Military nurses in the Auxiliary Force of the State of Rio de Janeiro: a historical study
Margareth Teixeira de Souza de Almeida1, Tânia Cristina Franco Santos2, Antonio Jose de Almeida Filho2, Maria Angélica de Almeida Peres2, Pacita Geovana Gama de Sousa Aperibense2, Marcleyde Silva De Azevedo Abreu2
1 Military Fire Brigade of the State of Rio de Janeiro, RJ, Brazil
2 Federal University of Rio de Janeiro, RJ, Brazil
ABSTRACT
Objective: To analyze the selective process of the first class of Nursing Officers of the Fire Department of the State of Rio de Janeiro, carried out from 1992 to 1993.
Method: This is a historical research, a documental one, which used as direct historical sources written documents concerning the theme. Outcomes: There were eight vacancies for nursing officers, who were submitted to a rigorous selective process that approved five men and three women after four stages along the contest. Discussion: Making part of the Fire Department meant to accept being submitted to its structural rules, and succeeding required updating the habitus of the candidates according to the ranking of the Corporation’s officers. Conclusion: Nurses were selected under the rigorous criteria as required by the Institution. Their knowledge abilities in the nursing area should come at equal pace as good health conditions and physical fitness, fundamental performance attributes of a military officer of the Fire Department.
Descriptors: Nursing; Military Nursing; Nursing History
INTRODUCTION
The Military Fire Department, created by Decree Nr. 2.587, as of April 30, 1860, replaced the Provisional Fire Department created by the Court by the Decree Nr. 1.175, as of July 02, 1856. Its main purpose was the “fire extinguishing” service, and, if so required, it could perform as a support for the Public Force(1).
The Military Fire Department of the State of Rio de Janeiro is an Auxiliary and Reserves Force of that State, and is part of the System of Public Security and Social Defense of the country, Brazil. Under the Federal Constitution passed in 1988, its members came to be identified as State Military Policemen, as were the members of the Military Policemen of that State.
Pursuant Act Nr. 880, as of July 25, 1985, which settles its statute, it is a permanent institution whose organization is based on hierarchy and discipline, meant to render fire prevention and extinguishing services, besides search and rescue services, and to provide help in cases of floods, building collapses or catastrophes, whenever there are victims in imminent death danger or threat of properties or goods destruction(2).
On July 09, 1986, the Brigade of Emergency Help (GSE) was created by the General Command of The Military Fire Department of the State of Rio de Janeiro, aimed at integrating and making operational the Program for Assistance for Medical Emergencies on streets and public sites in that State, whose main mission was to provide pre-hospital assistance. Until the GSE was created, firemen with no specific abilities were in charge of providing that help. Help on the streets was provided for the population by Combatants, who would transport the victims to hospitals nearby(3).
The mobile pre-hospital assistance (APH) is the help support that tries to reach the victim as early as possible after the occurrence of a medical emergency. Therefore, an adequate assistance and/or transportation is required by means of a dully hierarchical health service integrated to the Unified Health System (SUS), as determined by Resolution Nr. 1529/98 by the Federal Medicine Council (CFM)(4).
In 1986, when the first GSE team was selected, the contest was not allowed for women and nurses, as only male medical doctors and nursing auxiliaries could make part of the crew in ambulances that would render help. Therefore, the health team of the Fire Department included 180 medical doctors, 180 nursing auxiliaries, 180 drivers and 45 mechanics(5). The nurses who worked at health institutions of the Fire Department – the Central Hospital Aristracho Pessoa (HCAP) and Polyclinics – were civil servants transferred by the State Health Secretariat.
Only six years later, with the Publication Nr. 67 on the Official Gazette of the State of Rio de Janeiro(6) (DOERJ) on April, 1992,(6) nurses of both genders were allowed to join the Corporation as military officers. This was possible because, two years earlier, the Act Nr. 1723, as of October, 1993, had defined the effective of the Fire Department of the State of Rio de Janeiro. including nurses into the Board of Health Officers, for the following commissions: eight vacancies for 2nd. Lieutenant MF, five vacancies for 1st Lieutenant MF, and two vacancies for Captain MF. Medical and dentist doctors would join as 1st. Lieutenant MF, and could reach the higher rank, as Colonel. Thus, considering the hierarchical circles of Rio de Janeiro Military Fire Department (CBMERJ), those with these two professions were high rank officers7. Nurses, on the other hand, would enter as 2nd Lieutenant MF, and their maximum rank would be Captain, which, considering the hierarchical circle, corresponds to an intermediate officer (Act Nr. 1723, as of October 25, 1990)(7). Corresponding to a subordinate ranking, this position was disadvantageous for nursing officers when compared to medical end dentist doctors – who, by the way, were evaluated by the same contest.
These are important considerations, as hierarchy and discipline are the institutional basis of the Military Fire Department of the State of Rio de Janeiro, where both authority and responsibilities are proportional to the ranking achieved. The higher the ranking, the higher the responsibility and the authority of the military officer. It is worth remarking that, historically, nurses in command positions are still limited as a whole, and this is not different in military institutions(8-9).
Once passed in all eliminatory stages of the contest – written test, theoretical-practical test, medical examination and physical fitness –, the candidates to become nursing officers, both male and female, would start the Probatory Internship of Officers Formation, to follow the formation course of Military Fireman. At the end, those who have passed and were classified would enter the Corporation as 2nd. Lieutenant MF. The first class was empowered in a solemn session carried out on February 15, 1993.
The study is well-timed due to the need of recording the professional development of the nursing profession in Brazil, particularly in an Auxiliary Force of the Army that until 1992 did not include nursing officers of both genders. The number of female officers who entered the Department was not that expressive, considering that out of the eight vacancies offered only three were occupied by women. It is worth remarking that one of them was classified in the first position.
Considering the historical context exposed above, the present study is aimed at analyzing the selective process of the first class of Nursing Officers of the Fire Department of the State of Rio de Janeiro (CBMERJ), carried out from 1992 to 1993.
METHOD
Qualitative, historical, documental research. The timing involves the period from 1992 to 1993, where the initial mark refers to the year the contest was made public and when eliminatory tests were carried out; and the final mark refers to the year when the probatory internship was concluded and the solemn session for the graduation of those who passed the tests and were classified.
The historical sources used in the present study were written documents, with special attention to the publication of the contest, the Corporation’s official reports, laws and decrees. Those sources were located at the Central Headquarter of the Fire Department and at the Central Hospital Aristacho Pessoa. The selection of sources at the above-mentioned records took place from October 2018 to August 2019, and was carried out by one of the authors, who is nurse officer at the Fire Department of the State of Rio de Janeiro, and author of the Master Degree dissertation that led to the present manuscript. Following this stage, sources were organized and classified, applying the adequation analysis, so as to evaluate both the quality and the relevance of information therein, and to determine historical evidences, in order to analyze them later with critical considerations, inserting them into the context where they were produced. This analysis was based on the literature on the theme, found in books and articles, with emphasis on the knowledge produced on military nursing, particularly in those articles that adopted their own concepts for the historical methodology. Complying with the historical method, findings were analyzed after the classification and organization process(10). The results reliability was granted by the valorization of the documental whole, typical of the historical research, and not simply based on isolated documents.
The study fulfilled all formal requirements included in Resolution Nr. 510, as of April 07, 2016, on Human Science and Social Research.
RESULTS
In order to make operational the Emergency Assistance Program on Public Streets, the Fire Department of the State of Rio de Janeiro created, in 1986, the Help and Emergency Group, which included effective personnel of its own force (Decree Nr. 9.053, as of July 09, 1986)(11).
In that context, male nursing auxiliaries started being incorporated, ranked as Soldiers. Nurses were not included in the group, and the nursing auxiliary was subordinate to the medical doctor officer. The insertion of nursing professionals into the Fire department of Rio de Janeiro (CBMERJ), with officer position – 2nd. Lieutenant MF – occurred in 1993, following a long selective process started in 1992, after the Publication Nr. 67, as of April, 1992, on the Official Gazette of the State of Rio de Janeiro, which enabled nursing professionals of both genders to enter the officialdom of the Corporation.
The conditions exposed in the Publication for professionals who aimed to make part of the Fire Department were: being native Brazilian, maximum 32 years old incomplete, diploma from a nursing school and proof of inscription in the Nursing Regional Council. Male candidates should present proof of military service, 1st or 2nd categories, or proof and reason of dismission. They could not be sub-judice or convicted by the Justice, either Courts of Law or Military Courts. For both genders, being up-to-date with electoral duties was also required(6). The publication specified minimum height – 1.65m for males and 1.55 for females. For those up to 1.75m, the maximum weight should be the sum of the number exceeding one meter plus 10% of that value; for those over 1.75m, the maximum weight should be the sum of the number exceeding one meter plus 15% of that value(6).
Inscriptions were taken from 14 to 21 April, 1992, at the headquarters of Fire Departments in different cities of the State of Rio de Janeiro: Nova Iguaçu, Niterói, Barra Mansa, Angra dos Reis, Campos. At the inscription, the candidate should present ID, COREN* card or a valid temporary inscription, besides proof of having paid the annual contribution to the COREN for 1991. And diploma acknowledged under MEC*, with qualification registered on the overleaf or original declaration by the school, being mandatory the qualification area of the candidate; and two 3x4 photos, inscription form and payment – at the time, corresponding to 10% of 2nd Lieutenant’s salary(6).
The contest included four stages: written test, theoretical-practical test, health examination and physical fitness test. All stages were eliminatory. After the inscription, the first stage was the professional knowledge test. In this case, the intellectual exam would segregate the most skillful candidates to compose the Health board. For all candidates, school and professional education were required to take part in the contest. Besides, all investment in cultural and professional improvement would certainly be relevant for obtaining better results, and therefore, classification in the contest.
The written test included 100 (one hundred) multiple-answer questions. To be classified, the nurse should have 50% of correct answers – that is, 50 questions. At this stage, 233 candidates did succeed, 49 men and 184 women. This higher proportion of women – 79% – can be associated to the very character of the profession, mainly joined by women, but it can also stress their intent to enter spaces that are traditionally taken by men(12).
The higher mark in the written test was 76, the lower mark was 22. Should there be doubts about the correction, candidates could require review within ten days after the results were published in the Official Gazette(6), and that would cost 30% of the inscription tax.
According to the Publication, 24 candidates would be called for the second eliminatory stage, the theoretical-practical test. Those who did pass the first stage, but were not classified, could have a second chance within 24 months maximum, and that actually did happen after the formation year of the first nursing officers(6).
The theoretical-practical test required the candidates to prove their skills in the nursing areas of Emergency, Medical-Surgery, Obstetrics and Public Health, which would be related to activities to be developed by both male and female nurses, and would be demonstrated in both patients and manikins, depending on the availability. The theme would be proposed by the examiner for all candidates, and they should be assigned grade five as minimum mark(6).
The health examination was an important stage, as physical and health restrictions were incompatible with the job to be performed. The exams were carried out in the CBMER Hospital and in accredited laboratories. The candidates were responsible for the electro-encephalogram, and they could choose where to do it. Besides images, the medical report was also required for the candidates to pass this stage.
Those who were approved in the health exam could undergo the Physical Fitness Test (TAF)(6), and the exercises were focused on the physical quality during the pre-hospital assistance. Men and women were submitted to the same activities with different limits, and there were specific exercises for men and women(13). Such differences were justified by biological differences between men and women.
Nevertheless, despite gender differences in some TAF activities, the final result of the selective process showed that, out of the 24 candidates, 12 males and 12 females, only three women were in the group of eight candidates who passed and were classified for the formation internship and to join the Corporation. This outcome suggests that biological differences between men and women did directly reflect on the physical aptitude required for working as an officer at the Fire Department, which was certainly relevant for the board.
The formation internship took place from Monday through Friday, from 07:00 am to 11:00 am, from August 24, 1992, to February 15, 1993. Trainees proved excellent performance. Female trainees were outstanding in theoretical tests, on shooting instruction with revolver 38, obtaining more shots on target, and in the instruction for rescuing persons in helicopter, which was carried out at the CGOA(14).
DISCUSSION
The Publication Nr. 67 in the Official Gazette of the State of Rio de Janeiro, as of April 08, 1992, makes evident the long and well cared selection of officers that, counting on their professional skills, would be entitled to join the Fire Department of the State of Rio de Janeiro in 1992, specifically at the GSE, as military officers.
Considering the relevance of the GSE, as well as its impact on the continuous decrease of morbimortality indices, making part of a high-level help team required professional skills that are consonant with the nature of the job, as well as physical structure able to support adverse work conditions concerning the environment and the exposure to strong emotions. This is so because the effects that result from a new experience on the habitus of the candidates to be ranked as nursing officers depend on the practical compatibility relation between this experience and other experiences already integrated to the habitus. On the other hand, along the process of selective re-interpretation that results from this dialectics, the informative efficacy of this new experience tends to be continuously reduced(15).
Joining the CBMERJ would mean submitting to its structuring rules, and succeeding in this effort would require the candidates to update their habitus to the rank of officer in the Corporation. The individual who lacks such characteristics or is not able to update the habitus for living in a new group will be excluded from that group for lacking the sense of belonging to that group. Not fitting the group results in being disconnected. Once this is not a conscious connection, no matter how hard one may try to belong to a specific field, this will not happen just for willingness: if favorable disposition does not exist, disconnection will automatically occur, due to the difficulty of sharing the principles that rule that specific field(16).
The tacit acceptance of the conditions to join the CBMERJ started with the Publication and the application for the contest. This is a contest impregnated with meanings, as for the first time, in more than one century of existence, female nurses were offered the opportunity to make part of the Health board of the Corporation as officers, apparently in equal conditions with men – unlike the contest that took place in 1986, when only men were offered that opportunity –, a situation that led to reactions from a group of female medical doctors who aimed at running for one of the 180 vacancies offered to male candidates.
The contest carried out in 1992 attracted 3,180 candidates, 2,067 of which were women – that is, almost 65% of the total(17). Although women were majority among the competitors, men were still the majority in the board after the contest. Yet, in the first formation course for female officers, with just nine new female medical doctors, one female dentist doctor and three female nurses, those professionals were outstanding in classes and internships, toping expectations in regard of the female gender, whose biological differences were used as natural reasons for not allowing women in social spaces traditionally only accessible for men(14).
Although the curriculum was closed and instructors were already designated (all males) to give classes during the formation internship, Colonel Medical Doctor MF Portes required the Ministry of Navy to allow Captain Lieutenant Helsen (female nurse) to take part in the internship as instructor, specifically to teach military precepts and routines, so as to contribute with the process of incorporating the military capital by the candidates to the officialdom(14).
At the solemn graduation session, that took place on November 15, 1993, the excellent performance of women during the formation internship was stressed in the speech by Colonel Medical Doctor Jorge Alberto Soares de Oliveira (Health Director at the CBMERJ), who assured that those women were breaking up a barrier that for many years was only opened for males’ participation(14). Coming from a military authority in a solemn graduation session, the words referring to the outstanding performance of female officers during the formation internship – that is, in a rite when a new identity was communicated – has the social magic of giving existence to the person or the group, once a successful appointment is proportional to the authority who says the words and the audience those words are directed to(15), the power assigned to the group has to do with the lights objectively thrown on the fact that leads to the public nomination.
Despite the undeniable conquer of entering a space historically reserved for men, the final result of the contest, with just three women who did pass out of eight candidates –, and despite the significant predominance of women who applied and passed in the first eliminatory stage – 65% and 79%, respectively – reassert the unequal relations between men and women. The result also stresses power relations that derive from symbolic constructions, built on gender differences, which reflect, no doubt, precautions and concerns about the possibility of disturbing effects, as nursing, a predominantly female profession, is now inserted into a military ambiance where males are still predominant.
Furthermore, it is worth remarking that the nature and the rigor of the selective process of the future nursing officers were aimed at the selection of candidates able to be incorporated into the military practices that, without further appeal, used to represent the learning of an adequate behavior concerning the new professional and social position. Such incorporation made evident the need to internalize a practice based on the purposes of the military spaces, which are grounded on the values on discipline and hierarchy(18).
CONCLUSION
The GSE creation, in 1992, was a determinant factor for the creation of a board of nursing officers at the CBMERJ, though with a not expressive number at the first selection. For the eight nurses selected with the rigor as required by the Institution, the full knowledge on the nursing profession should come side by side with good health conditions and physical fitness,
fundamental attributes for performing military activities at the Fire Department.
With the new structure of the Health board, the CBMERJ was forced to adapt the space that for 136 years had been men-exclusive. Thus, the physical structure of the headquarter was changed so as to integrate women, yet without given away the identity of the Military Fire Department.
In 1992, when the intake of women into the CBMERJ was made public, telephones at the Corporation became congested, with people looking after information on the admission of combatant women in the board of officers. Indeed, that situation was due to a fact people had never heard of before, but also because making part of the CBMERJ was a symbol of the conquest of a social capital – reputation, prestige, fame –, which, on its turn, creates more symbolic capital, once being a military member of the Fire Department means having credibility before the society.
* COREN: The Nursing Regional Council
* The Ministry of Education
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Revised: 03/03/2021
Approved: 03/11/2021