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Abstract
Aiming at analizing manager-nurses’ perceptions and wits as to processes of structural and
managerial changes in a hospital organization this work was written. It is a case study- qualitative
approach- carried out in a extra-sized charity hospital in Belo Horizonte. Data were collected
through semi-structured interviews with 10 manager-nurses, submitted to analisis of content.
According to the results obtained it was verified that the managers realize, as facilitators, the
managerial and structural changes occurred in the organization, namely the decentralization of
decision-making, the increase in the managerial groups’ autonomy, the improvement in the
communication and information system, as well as the re-definition of the nurses’professional role.
Also identified was a new workspace for the orderly in hospital management and changes in the
managers’ professional posture which showed themselves as being open to innovation, to the
challenges imposed by the job and the need to obtain further knowledge in order to perform such
job. The innovator character of the changes in the hospital organization as well as the participation
of the nurse/orderly in the process of management deserve special attention in their diverse
aspects, for they can come to constitute an important professional alternative for the nurse and for
other hospital organizations in a moment of turbulence and transition in the health sector.