Contributor: Luz Galdames, PhD (Nursing)

Today, more than twenty years after nursing was incorporated into the Chilean Health Code in 1997 as an autonomous profession, one begins to see how nurses empower themselves defending their rights at the institutional, social and political level. This is seen through events such as the establishment of the National Nursing Directorate at the Ministry of Health and the role that nursing has had in the Covid-19 pandemic. Nurses are raising their voices. In the political sphere, nurses are campaigning as representativeness to draft the new Chilean Constitution, defending/advocating care as a constitutional right and guarding professional autonomy. Another important example of nursing empowerment is the growing generation/development of nursing scientific associations. These organizations seek to socialize what nurses do, the ongoing research in different areas of care and the development of profession itself. Currently, there are more 40 scientific nursing societies in the country.

In 2005, through the Health Authority Law 19,937, self-managed hospitals were established, which brought with them an important change in their administrative organization. It implied that hospitals in their structure should consider the Medical Directorate and the Subdirectorate of care management, both with direct dependence of the hospital management. Historically, nursing had depended on the medical directorates. In this context, the nursing professional association of the time and, the scientific societies (in that period there were no more than ten) defended before the authority of the Ministry of Health and the Comptroller General of the Republic, that by then nursing was the only profession that in its definition evidenced care management as a component of its role. As a result of these negotiations in 2007, by means of the General Administrative Norm No. 19 of the Ministry of Health, it recognized the nursing profession as the most suitable for implementing the care management model in self-managed hospitals.

In this context, “Nursing Care Management” was defined as the professional practice of the nurse based on the nursing discipline, the science of caring (based on Watson’s philosophy and theory), understanding the exercise of the profession as the application of professional judgment in planning, organization, motivation and control of the provision of timely, safe, comprehensive care that ensures continuity of care and is based on the institution’s strategic policies and guidelines. This achievement was constituted a demonstration of empowerment of the nurses of the decade.

However, even when the definition indicated that “care management” was based on the science of caring, the care provided to people was mainly focused on the biomedical model. The National Directorate of Nursing: it is specified through Exempt Resolution No. 1443, on August 20, 2019, during the mandate of the Minister of Health Jaime Mañalich who formalized the appointment of the National Director of Nursing. Being a milestone for the profession, providing from the central level, support to direct and guide the care of people, develop the nursing structure for the health sector, ensure that the nursing care management sub-directorates are not only considered in in-hospital care, but also in primary care.

In parallel, there have been other relevant events in the country, which show the awakening of nurses as a professional group. An example has been the number of nurses who present themselves to the process of electing representatives to the constituent assembly, in defense of care as a constitutional right, as well as the defense of the autonomy of the profession and the rights of nurses.

Another event that has led to the empowerment of nurses has been the Covid-19 Pandemic, which has resulted in the defense of the right of profession, the union of the group to be in the spaces where decisions are made. Likewise, the growth of scientific Societies that bring together nurses for a common purpose, whether it is around the care of people, such as the defense of the rights of the profession (see the list of Scientific Societies below).

The immunization of the population through the vaccine for Covid-19, means another instance in which the nurses raised their voices to defend the vaccination process as a historical nurse’ s responsibility. To respond to the vaccination demands, other healthcare professionals were called by the authorities as volunteer. This led, the nurses defended before the authorities, that although the voluntary participation of other professionals in vaccination is recognized, the vaccination programmeshould be under the supervision of the nursing staff only. Highlighting that, vaccination does not only imply the act of inoculating the vaccine, but an entire process of organization, administration, register and following up.

One of the last events that brings together nurses as an empowered group is the call that the National Director of Nursing makes to Scientific Societies to be part of a Technical Working Table, with the purpose of generating strategic collaboration links in for the development of protocols for the management of care and research in the discipline of Care.

Scientific Societies

• Agrupación de enfermeras holísticas de Chile (AEHCh)
• Agrupación de enfermeras y enfermeros ecologistas
• Agrupación de enfermeros perioperatorios (AGEPCH)
• Asociación chilena de enfermería en estomas heridas y/o continencias (ACCHIEHC)
• Asociación chilena de enfermeros educadores en diabetes (ACHIENED)
• Capítulo de enfermería de la Sociedad Médica de Cuidados paliativos
• Capítulo de enfermería de SOCHIQUEM
• División de enfermería intensiva de la sociedad chilena de medicina intensiva (SOCHIMI)
• Federación Latinoamericana Esterilización FELACEH
• Fundación de enfermería Gestión del Cuidado
• Fundación latinoamericana de enfermería en cuidado humanizado (FLECH)
• Sociedad de Enfermera Latinoamericana en Heridas (SELH)
• Red Nacional EBE Chile
• Red Chilena de Enfermería en Lactancia Materna (REDCHIELM)
• Red Chilena de Enfermeros En Odontología (RECHIENFOD)
• Red de Enfermería en Informática Chile
• REDENFI Chile
• Red Chilena de Gestión del Cuidado REDGECU
• Red de Enfermería en Salud del Adulto Mayor- Chile (REDESAM)
• Red Chilena de Historia de la Enfermería
• Red en Salud Ocupacional (RedENSO Chile)
• Red iberoamericana de investigación en educación en enfermería-RIIEE Chile
• Red Internacional de Enfermería en Cuidados Paliativos – Chile (RienCupa)
• Red internacional de enfermería quirúrgica -RedIEnQu Chile
• Sociedad Chilena de Enfermería en Salud Ocupacional (SOCHENSO)
• Sociedad chilena de enfermeras de salud escolar (SOCHIESE)
• Sociedad Cientíca chilena de enfermeras del niño y adolescente (SOCHENA)
• Sociedad Chilena de Enfermería en Cardiología y Cirugía Cardiovascular (SOCHICAR)
• Sociedad Chilena de Enfermería en Donación, Procuramiento y Trasplante (SOCHIENFDPT)
• Sociedad Chilena de Enfermería Oncológica (SEOC)
• Sociedad científica de enfermería comunitaria y familiar (SOCHIENFA)
• Sociedad chilena de enfermeras comunitarias (SOCHIENCO)
• Sociedad Chilena de Enfermería Prehospitalaria, Agrupación Científico-Técnica. (SOCCHIENPRE)
• Sociedad chilena de prevención y control de infecciones asociadas a la atención en salud, (SChIAAS)
• Sociedad Chilena de Enfermeras de Pabellones Quirúrgicos y Esterilización
• Sociedad Chilena de Terapia de Infusión (SOCHITEIN)
• Sociedad científica de atención temprana, rehabilitación e inclusión
• Sociedad Científica Docente Estudiantil de Enfermería UACh Pto Montt (SOCIDENF)
• Sociedad de enfermeras de diálisis y trasplante renal (SENFERDIALT)
• Sociedad Chilena de Enfermería Geronto-Geriátrica
• Sociedad de Enfermeras Dermoestéticas (SOCHIEDE)
• Sociedad de Profesionales en Esterilización de Chile
• Sociedad Chilena de Simulación Clínica (SOCHISIM

About Luz Galdames

Luz Galdames Cabrera Ph.D. in Nursing, Mg. Instructional Design, Nurse-Midwife, Research Professor, School of Nursing, Faculty of Sciences, Universidad Mayor. Researcher in project “Development and validation of the prototype dressing with copper nanoformulation for the treatment of infected chronic wounds, Universidad Mayor, Project ID18I10085 Funded by the Fund for the Promotion of Scientific and Technological Development FONDEF 2018-2020. Director of the Nursing Specialization Program in Adult Oncology at the Universidad Mayor. Member of the International Center for Nursing Research CIIENF of the Chilean Association of Nursing Education. Coordinator of the international Care Management Network. Founder and President of the Chilean Network of Care Management Last publication Galdames l., Enders B., Pavez A. Self-regulation, Autonomy and Identity of Nursing as a profession. Science and Nursing Magazine. 2019 24 (4). Doctoral thesis Care Management: Understanding the Meanings of the Social Role and Professional Autonomy of the Nurse in Chile. Funded by the Vice-rectory for Research and Doctorate as a start-up project, Universidad Andrés Bello Chile 2014.