Discursos de enfermeiras da atenção primária sobre o impacto do trabalho na pandemia de COVID-19 na saúde e vida

Abstract

The COVID-19 pandemic deepened historical contradictions in health work and produced significant impacts on the lives, health, and professional practices of Primary Health Care (PHC) nurses. Despite their central role in the territorial response to the health crisis, qualitative studies that comprehensively address the repercussions of this period on their experiences and working conditions remain scarce.Objective: To analyze the meanings attributed by Primary Health Care nurses to the repercussions of work during the COVID-19 pandemic on their health and lives. Method: This is an exploratory, descriptive, and qualitative study grounded in French Discourse Analysis, articulated with a Marxian perspective on work, exploitation, and alienation. Data were generated between October and November 2022 through semi-structured interviews, which were audio-recorded, fully transcribed, and organized using ATLAS.ti®. The analysis followed the stages of Discourse Analysis and was approved by a Research Ethics Committee. Results: Twenty-one PHC nurses from Goiânia, Brazil, linked to 19 Primary Health Care Units, participated in the study. Two predominant discursive formations were identified, synthesized into three discursive blocks: (1) When life is reconfigured by fear: guilt and the erasure of self care, highlighting guilt, suffering, and solitary self-protection strategies; (2) When care becomes illness: exhaustion, creativity as a strategy for managing the precarization of working conditions, resistance, and subjective responsabilization during the pandemic, revealing work intensification, resource shortages, instability in care delivery, and individual responsabilization; and (3) Mission, solidarity, and heroism: between affective resistance and ideological capture of care, describing meanings related to mission, self-sacrifice, and moral commitment. Conclusion: Work during the pandemic overflowed into domestic life, affected support networks, generated moral suffering and emotional exhaustion, and strained social roles, particularly among women who are mothers. Discourses of heroism, vocation, and resilience were ideologically mobilized to naturalize precarization. These experiences reflect historical, political, and organizational determinations of health work in Brazil. Final considerations: The urgency of actions to ensure decent working conditions, institutional protection, mental health care, and professional recognition of PHC nursing is reaffirmed.