Working conditions of Nursing professionals in coping with the Covid-19 pandemic.

OBJECTIVE: To trigger a reflection on the current working conditions of Nursing professionals in coping with the Covid-19 pandemic. METHOD: A theoretical-reflective study supported by studies from the Marxist perspective, national and international scientific articles, and official documents from the World Health Organization and the Federal Nursing Council. RESULTS: The daily work of Nursing professionals in the face of the Covid-19 pandemic presents unfavorable working conditions in Brazil and worldwide, with emphasis on the deficit of professionals, overload of activities, low pay, and personal protective equipment, often insufficient and inadequate, conditions that can lead to exhaustion, illness and death. CONCLUSION: This study can contribute to raising discussions about the need for improvements in the working conditions of Nursing professionals, especially in pandemic times and the impact on the health of these professionals.

Direct costs of integrated procedures of conventional hemodialysis performed by nursing professionals.

OBJECTIVE: to analyze the mean direct cost of the constituent procedures of conventional hemodialysis, performed in three public teaching and research hospitals. METHOD: quantitative, exploratory-descriptive study, of the multiple case study type. The mean direct cost was calculated by multiplying the time (timed) spent by nursing professionals, on the execution of procedures, by the unit cost of direct labor, added to the cost of materials and solutions/medications. RESULTS: the total mean direct cost, in patients with an arteriovenous fistula corresponded to US$25.10 in hospital A, US$37.34 in hospital B and US$25.01 in hospital C, and in patients with a dual lumen catheter, US$32.07 in hospital A, US$40.58 in hospital B and US$30.35 in hospital C. The weighted mean values obtained were US$26.59 for hospital A, US$38.96 for hospital B and US$27.68 for hospital C. It was noted that the "installation and removal of hemodialysis fistula access" caused a significantly lower economic impact compared to "installation and removal of hemodialysis catheter access". CONCLUSION: with the knowledge developed it will be possible to support hospital managers, technical managers and nursing professionals in the decision making process, with a view to the rational allocation of the necessary inputs for the performance of conventional hemodialysis.

Direct cost of monitoring conventional hemodialysis conducted by nursing professionals.

OBJECTIVE: to analyze the mean direct cost of conventional hemodialysis monitored by nursing professionals in three public teaching and research hospitals in the state of São Paulo, Brazil. METHOD: this was a quantitative, explorative and descriptive investigation, based on a multiple case study approach. The mean direct cost was calculated by multiplying (clocked) time spent per procedure by the unit cost of direct labor. Values were calculated in Brazilian real (BRL). RESULTS: Hospital C presented the highest mean direct cost (BRL 184.52), 5.23 times greater than the value for Hospital A (BRL 35.29) and 3.91 times greater than Hospital B (BRL 47.22). CONCLUSION: the costing method used in this study can be reproduced at other dialysis centers to inform strategies aimed at efficient allocation of necessary human resources to successfully monitor conventional hemodialysis.

Direct cost of monitoring conventional hemodialysis conducted by nursing professionals / Costo directo del monitoreo de hemodiálisis convencional realizado por profesionales de enfermería / Custo direto da monitorização da hemodiálise convencional realizada por profissionais de enfermagem

ABSTRACT Objective: to analyze the mean direct cost of conventional hemodialysis monitored by nursing professionals in three public teaching and research hospitals in the state of São Paulo, Brazil. Method: this was a quantitative, explorative and descriptive investigation, based on a multiple case study approach. The mean direct cost was calculated by multiplying (clocked) time spent per procedure by the unit cost of direct labor. Values were calculated in Brazilian real (BRL). Results: Hospital C presented the highest mean direct cost (BRL 184.52), 5.23 times greater than the value for Hospital A (BRL 35.29) and 3.91 times greater than Hospital B (BRL 47.22). Conclusion: the costing method used in this study can be reproduced at other dialysis centers to inform strategies aimed at efficient allocation of necessary human resources to successfully monitor conventional hemodialysis.

RESUMEN Objetivo: analizar el costo directo promedio derivado de la participación de profesionales de enfermería en el monitoreo de hemodiálisis convencional, en tres hospitales públicos de enseñanza e investigación del estado de São Paulo. Método: investigación cuantitativa, exploratorio-descriptiva, modalidad de casos múltiples. El costo directo promedio fue calculado multiplicando el tiempo (cronometrado) utilizado en la ejecución del procedimiento por el costo unitario de la mano de obra directa. Para realizar el cálculo se utilizó la moneda brasileña (Real, R$). Resultados: el mayor costo directo promedio se obtuvo en el Hospital C (R$ 184,52), valor 5,23 mayor que el del Hospital A (R$ 35,29) y 3,91 veces mayor que el del Hospital B (R$ 47,22). Conclusión: la metodología de costeo desarrollada podrá replicarse en otros Centro de Diálisis, con el fin de ayudar con la propuesta de estrategias para el éxito del monitoreo de la hemodiálisis convencional.

RESUMO Objetivo: analisar o custo direto médio relativo à participação de profissionais de enfermagem no procedimento de monitorização da hemodiálise convencional, em três hospitais públicos de ensino e pesquisa do estado de São Paulo. Método: pesquisa quantitativa, exploratório-descritiva, na modalidade de estudos de casos múltiplos. O custo direto médio foi calculado multiplicando-se o tempo (cronometrado) despendido, na execução do procedimento, pelo custo unitário da mão de obra direta. Para a realização dos cálculos, utilizou-se a moeda brasileira (R$). Resultados: obteve-se o maior custo direto médio no Hospital C (R$ 184,52), valor 5,23 vezes maior do que o valor do Hospital A (R$ 35,29) e 3,91 maior do que o valor do Hospital B (R$ 47,22). Conclusão: a metodologia de custeio desenvolvida poderá ser reproduzida em outros Centros de Diálise, a fim de subsidiar a proposição de estratégias visando à eficiência alocativa dos recursos humanos requeridos para o êxito da monitorização da hemodiálise convencional.

Salaries for Nurses Decrease, While NP Salaries Rise.

Nurses say salaries aren't commensurate with experience.

[Training and development of the nursing staff: a model of spread sheet cost]. / Treinamento e desenvolvimento de pessoal de enfermagem: um modelo de planilha de custos.

This paper presents a model of spread sheet cost for training and development programs to the nursing staff in a hospital organization. Significant items of the total cost have been considered in relation to its elaboration and proper functioning. This model is divided into four parts: Item 1--data related to the training programs; Item 2--direct costs of these programs; Item 3--indirect costs (Continuum Educational Center structure), and Item 4--cost amount. The use of spread sheet cost may provide knowledge and managementfor the nurses and nurse managers. However, the related costs should be reviewed according to each service.

Treinamento e desenvolvimento de pessoal de enfermagem: um modelo de planilha de custos / Entrenamiento y actualización del personal de enfermería: un modelo de planilla de costos / Training and development of the nursing staff: a model of spread sheet cost

Este artigo apresenta um modelo de planilha de composição de custos para programas de treinamento e desenvolvimento de pessoal em uma organização hospitalar. Para sua elaboração foram considerados os elementos relevantes na composição do custo total dos programas de treinamento. A planilha proposta está dividida em quatro partes: Item 1 - dados relativos aos programas de treinamento; Item 2 - custos diretos desses programas; Item 3 - custos indiretos (estrutura do CEC) e Item 4 - total dos custos. A utilização de planilhas de custos auxiliam no conhecimento e gerenciamento dos mesmos por parte dos enfermeiros, gerentes de unidades. No entanto, para sua aplicação, devem ser revistos os custos que serão agregados, conforme especificidade de cada serviço.

This paper presents a model of spread sheet cost for training and development programs to the nursing staff in a hospital organization. Significant items of the total cost have been considered in relation to its elaboration and proper functioning. This model is divided into four parts: Item1 - data related to the training programs; Item 2 - direct costs of these programs; Item 3 - indirect costs (Continuum Educational Center structure), and Item 4 - cost amount. The use of spread sheet cost may provide knowledge and management for the nurses and nurse managers. However, the related costs should be reviewed according to each service.

Este artículo expone un modelo de planilla de composición de costos para programas de entrenamiento y actualización en una organización hospitalaria. Para su elaboración se consideraron los elementos relevantes en la composición del costo total de los programas de entrenamiento. La planilla propuesta está dividida en cuatro partes: Item 1 - dados relativos a los programas de entrenamiento; Item 2 - costos directos de esos programas; Item 3 - costos indirectos (estructura del CEC) y Item 4 - costos totales. La utilización de planillas de costos contribuye al conocimiento e gerenciamiento de los mismos por parte de los enfermeros, gerentes de unidades. En tanto, para su aplicación, deben ser revisados los costos que serán añadidos, conforme a la especificidad de cada servicio.

Nuevos desafíos, nuevas oportunidades, nuevos horizontes éticos del tercer milenio / New challenges, new opportunities, new ethical horizons of the third millennium

El texto de la conferencia ilustra los desafíos de la enfermería ante un nuevo milenio desde la perspectiva bioética y propone la ética del cuidado como base para enfrentar los diversos cuestionamientos éticos de la práctica profesional

Nuevos desafíos, nuevas oportunidades, nuevos horizontes éticos del tercer milenio / New challenges, new opportunities, new ethical horizons of the third millennium

El texto de la conferencia ilustra los desafíos de la enfermería ante un nuevo milenio desde la perspectiva bioética y propone la ética del cuidado como base para enfrentar los diversos cuestionamientos éticos de la práctica profesional (AU)

The influence of nurse wage differentials on nursing home staffing and resident care decisions.

This study examines the extent to which nursing homes adjust staffing and care practices relative to local market conditions. Weighted two-stage least squares regression results suggest that facilities employ more nonprofessional nursing staff in markets in which professional nurse wages are higher. RN staffing levels are higher in markets with a higher percentage of self-pay nursing home residents and a lower percentage of for-profit nursing homes. Controlling for resident characteristics, the use of labor-saving practices is higher in markets with higher average nursing home wages, suggesting that there are economic incentives to hire fewer nursing personnel.