Interfaces das mudanças hospitalares na ótica da enfermeira-gerente

The current change ascribed by social and economic instabilities implies in hospital restructuring. This research investigates – with a qualitative approach – the changes observed in the field, and the managerial roles taken by nurses. It aims to characterise the main changes of medium and large-sized private hospitals of Belo Horizonte, Brazil in order to identify the internal and external determinants that affect the managerial style, and understand the factors that interfere on the daily routine of managers. We studied 19 hospitals and interviewed 29 nurses that hold managerial jobs. These results suggest a structural, strategic, cultural, technologic, and human and regulatory changes. The managerial styles were affected by the organisational dynamic, the professional education of nurses, and by specific characteristics of the managerial role. The Sistema Único de Saúde (SUS) was pointed out as the most important external factor for the organisation. Finally, the study concludes that the daily activities of managers were influenced by organisational and professional factors.