NURSING PROFESSIONALS TRAINED FOR THE LABOR MARKET IN THE STATE OF MINAS

The present study aimed to analyze the profile of nursing professionals trained for the labor market. This was a quantitative and retrospective study on nursing workers who applied for the Main Provisory Registration (IPP) in the Regional Council of Nursing in the State of Minas Gerais, between 2005 and 2009. A total of 48,064 IPP requests were analyzed, being 40.42% requested by nurses and 65.36% by nursing technicians. The IPP requests increased 240% among nurses and 22% among nursing technicians. There is a prevalence of the female gender, aged under 30 years, and in stable marital unions. The availability of nursing workers for the labor market was concentrated in the State capital compared to the State’s municipalities. Globalization and the competitive labor market impose new challenges facing the technological development and migration of workers requiring professional qualifications to guarantee substantial achievements in the Brazilian nursing


INTRODUCTION
Currently, increasingly qualified human resources are required for the implementation of effective practices in response to the peculiar demands from the health labor market and social complexities.Therefore, even in the face of technological advances, the appreciation of human resources is a fundamental condition for the viability of health projects. 1,2n general, economic repercussions of the neoliberal globalized market have influenced the specifics of work in health and the skills required for its performance.For Nursing, these implications indicate new challenges, supported by the need of re-appropriation of knowledge and skills in the appreciation of professional autonomy and stimuli towards the proactive mode to intervene in health before different social demands. 3,4n the health labor market, according to national indicators, nursing workers occupy a significant space, with 41.9% of total jobs -679,215 jobs in 2005, and of these, 17. 1% represented by nurses, 23.8% by nursing technicians, and 59. 1% by nursing assistants. 5ursing professionals are inserted into different scenarios of health care, households, offices, health care facilities, hospitals, and other institutions with the aim of promoting quality of life for people.They act on urgent and emergency assistance participating in prevention and epidemiological control of aggravations, recovery, and rehabilitation of the sick. 3,6hey perform administrative and organizational activities in health management; they integrate teaching-research activities composing specific scientific multiprofessional or inter-sectorial projects.In addition, different social spaces are increasingly sensitive to the practice of nursing, making it important to potentiate the multiple scenarios of action to ensure more job opportunities. 3,6hus, it is highlighted that, nursing professionals should seek knowledge about computers and other languages, stay in constant improvement, and adopt entrepreneurial conducts with initiative, problem-solving abilities, and teamwork to remain inserted in the labor market. 4,6,7n the worldwide context, the nursing profession stands out for its ascension.However, it presents itself as a critical category because of professional shortages in different parts of the world, mainly in central countries as Canada, United Kingdom, and United States; and their deficiencies have been increasingly met by nursing professionals from peripheral countries.Similarly, Nursing Organizations from 69 countries identify the lack of professionals in 33 countries in the Oceania, Africa, and Central America.To meet this market demand of a globalized world, it is necessary to increase the quantitative training of nursing professionals. 8n Latin America, studies on demand and supply of jobs in nursing are recent and do not allow for a precise definition of professional labor shortage.In countries such as Panamá and El Salvador, where there is considerable training of nurses, the mi-grations of professionals are constant to meet the demands of central countries. 9In Brazil, there are no representative studies on indicators specifying the migration of nurses. 8he fact that nursing is considered a profession in ascension has driven the search for professionalization in this area. 4,8herefore, the execution of critical investigations about graduates in nursing schools is essential, their ability to respond to current health needs and, primarily, the quantitative monitoring of nursing workers by examining the increased manpower available and their impact on jobs.
However, the reality of the nursing labor market in the Brazilian scenario must be followed precisely to ensure regulatory measures between labor supply and demand for jobs.Hence, the present study aims at analyzing the profile of nursing professionals training for the labor market in the State of Minas Gerais.

METHOD
This is a historical cohort study on characteristics of nursing professionals available for the labor market.The study population was composed of nursing workers requesting the Main Provisory Registration (IPP), which is characterized as the mandatory registry that enables the initial activity of nurses who actually seems to be joining the labor market, in the Regional Council of Nursing in the State of Minas Gerais (COREN-MG), during the period between January 1, 2005 and December 31, 2009.The sociodemographic aspects (gender, age, and marital status) and professional category (nurses and nursing technicians) of applicants were evaluated over these five years.
In the present study, the COREN-MG subsections, located in the cities of Belo Horizonte, Governador Valadares, Juiz de Fora, Montes Claros, Passos, Pouso Alegre, Teófilo Otoni, Uberaba, Uberlândia, and Varginha were considered.Nursing Councils constitute an authority body linked to the Ministry of Labor and Social Welfare and play disciplinary functions controlling the exercise of the nursing profession. 10he data were obtained from the database provided by COREN-MG.The analysis included information about nurses and nursing technicians who seek the IPP and excluded information that did not present identification with the professional category.The data was managed using the Excel ® software, based on descriptive statistics.
The IPP was a legal qualification conferred by COREN, according to the jurisdiction of the applicant's professional domicile, to approve the exercise of nursing.It was an alternative to nursing workers whom, even after the completion of their courses, had not yet received their certificate/diploma -a document essential for Main Definitive Registration request (IDP).The provisional license requirement was a common practice among nursing professionals because the educational institu-A stable union was the most prevalent marital status represented in 42.78% among nurses and 41.24% among nursing technicians.The single condition was more common among nurses than among nursing technicians.This information was absent in 35.15% of the applications from nurses, and 44.94% from nursing technicians (Table 3).

DISCUSSION
The nursing staff has an important participation in the health labor market occupying 2 / 5 of the total number of jobs in the sector. 5,12 n 2011, the Federal Council of Nursing (COFEN) re-tions took up to six months to issue licences to mid-level professionals and diplomas for nurses with a Bachelor degree.The IPP had a validity of 12 months and was only issued upon the presentation of the course transcript with all disciplines completed and approved with a statement of course completion, issued by the educational institution. 11his research was approved by the Committee of Ethics in Research with Humans from the Federal University of the Triângulo Mineiro (UFTM) under the Protocol 1,534/2009, and was developed in compliance with the provisions of the 196/96 resolution from the National Commission of Ethics in Research.

RESULTS
A total of 57,625 nursing professionals were identified as applicants for the Main Provisional Registration (IPP) from COREN-MG, in the period between January 1, 2005 and December 31, 2009.Of these, 9,571 requisitions (16.60%) were excluded because they did not provide professional category identification.Thus, 83.40% of the records were analyzed in this study, making a total of 48,064 provisional registrations in Minas Gerais.
Nursing technicians totaled the highest number of IPPs, with 31,416 (65.36%); followed by nurses with 16,652 (40.42%).During the studied period, from 2005 to 2009, a significant increase in IPP requests was observed, from both nurses and nursing technicians, from 8,005 applicants in 2005 to 13, 182 in 2009, representing an increase of 63.92%.IPP requests by nurses contributed the most to this increase in 2005, totaling 19.55% of requested IPPs, and reaching the percentage of 42. 10% in 2009 (Table 1).
Of the total number of IPP applicants, 86.84% of nursing technicians and 83.50% of nurses were women portraying a female predominance in both occupational categories.
The most prevalent age group was less than 30 years, 74.60% among nurses and 45.60% among nursing technicians.The percentage of nursing technicians was 39.29% in the age group of 30 to 40 years.In general, these results express the availability of relatively young people joining the health labor market in the State of Minas Gerais (Table 2).The statistical data estimate the proportion of 0.65 nurses and 1.34 nursing technicians per thousand inhabitants based on the administrative records available at federal and regional health councils on labor supply of nursing professionals in activity in Brazil, and the binding obligation to councils for the professional practice.In the Southeastern region, this proportion is 0.73 nurses and 1.33 nursing technicians per thousand inhabitants.In the State of Minas Gerais, these proportions are inferior for the two professional categories, with estimates of 0.5 nurses and 1.04 nursing technicians per thousand inhabitants. 5In countries of the northern hemisphere, the proportion of nurses is 10 for every thousand inhabitants. 8lthough the present study reveals absolute increase in the number of nurses trained for professional practice -1,565 professionals were trained in 2005 and 5,328 in 2009.These data indicate a deficit compared with international and national statistics.Faced with this reality, the importance of redesigning the training of nursing professionals is evidenced to ensure increased availability of quantitative health workers for the labor market who could respond to the needs of the population and act efficiently, with technical and scientific knowledge. 7,13ny change must be based on the dynamics of public policies and transformations in the world of work in health.3][14] In the composition of the impact of hiring new workers by the SUS, the Family Health Program is represented as a symbolic example in formatting new jobs for nursing professionals. 2,8,12n health institutions, the improvement in the qualification of nursing workers, their professionalism, brings benefits to the care, organizations, and the workers themselves.Health establishments are best evaluated by both clients and workers, to the extent that they enable professional development.Among the nursing workers, professionalization relates to better salaries, more job satisfaction, and personal fulfillment. 15 Brazilian experience that is relevant for professional qualification was presented by the Project of Professionalization of Nursing Workers (PROFAE), which aimed to empower nursing workers for better integration into the labor market since 2000.The main impacts from the PROFAE were offering courses in primary and middle education level to complement the training of workers at the technical level.16 The results of this study indicate a growth of 22% of IPP requisitions for nurs-ing technicians as an important impact on the professionalization of this category in Minas Gerais.
Another aspect of the Brazilian nursing professionalization occurred from the expansion of undergraduate courses.This expansion began in early 1970 as a strategy for overcoming the national deficit of nurses.In 1990, this growth was more pronounced, influenced mainly by the increase in undergraduate courses in nursing teaching private schools.It should be noted that in 1999, 68.8% of slots offered at nursing undergraduate courses belonged to the private sector. 2,8n the year 2000, the expansionary trend of undergraduate courses in nursing prevailed, however, this time, driven by the expansion of slots in public education institutions, particularly in the country side.Between 1990 and 2004, considering the public and private education networks, the accumulated growth of national slots for undergraduate courses in nursing was 843.7%. 8In the present study, the impact of the expansion of undergraduate nursing courses was evidenced by the increase of 240% in nursing IPP seekers between 2005 and 2009, in Minas Gerais.
Another important factor for the category of Brazilian nursing in the health job market is the viability of jobs for workers who have elementary or middle school education as long as they are qualified.The factors that attract students to professionalize in nursing relate to the prospect of a stable career, absorption in the labor market, and opportunity of better remuneration. 17n Brazil, the average income of the employed population in 2005 amounted to R$ 945.20.Health care workers received an average income that is 1.4 times greater than the average worker income, amounting to R$ 1,329.10. 5 Therefore, the option of a professional qualification in the field of nursing can be linked to both prospects of a promising job market and financial remuneration. 17conomic issues decisively affect the territorial distribution of nursing workers because there is concentration of professionals in the territories with more economic development.The present study shows that more than half of the IPP requests performed in Minas Gerais were focused on the Belo Horizonte-MG subsection, capital of the State and city-center in the metropolitan region.This concentration of the nursing workforce in metropolitan areas is similar at the national level.The Southeastern region, which hosts the three most important national metropolises, with the highest rate of urbanization, such as Belo Horizonte, concentrates more than half of the health workforce. 5,18esides, the analysis of this historical cohort showed that 65.36% of the total IPP requests correspond to the category of nursing technicians.This fact corroborates the reality expressed in Latin America.The analysis of the distribution of acting nursing in categories showed the predominance of fundamental or medium level education professionals -nursing assistants or technicians. 9This situation relates to the historical available for the labor market.There is a contingent of nursing workers that despite having their training completed, they do not request the IPP until they actually enter the labor market.
Still, some indicators demonstrate that there has been considerable training of nursing professionals in certain regions of the country, including in the State of Minas Gerais.However, this formation was not followed by an increase in jobs; and thus, there is an imbalance in supply and demand of professionals resulting from difficulties in creation of new jobs related to the reproduction of socioeconomic inequalities in the regions and States. 22Thus, the need for future discussions about site-regional relations, training, job occupation, expansion, or retraction of the market for nursing is fundamental.

CONCLUSION
A total of 48,068 main provisional registration requests (IPP) to COREN-MG were analyzed in the State of Minas Gerais, which revealed the increased availability of nursing professionals for the labor market between 2005 and 2009.The profile of nursing professionals available for the labor market showed that the majority of IPP applicants were nursing technicians (65.36%) and nurses (40.42%), females, and aged less than 30 years.
The availability of nurses for the health labor market was significant, with 240% increase in IPP requests during the studied period compared with nursing technicians, which showed an increase of 22%.A concentration of nursing workers was observed in areas of economic development, mainly in the State capital.However, compared to the global data and data from other areas in Brazil, the proportion of nursing workers per thousand inhabitants in Minas Gerais is still inferior.
The different scenarios of nursing activity have required professionals who articulate multiple areas of knowledge to ensure effective actions, increasingly close to the health needs of patients.Thus, the labor market transformations in the globalized world for the contingent of nursing professionals, in particular in the State of Minas Gerais, require urgent need to transpose the marginalization of the nursing work, which, often, is still understood in a limited way.
Despite that the IPPs do not represent the total contingent of professionals available for the labor market they represent a relevant source for this analysis in the view of its mandatory aspect for the beginning of working activities.The development of future studies that approach the relations between training and availability of jobs for nursing is suggested.
Hence, to reach substantial achievements in the nursing field, in the State of Minas Gerais, facing the current and competitive job market, the determined and creative implementation of quality in the nursing practice, which articulates technical-scientific, administrative, political, and relational skills is essential.model of provision of nursing services, by the technical division of labor, in which the nurse manages the care that is executed by a large number of workers of elementary level education. 7,9he highest concentration of workers of elementary level education in the composition of the staffs of nursing professionals also relates to the low economic capacity in Latin countries to afford the cost of more qualified professionals. 9ocalities in Latin countries, presenting more pronounced economic development, where there are numerous hospital services and high public budget show a concentration of nursing jobs.In contrast, disadvantaged territories, characterized by rural areas that lack community services and direct assistance among nursing workers and the population are served predominantly by nursing professionals of fundamental or technical level. 9he sociodemographic profiles of the nursing workers showed that women, at young adult ages, are the most expressive representation among nursing workers.This reality is characterized by factors with more socio-historical approach in the exercise of activities that involve caregiving. 7The predominance of nursing workers aged around young adults converge in different studies.Nursing graduates from the State University of Rio de Janeiro were predominantly represented by women (97.6%), age between 24 and 26 years, (68.3%) and married (26.8%). 19Graduates from the School of Nursing from the University of São Paulo (92%) were females, unmarried (68.8%), with an average age of 27 years. 2ursing technician graduates from a school linked to a university in Minas Gerais were 81.13% females. 20In educational institutions, one public and one private, in the Rio de Janeiro municipality, the prevalence of approximately 85% females was observed among nursing students, with 84% between the ages of 17 and 22 years.The single civil status was prevalent (95%) in both institutions. 17n face of the different labor market scenarios, health services, public or private, have required professionals capable of decisions, ethically articulating different areas of knowledge and considering humanistic and socio-cultural dimensions. 16,20nd the constant development of technology and discoveries of new treatments, places the health sector as a labor market increasingly competitive. 20,21his reality defines the challenge for Brazilian nursing to be continually qualified.For this reason, the professional qualification of nursing staff should be guided in the expansion of welfare demands and the importance to overcome the hegemonic model of attention. 13e need to exercise caution based on the considerations from the present study.It is guided in the number of early registrations in the councils (IPP) as an indicative of nursing professionals for the market.Even being an important historical source for the analysis of the reality of the Nursing labor market in Brazil, this source of information has limitations because the IPP requests do not express the totality of professionals

Table 1 -
Distribution of nursing professionals, applicants for the Main Provisional Registration (IPP), according to professional category, COREN-MG, from 2005 to 2009

Table 2 -
Distribution of nursing professionals, applicants for the Main Provisional Registration (IPP), according to age group, CO-REN-MG, from 2005 to 2009

Table 3 -
Distribution of nursing professionals, applicants for the Main Provisional Registration (IPP), according to marital status, COREN-MG, from 2005 to 2009