This is an investigative study into the actions required of nurse managers in hospital units. Given the changes that have taken place in the health sector in recent years, especially since the 1990s with the creation of the Unified Health System (SUS), nurses have been required to have managerial competences and skills so that they can manage hospitals in a way that meets the expectations of more effective management. This research study concludes by confirming that in the hospital context, nurse managers must develop their actions in a critical and reflective manner, especially with regard to the competences required for good professional performance, in order to always seek quality in the services provided to patients.