At the turn of the XIX century to XX century, brazilians lived moments of extreme social commotion whose contigenties profoundly marked the democratic institution in Brazil.
The population and geographic area were transformed by the impositions of the new political regime, which resulted in a social conflict in constant movement, considered as urban and cosmopolitan processes; therefore, it was different from the rural population which in anterior regimes represented, a large part of the population.
Modern times, founded in the spirit of order and progress, used to be one of the symbols of the Republic.
In apllied science the imperatives of the modern world were the same; it is important to mention that they stimulated techniques and new technologies, in this case, in the hospitals, as well as controling strategies and demanding resolutions from social medicine itself.
In the case of social medicine and hospitals, these forces also made their demands and with this, medicine and nursing as practiced in São Paulo, within this context, became references in their fields in Brazil, especially in the field if health and research.
São Paulo became the center from which radiated modern technologies of learning and professional training especially in the areas of providing assistance and promoting health, wich received large investiments coming from international agreements between Brazil and the United States ( Oguisso, Souza Campos, 2007; Castro Santos, Faria 2004, Barreira 2002).
These modern projections resonated with the propasals of the International Red Cros mainly in terms of the necessity of training nursing aid professionals to operate in times of peaces.
According to Mott and Tsunechiro, the first Brazilian initiative in this sense was taken by Dr. Maria Rennote, in São Paulo, who began a school for voluntary nurses based on the humanitarian principles of the Red Cross.
According to the authors this initiative preceded the founding of the School of Nursing Ana Mary (1923), which was considered the one and only nursing school to arise in the first decades of the twentieth century and have been the foudation of the beginning of professional nursing in Brazil.
Research done in several types of documents; news-paper and magazines article, congressional records, and correspondeces, necrology reports, regulations, curriculums, and manuals suggests though that there were several nursing schools and among them highlighted the Red Cross.
From WWI(1914 – 1918) through the Constitutional Revolution (1932) and specially during WW II (1939 – 1945), The Brazilian Red Cross excelled in the training of voluntary nurses and intensified courses in emergency first aid for anti-aircraft civil defense nurses.
After the war period, in the city of Rio de Janeiro as well as in São Paulo, coursefor volunteers were restablished and in 1936 was know as Samaritans, for young girls and women that didn´t want to become professional registered nurses and could become qualified within a year of basic studies; they could collaborate with the Red Cross in its philanthropic quest to give aid in times of peace or war.
The training courses for professional Red Cross nurses,even though they were subordinated to the Ministry of War , were recognized as able and separate entities and were not subjected to command that was previewed by the Dcree n. 20,109/31. For nearly 30years(1917 - 1945), the nursing school inRio de Janeiro was directed by medical physicians, nhich was opposite to the norms of equalit, having prior to been defined as a position for an RN (Registered Nurse) and in the domain of nursing only. The first female director of professional nursing was Maria Beatriz Cavalcanti Alburqueque and she was succeeded by sister Marta Telles. In 1940, under the direction of Isabel Gomm, a sophisticated and intelligent woman, whose strong leadership skills would permeate the school until 1946 when she then took up other obligations in the Red Cross, in the Red Cross, the Red Cross School of Nursing in São Paulo graduated its first class of Samaritans.
Several Samaritans continued their studies and became professional nurses (RNs) by taking courses that were open to candidates of both genders and were able to graduate in three years of study. The first class of professional nurses graduated in 1943. Even though courses were open to both genders, women dominated the classes. This predominations is evident in the regulations of EECVB-FESP (Brazilian Red Cross School of Nursing of São Paulo)where article 10 stipulates that “the woman in order to enroll should posses their own bedding and uniforms accotding the school demand and cost of books would also be paid for by the students”, without even any mention of male candidates.
The Red Cross Nursing School of São Paulo, CVB-FESP “formed two principal categories of nurses: a) voluntary or Samaritans; b) professional or from hospital”. The school never measured forces in the field of nursing and training and became the first CVB school to be founded in Brazil (1914). This school possessed its own buildings and was located in the center of São Paulo at Rua Líbero Badaró, n.595. Courses were ofered in profissional nursing, Smaritan nursing domestic nursing, and first aid.
Based on studies done in Report CFE 3.814/76, Esther de Figueredo Ferraz states that in the area of nursing in the beggining of the First Word War , evidence shows that the Brazilian Red Cross had already created a nursing school at its Branch in Sçai Paulo. The first systematic initiatives at higher education at the Red Cross Nursing School in CVB-FESP decame more concrete with the first graduating class of registered nurses, which was the successor of the”Samaritan” nursing course.
Beyond the professional training and preparation similar to other nursing school in Brazil, the Red Cross School of Nursing São Paulo Branch, EECVB – FESP, also conferred the title of Red Cross Volunteer to those concluding the first year of studies.
The nursing was re-established in March 10, 1932 though Federal Decree n. 21.141, which incorporate the nurses into the military and characterized the military stance taken by the EECVB – FESP. The school was subordinated to the ministry of War and was permanently scrutinized by the Directory of Health in War where the annual study curriculums were submitted. In this Decree, art.33 2º stipulate that “that graduates of military nursing or Red Cross nursing can the civilians in any part of the country”.
“A nurse according to Florence Nightigale should be trained to undertake a multitude of tasks. The areas of care giving, moral and emotional support, as well as that os spiritual guidance, and even medical procedures that protects the enviroment. In the area of technology the nurses should be competent in medical procedures, know how to operate medical components, and have administrative capabilities”. Declaration of Dr. Zerbini, pioneer in heart transplants in Brazil(1968) and founder of the Heart Institute HCFMUSP founded in 1974 (apud Dutra; Ishii, 1981).
Nursing in the molds of the Nightigale system was brought to Brazil by English and North American nurses at the end the beginning of the XX century. The first initiatives are chonicled in 1984, with the founding of the School of Nursing of the Samaritan Hospital in the city of São Paulo, that was under rigid moral standards and basis stablished by Florence Nightigale, i.e., only for women, linked to a Hospital with internships for matrons, sisters, and nurses which opened in the hospital and offered the structual organizations necessary to train them ( Mott 1999; Oguisso, 2007; Carrijo, 2007).
One of the characteristics of the learning system is that the students are defined by the social class to which they belong, and due to this the lady nurses, as they were called, coming from the higher classes were expected to play a certain amount of the cost of the uniforms ond food expenses, and they accomplished intellectual tasks. The nurses that could not afford to remain for the duration of the course offered their nursing services as a counterpart but were paid for their work. The direction of the school was occupied by nurses and the curriculum included theoretical and pratical aspects of nursing with internships in hospitals where the staff, religious and secular women were part of. An evaluation system was enacted and the nurses ‘Trainees needed to register all the accomplished activities’.
In the residencies and intership the so called home sister was strict in regards to discipline and dressing rules; a Roman Catholic priest said weekly Masses for the students. In the formation of nurses there was no distriction made between religious belives which gave the opportunity fot the secularization of the profession( Parentini 2002, p.79).
Until the middle of 1940, nursing training at the Brazilian Red Cross was associated with volunteer work and charity. It counted on the Daughters of Charuty of Saint Vicent di Paul, which had participated in the Red Cross since 1942, mainly workyng in Children’s Hospitals , where Sister Maria Candida Memescal graduated from Anna Nery Nursing School, as the first director of the Rde Cross Children’s Hospital in São Paulo.
Iracema Isabel Nieble, graduated from Anna Nery Nursing School was initially contracted to work as head nurse in the Hygiene Institute( Actual Faculty of Public Health in São Paulo from USP), and in this same period she helped in the preparation od school curriculums and classes for the Nursing University of São Paulo from 1943 to 1944. She was invited to substitute Isabel Gomm as director of EECVB – FESP, and remained in this position until the middle of the decade 1950, when she also taught ethics and the history of nursing.
Many Samaritans and registered nurses would graduate in honors from the nurses training courses of CVB and go on to excel as nurses working in São Paulo Community Children’s Hospital and also with the soldiers coming home from the II WW. Several from CVB even severed on the European front as noted Roney Cytrynowicz(2002). Edith de Magalha~es Fraenkel, the first director of de Nursing University of São Paulo – USP, began her pioneer nursing career in a short course for volunteer nurses at the Red Cross in Rio de Janeiro before studying in the United States.
Initially the course at EECVB – FESP had the duration of three years of study divided into two distinct periods: a) a period of theory and practice – theory laboratory study, b) a period of pratical application and internship. In the middle of the 1950s the course was extended from thee to four years. The teaching methods contemplated student inolvement, the development of a critical mind, leadership and a behavior of intervention in the manner of the “Nightingale System”, and long regimes of internship for some students, when it was necessary.
In a publication dated in 1940, Maria Luiza Sampaio e Castro(1923), Smaritans and graduated nurse from the first class of EECVB – FESP, showed that the primary objectives of the course were: the formation of students to work in the nursing profession in the field of first aid relief, teaching, adminitration(heading nurse staffs), and in public health. In accordance with the legisçation of this time the cours should offer and all round technical and scientific background in health care.
In this sense, different aspects of health care were taught; first aid, health and disease prevention, and the complex care procedures of hospitalized patients. The nursing trainees were stimulated to assume a teaching role in community health education, to improve personal hygiene of the population the development of a responsible moral and ethical attitude, and also to become team worker en emergency health and disease situations involving individuals, families, and/or the ommunity in various circumstances. A qualifiel nursing school recognizes the fact that directorship of the school should be confidend to graduated nurses with teaching and administrative experience in nursing schools. The admissin requirements, the duration of the course, and the organization of the course’s curriculum should in all cases follow the norms of the institution. In regards to admission requeriments, only qualifield candidates were to be accepted, ones that had completed secondary aducation or its equivalent. The admissions exam included test in Portuguese, mathematics, biology, a foregn language(English), physics, and chemistry. The minimum age requirement was of 18 years for both sexes.
Althogh no equivalency with other school standards was required in Decree n.20109/31, the Red Cross CVB nursing school of São Paulo and Rio de Janeiro in 1940 still required this qualification. For Rio de Janeiro it was conceded though Decree n. 2.768, of 04/06/48 and São Paulo by Decree n. 27.020, de 08/08/49. At the same time, law n.775, of 08/06/49 and Decree n. 27.426, of 11/14/49 were promungated for the regulation of all nursing school in Brazil. This federal legislation besides creating professional nursing school and nurses aid courses, determined that the school and courses be recognized by decree of the president of the Republic, and not required to have matching curricula.
From then on the Red Cross CVB nursing schools followed the legislation and had an institutional statu, and this status was assured by its president; Cel Arthur Diederichsen, Dr. Afranio do Amaral, Dr. Luiz L.Reid, Dr. Antonio Erminio de Moraes and Dr. Jorge Wolney Atalla.
The curriculum of the decade of 1950 was elaborated following this legislation on teaching and learning, in accordance with the new regulations and these new regulations had the duration of four years. The curricular structure, for these fours years was divided into learning periods: the pre-professional period was the first semesterof the course, prepared the students in basic courses of anatomy, physiology, bio-chemistry, social science, art, and nursing techniques.
The pre-profesional period covered the first semester of the course and the students were required to learn credits in basic subjects as anatomy, physiology, biochemistry, social science, art, and nursing techniques.
Medical, theory classes were taught by professor, from the Medical School of the University of São Paulo or physicians from the Hospital da Clinicas of University of São Paulo: Waldomiro de Paula(Anatomy), Victorio Barbosa (microbiology), Roberto Brólio (Epidemiology), Álvaro Guimarães Bastos(Gynecology), Paulo David (Surgery), Wilson Broto ( Neurology), João Carvalhal Ribas(Psychiatry), among others.
At dis time, in the área of Behavioral Sciences there were:Silva Tatiana Maurer Lane ( General Psychology),in nursing, Ernestine Maurer Bastian, a graduate of EECVB – FESP, and maria de Lourdes Almeida (both taught classes in Practice and Theory in Rural and Urban Public Health), Ida de Jesus Picanço, who was a native of the state of pará and a graduate of the Nursing School of São Paulo, and Iracema Isabel Nibler ( both taught the disciplines of Technique of Professional Nursing and Ethics of Nursing). These courses transmitted to the students an advanced knowledge of moral behavior and gentil movements.