Nurse managers difficulty to glimpse alternatives, in a complex and clogged structural conjuncture, subjection to situations at the limit of emergence, the permanent oppression they suffer, as a result of factors internal and external to the structure they feel responsible for, reveal the maintenance of the reiterating practice that was consolidated by the nursing agents in charge, even when this transcends the category’s hierarchy, and who are responsible for different services inside hospital organizations. It is in small daily actions that one consolidates a health system model and nurse managers, through their actions, most of which are more reproductive than reflexive, help to strengthen the established model.