Expressões da precarização do trabalho: um estudo sobre a enfermagem da Estratégia Saúde da Família

Abstract

This study aimed to analyze the nursing work of the Family Health Strategy (FHS) in the context of the precariousness of work as a social and multidimensional process intrinsic to the capitalist mode of production. The theoretical framework was fundamentally based on critical thinking on the following themes and their authors: the capitalist economy and work from the perspective of Karl Marx; the Brazilian dependent state by Ruy Mauro Marini; and the social precariousness of work by Graça Druck, a typology consisting of dimensions: employment relationships and contractual relations; organization and working conditions; workers' health; the consistency of the social fabric; and collective representation and organization. These dimensions, in particular, guided the development of a descriptive and exploratory research, with a quantitative and qualitative approach, based on a study of secondary data and a bibliographic study of the scope review type. The data analysis used was guided by the multi-method approach. The study of secondary data revealed that the nursing working class of the FHS experiences stable and unstable employment contracts and modalities, protected and unprotected by labor rights; losses in relation to the average real remuneration of mid-level workers; and work-related accidents and mental disorders. The scoping review showed that most of the selected publications did not directly address the typology of social precariousness of work, but the results and discussions of the studies contained elements capable of dialoguing with its dimensions. The integration of the results of the adopted research procedures allowed inferences about expressions and signs of precariousness in the nursing work of the FHS. In light of the theoretical framework, it was concluded that the objective expressions of precariousness in the nursing work of the FHS were revealed in the modalities of unstable employment contracts without protection of labor rights and in inadequate or insufficient work means. In relation to the other dimensions of the typology of social precariousness of work, although it was not possible to establish a relationship between the elements and effects of the nursing work process of the FHS with precarious employment contracts and modalities, in addition to the precarious forms of work organization, this did not mean to say that there were no signs of precariousness, such as the loss of payment of the mid-level workforce; the achievement of goals and the demand for productivity; the weakening of worker safety and health through work-related accidents and mental disorders; and the weakening of identity and collective bargaining mechanisms.