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The study presents some reflections on the possibilities and limitations of the rationalization and flexibilization of the management process of the health services under the economic perspective, focussing on the introduction of mechanisms and instruments centred in the economic and organizational responsibilization of the resources and nursing participation in these processes. Authors discuss the adoption of a system of economic control in order to coordinate the interests of the several subjects involved; to privilege the results of the processes and to improve the economic combination of the resources. Under this perspective, two concepts are considered relevant in the elaboration of the budget of the Nursing Services: the controllability of the resources and the negotiation in the processes of allocation and utilization of these resources. The use of these concepts in the organization of health services, especifically in nursing area, creates new possibilities of participation in the processes of services production, enabling more transparency in the decision processes and restructuring new modalities of management for the nursing services.

This study aimed at estimating the employment "survival" time of nursing workers after their admission to a public hospital as a turnover index. The Life Table method was used in order to calculate the employment survival probability by X years for each one of the categories of workers. The results showed an accentuated turnover of the work force in the studied period. The categories nursing auxiliary and nurse presented low stability in employment while the category nursing technician was more stable.

The present study aimed at identifying supply and demand of university-level nursing programs in São Paulo, Brazil, during the 1980s. A questionnaire was sent to the 28 nursing programs (public and private) existing in São Paulo in 1991. The 24 institutions that responded to our survey provided information on: year when the program was established, year when program was officially recognized by the Ministry of Education and Culture; year when entrance examinations began to be required for the nursing program; sources (public or private) of financial support received; and number of students accepted for each term (day or night) in 1980 and 1991. The data collected revealed that every year fewer students applied to nursing programs in São Paulo. In 1986, 34% of the vacancies remained unfilled; this was the lowest occupancy rate registered during the period studied. The situation outlined by our study suggests that in the medium and long run nursing work potential in Brazil could be compromised.

The present study was carried out in 1990 with the objective of measuring and analyzing the turnover of nursing personnel in nine general hospitals located in Ribeirão Preto, São Paulo State, Brazil. The population under study consisted of nurses, nursing assistants, nursing technicians, and nursing attendants who started work or left their jobs between 1 January and 31 December 1990. Employment status for these workers was checked monthly based on information from the human resources department of each hospital. Two types of turnover indices were calculated: the liquid rate of substitution and the median length of service of the departing workers. Results showed that the number of nursing personnel employed in Ribeirão Preto increased in 1990. However, results also revealed a high turnover rate, especially for philanthropic and private institutions, with liquid substitution rates of 32% and 39% per year and median lengths of service of 8 months and 12 months, respectively. These circumstances could lead to higher costs and reduced productivity. The only public hospital in the study presented the lowest level of turnover (liquid substitution rate of 6% and median length of service of 42 months). Nurses and attendants had the highest substitution rates and thus were the least stable categories.

The authors discuss the activities developed by Nursing in two general orientations: the assistance and the management, concerning the concrete work and its perspectives. Therefore, they engage in polemics around the administrative versus assistance functions and attract the attention to the impossibility of thinking the nursing work inarticulated of different health practices, as a whole they accomplish each other in attempting the necessities of health of the population in a social level.

The administrative role of the nurse has been a polemic matter for the theory of nursing. The practice of nursing administration has been limited to meeting the employers and other professionals expectations. In this context the authors attempt to characterize their position towards the importance of the administration of the assistance scheme as one of the roles of the nurse.