INTRODUCTION: territorial characteristics, with an emphasis on the geography of the
North region, require individual and collective practices in the work of Primary Health Care
nurses that meet the peculiarities of the populations that inhabit this territory. OBJECTIVE:
to analyze individual and collective practices that are associated with the dificulties of nurses
working in Primary Health Care in the North region. METHOD: mixed methods study
carried out with Primary Health Care nurses in the North region, between November 2019 and
August 2021, using an electronic form and interview. The data were analyzed using the
Bioestat program and the IRaMuTeQ® software, using Bardin's thematic content analysis.
RESULTS: 626 nurses participated in the quantitative stage and 31 in the qualitative stage.
Difficulty in carrying out practices was described by 15.7% (98/626) of nurses. Four
categories were identified in the qualitative analysis: professional autonomy in their activities;
need for a prescription from another professional to complete a service; work facilities;
difficulties at work. Among collective practices, there was an association between difficulty
and participation in the management of inputs (p = 0.03), but it was evident from the
interviews that the nurse participates in the request for technical material, but does not receive
it as requested. In individual practices, there was an association between the difficulty in
carrying out a consultation (p = 0.03) and the prescription of medications (p = 0.02). The
qualitative analysis demonstrates that the nurse needs a prescription from another professional
to complete a service he started. The association between difficulty and resolution showed
significance between prenatal consultation (p = 0.000), activities to monitor child growth and
development (p= 0.001; 25%) and family planning (p= 0.000; 25.7%) . However, these are
practices that nurses report that they exercise with greater autonomy. The association of
difficulty with caring for hypertensive patients (p <0.0001) and diabetics (p<0.0001) also
showed insufficient resolution. In these activities, the nurse describes needing the doctor to
prescribe medications and complete the care. CONCLUSION: The work carried out by
primary health care nurses requires the continuous improvement of these professionals' skills
and abilities, especially with regard to nursing consultations and medication prescriptions.
The implementation of nursing protocols and continuing education help in the development of
professional autonomy, aiming at the quality of the service and the resolution of the assistance
provided to users.
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