Análise do exercício da discricionariedade dos burocratas de nível de rua da área da saúde de Arabutã-SC

Abstract

The present research is conducted as part of a final project for the Administration program and aims to analyze how nursing professionals manage the discretionary aspects of their roles within a Basic Health Unit (BHU). This research falls under the field of Public Administration, specifically in public policy management, as it addresses the policy implementation phase, where public servants have greater influence in executing policy guidelines. In the literature on public policy implementation, a public servant who directly serves the public is known as a Street-Level Bureaucrat (SLB). These SLBs face various situations in their daily work that require decisions differing from the established norms, thus allowing room for discretion. To achieve the research objective, a case study was conducted in the BHU of the municipality of Arabutã, SC. Three nursing professionals working in the two BHUs of the municipality were interviewed using an interview guide; these professionals were chosen by convenience. The research results indicated that, although the healthcare sector has numerous sanitary protocols and legal regulations for the profession, which the interviewees strive to follow closely, many situations still involve discretion, such as in health education practices, public sector operation guidance, and certain decisions on how to carry out specific technical procedures. It was also found that these discretionary actions improve public services, contributing to better health outcomes for the municipality's population. Another observed result is that, working in a small town, the professionals experience significant user influence (pressure) beyond their work hours. To prevent this pressure from impacting their mental health, they develop psychological strategies to avoid emotional strain. These observed behaviors align with SLB literature. The findings suggest that the results can be utilized by municipal management to enhance the delivery of healthcare services to the population, acknowledge the work of nurses, and, most importantly, promote public awareness campaigns on how to use public health services effectively.