1. The interdisciplinary practice implies a flexible and dynamic partnership of the authority statute-reflexions on the Portuguese situation Ana Albuquerque Queiroz Nursing School of Coimbra Aven Bissaya Barreto, apartado 55 3001 901 Coimbra Portugal aaq@esenfc.pt Maria Amélia Meireles, Nursing School Ponta Delgada, Portugal meireles.amelia@gmail.com The 13th Annual International Philosophy of Nursing Conference Bristol, U.K. 7th - 9th September 2009 Nursing in an Interdisciplinary World: cooperation, collaboration or compromise?

2. Summary Portuguese Context Cultural and Geographic Context -Portugal -Lisbon Health and Demography Indicators -Statistical Data -Foreign Nurses in Portugal -Etary Piramid -Aging Index Portuguese Health Care Sistem -National Health System Nursing in Portugal -Ordem dos Enfermeiros -Skills of nurses in general care -Quality standards of nursing care Nursing Licence Degree -Length -Structure 2 Content: Nurse interventions/unique contribution Incapacity to affirm the aim of the nursing intervention The dominant standard of submission Interdisciplinary health care teams

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4. Cultural and Geographic Context - Portugal Portugal has been a country since 1143 Almost 11 million people (in 2004) Official Language: Portuguese (6th most spoken in the world) Official Secondary Languages: English and French Immigration Country: African Countries of Portuguese Official Language (Angola, Cape Verde, Mozambique, Guine, etc.), some east European countries (Ukraine, Russia, Moldova, etc.) 4

5. Portuguese Health Care System Three Co-existing Systems National Health Service (NHS) Special Public and Private Insurances Schemes for certain professions Voluntary private Health insurance 5

6. Etary Piramid INE, 2008 6

7. Health and Demography Indicators Population (2005): 10.569.600 Birth rate (2005): 10.4 birth/1000 OE, 2007 7 Ratio: 4.02 nurses/1000 habitants

8. National Health System  The main health care provider is the State, througt the public insitutions that constitute the NHS;  NHS is mainly financed througt taxes and provides health promotion, treatment and desease surveilance and prevention; 8

9. Nursing in Portugal There are references to nurses in Portugal as early as 1120 and, as other parts of the world nursing care was provided by monks and nuns... Some historic facts about Nursing in Portugal: 9

10. Nursing in Portugal Present status:  In April 2007, there were 51.167 nurses registered in Ordem dos Enfermeiros,whose average age was of 39 years.  Since 1998, the initial education has been comprised of four school years and has awarded a higher education degree.  Portugal is among the 27 European Countries that sign the Bologna Declaration. 10

11. Nursing in Portugal

12. OE, 2007 12 96% 19% 81% 4% 14%

13. Nursing Licence Degree - Length The course gives a scientific training, technical, human and cultural, of the highest quality, in the provision, research and management of general nursing care to the person throughout its cycle of life, family, community groups and, given the different levels of prevention. Students who completed the course in Nursing Licence are able to provide general nursing to the individual, family and community; and can develop their practice into three distinct sectors: public sector, private sector (Health Centers, Hospitals, Clinics, Companies, Schools, Senior Centers, among others) or on a liberal exercise. Duration: 4 years 13

14. Ordem dos Enfermeiros (OE) - Deontology and Ethics -  The activity of Portuguese nurses must be guided by: -The responsabilitys inherent to the role played by nurses in society; -The respect for human ritghs in the relationship with clients; -Excellence in the practice of the profession in general and the relationship with other professionals in particular.  The nurses Deontological Code is included in the Constitution of the OE and states that nursing interventions have to guarantee the defense of the fredon and dignity of the human being and of the nurse. 14