y el desarrollo profesional. El campo de dominio disciplinar debe impregnar las reglamentaciones de una ley de ejercicio profesional, integrando nuevos estilos de pensamiento, que se fundamenten en las interacciones humanas e interdisciplinares.

Actually, the Uruguay has a law on professional practice, which has been an effort from the professional group which is now a reality expressed in the Law 18.815. Currently we are treading a path in order to regulate such legislation and it becomes relevant to reflect some aspects that have to do with the professional role, which is distinguished largely by the care management. In this line, the aim of this article is to address some key aspects that allow to illuminate the regulatory process of law in the country, presenting some considerations regarding the challenges that are supposed for the collective this process, to empower the care, management and the professional role. The nursing professional has many strengths that can be addressed as a unique opportunity at the time of regulatory law. Increasing skills in care management is now a special field that offers opportunities, as long as the expectations of nurses are high, with a focus group, according to the new model of health care, strengthening the interaction nurse/patient. Today, given the unflattering stages for the development of professional nursing role, the regulation of law practice in the country offers an opportunity to strengthen the autonomy and professional development. The domain field discipline must permeate the regulations of a law practice, integrating new ways of thinking, which are based on human and interdisciplinary interactions.

The discursive practices of nurse practitioner legislation in Australia.

AIM: The aim of this paper was to examine the nurse practitioner legislative framework in Australia from a critical social theory perspective. BACKGROUND: National regulation for nurses and midwives has superseded all previous state legislation with effect from July 2010. The aim of this change was to streamline regulation processes across all health professionals requiring regulation, in order to eliminate diverse state-based regulatory policies that were identified as hindering transferability of the workforce across Australia. This paper explores the changes with reference to nurse practitioners. Since their introduction to Australia different legislative practices between states have presented difficult endorsement procedures which have affected employment. DATA SOURCES: Information for the paper is drawn from a doctoral study which examined the politics of advancing nursing in Australia, with particular reference to the discourses of nurse practitioners. This is augmented by more recent legislative documents and policies, as well as media reports, to examine the process of change in legislation and the unfolding discourses on employment and practice. IMPLICATIONS TO NURSING: Nurse practitioner endorsement may be more complicated, defeating the original premise of transferability of a skilled workforce across state jurisdictions. CONCLUSION: This paper exposes the influence that powerful discourses can have on a major change to professional practice.

Swedish student nurses' knowledge of health statutes: a descriptive survey.

BACKGROUND: The nurse's function, no matter the working area, is guided by ethical approaches, grounded in science and well-tried experiences, and has to be conducted according to national laws, statutes and instructions. AIM: To survey newly graduated Swedish nurses' knowledge about current statutes and laws that govern their healthcare system. METHOD: A questionnaire was developed from facts in relevant statutes and laws presented and used in the nursing education programmes. Following a pilot study testing the items, a 20-item questionnaire, with mostly open-ended questions, was distributed to student nurses in the last semester of their nursing education programme before graduation. RESULTS: One hundred and seventy-eight participants answered the questionnaire (response rate 59%). Only 29% of responses on all questions showed correct knowledge about the different statutes and laws that regulate their work as nurses. The best knowledge was found in the area of documentation (range 35-86%) and in the area of information (range 16-54%) on group scores. CONCLUSION: This survey concerning novice nurses' knowledge about statutes and laws showed great deficiencies. It was surprising to find that, on existing demands regarding nurses delegating medical tasks, not a single respondent presented a correct answer. Evidence-based knowledge was difficult to recognize. Nurses will be more conscious of their own limitations and more prepared to meet the reality of practice if there is emphasis on relevant statutes and laws during their education.

NICU managers make their mark on practice. To advance neonatal nursing, a dynamic group of managers forged an idea-exchange program.

Detroit-area neonatal intensive care unit nurses merge in a spirit of cooperation and support to further the interests of their specialty.