Bolsonaro’s MP extends journey and reduces rest for doctors and nurses 03/26/2020

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By allowing health workers to work longer hours and reduce rest time, provisional measure 927, issued by President Jair Bolsonaro on Sunday (22), tends to leave nurses overloaded and even more exposed to the new coronavirus. The MP allows these workers to work unlimited hours, with rest that can be reduced to 12 hours, while the state of public calamity lasts.

The report sought the Ministry of Economy to question the points of the MP, but did not receive an answer until the publication of this text. The response will be included as soon as it is sent.

Despite referring to health professionals, which includes doctors, the change made by the MP mainly affects nurses, who usually work on a 12-hour schedule for 36 hours off. In the case of doctors, the impact would be less, since the majority work as a self-employed person, even when working in hospitals, and they work 24-hour shifts – or more. The MP validates these long shifts, which should be an exception, and can cause a ripple effect in other types of contracts.

This change will generate physical and mental fatigue that can cause a drop in quality, errors made by health professionals and even a decrease in immunity, increasing the risk of contamination by the new virus. “
Ângelo Fabiano Farias da Costa, President of the National Association of Labor Attorneys (ANPT)

Concerned about the lack of personal protective equipment, such as masks and gloves, to face the pandemic, a nurse who works in an emergency room in the interior of Minas Gerais said that he is concerned about the possibility of increasing the workday. “A 12-hour shift is already too long,” he said.

Another nurse who works in São Paulo said that professionals do not have the physical and psychological conditions to support a 24-hour shift, for example, during the Covid-19 pandemic. “Our biggest fear is taking the disease home.”

“The nurse and the technician are always at the bedside. Any changes, we have to be aware. The patient will be at risk, and the professional too [com essa mudança promovida pelo governo]”, stated the president of the Minas Gerais Nurses Union, Anderson Rodrigues. According to him, the category is articulating to pressure the deputies to stop the MP in Congress.

The president of the National Federation of Doctors (Fenam), Gutemberg Fialho, agrees. “This increase in working hours and this reduction in time off leads to overload and stress. The professional is unable to have restful rest and is more susceptible to falling ill,” he says. The measure is dangerous, he continues, especially at a time of pandemic, when everyone is more susceptible to infection.

Coronavirus contamination by healthcare professionals has been one of the problems faced by countries where the pandemic is a little more advanced. In Italy, 23 health professionals died from the new virus. In Spain, about 4,000 doctors and nurses are infected with Covid-19.

‘Hunger MP’

The publication of the provisional measure on Sunday drew criticism from prosecutors, lawyers, union and parliamentary organizations and was dubbed, on social networks, “MP da Morte” and “MP da Fome”. After this repercussion, Bolsonaro revoked, on Monday (23), an article of the MP that allowed the suspension of labor contracts and salaries for up to four months.

The other points of the provisional measure, however, are in effect, and some of them remove workers’ rights in times of pandemic, even in the face of the prospect of a serious economic crisis in Brazil.

Repórter Brasil showed that workers infected by the virus in the workplace lose stability and can be fired – in case of death, the MP makes it difficult to receive compensation for moral damages.

24h of work, 12h of rest

Another of the changes foreseen in the text allows not only to increase the workload for nurses, but also that this be done through an individual written agreement without the participation of the union in the category.

“The MP allows a 24-hour work regime, for example, with 12 hours of rest, which is extremely worrying, especially considering that it is an unhealthy activity”, said Farias da Costa, from the association of labor prosecutors. “We know that we need to make the journey more flexible in times of crisis, but there will be a moment of mental fatigue for health personnel. Is giving the carte blanche to increase the journey the right way?” He asks.

The provisional measure also speaks of the overtime of these professionals and establishes that they can be paid (or compensated with time off) within a period of up to one and a half years, which begins to take effect when the state of public calamity ends. Today, the individual hour bank is six months and can be extended to one year, according to labor lawyer Fernando José Hirsch, a partner at LBS Advogados.

The employment contracts of nurses and nursing technicians work 40 hours per week: either five days a week in 8-hour shifts or 12-hour shifts, followed by a 36-hour rest.

Pejotization of doctors

In the case of doctors, it is common that their hiring is not made by CLT, but through medical cooperatives that provide services to public and private hospitals. A resolution by the São Paulo Regional Medical Council authorizes shifts of up to 24 hours to be made, but a doctor heard by the report says that longer hours are common. “When I worked more than 24 hours, it took me three days to feel rested.”

According to the CLT, it is possible for doctors to do 24-hour shifts, but with a 72-hour rest, depending on what was agreed in the collective agreement between employers ‘and employees’ unions. Regarding the changes made by the government due to the pandemic, the duty officer says that “there will be a lot of sick health professionals, because 12 hours is too little to rest from a 24-hour shift.”

According to an infectologist from the interior of São Paulo, many doctors usually adhere to “pejotização” because they have more flexibility and income. When making this option, however, they are left without labor rights – which, now, in a time of crisis, can leave them more vulnerable to exhausting hours, since they are not subject to a workload regulation.

Formal hiring, by contest or CLT, in the opinion of the infectologist, usually results in more qualified professionals, because these modalities guarantee rest and training, which at the moment are “vital for good performance in the profession”.

The solution, in the opinion of the president of the federation of doctors, is not to increase the journey. “It is necessary to hire more professionals and not physically exhaust those who are already exposed”. Fialho also criticizes the fact that the MP was edited by the government without dialogue with the category.

New and more doctors

“The argument that there are not enough people is not valid. If you don’t have enough people, you train people, you call outsiders,” said Valdete Souto Severo, president of the Association of Judges for Democracy (AJD). “What is unreasonable is for the government to say that our pandemic shields could stay 14 hours, 15 hours in a contaminated environment. From a health and human perspective, this change is absurd.”

Hiring more professionals would allow to increase the relay among workers – instead of increasing the workday, in the opinion of Farias da Costa, labor attorney. Thus, nurses and doctors would be more rested, protected and focused on caring for those infected by the coronavirus.

Countries with health systems overburdened by the pandemic adopt this strategy. Case of Italy, which was the first European country to receive Cuban doctors.

On Sunday (22), 53 professionals from Cuba, with previous experience in other epidemics such as Ebola, arrived in Lombardy, the Italian region most affected by Covid-19. The Cuban government currently maintains doctors in more than 60 countries. They have already worked in Brazil, but with the election of President Bolsonaro – and his recurring criticisms of the country – Havana ended up removing the 8,332 professionals who worked in remote areas and small Brazilian cities.

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