FROM STANDARD TO TERRITORY: THE ROLE OF NURSES IN IMPLEMENTING THE "NOW THERE ARE SPECIALISTS" PROGRAM IN THE BRAZILIAN AMAZON – AN EXPERIENCE REPORT IN HUMAITÁ/AM, LÁBREA/AM AND THE DISTRICT OF SANTO ANTÔNIO DO MATUPI (MANICORÉ, AM)

Abstract

Introduction: Timely access to specialized care remains one of the main challenges for the Brazilian Unified Health System (SUS), particularly in Amazonian territories marked by large distances, gaps in care, and weaknesses in the regionalized organization of the network (Giovanella et al., 2020; Garnelo et al., 2017). In response to this scenario, the Ministry of Health instituted, through Provisional Measure No. 1,301, of May 30, 2025, later regulated by Ordinance GM/MS No. 7,266, of June 18, 2025, and in the context of the Public Health Emergency declared by Ordinance GM/MS No. 7,061, of June 6, 2025, the "Now There Are Specialists" Program, with support from the Brazilian Agency for Support to the Management of the SUS (AgSUS), structured on the logic of regulated access, comprehensive care and the use of mobile specialized care units (Brazil, 2025a; Brazil, 2025b; Brazil, 2025c). Objective: To report and analyze the role of nurses in the implementation of the "Agora Tem Especialistas" Program in Amazonian territories, emphasizing the processes of inter-federative articulation, organization of regulation through SISREG and e-SUS Regulation, community mobilization, and operationalization of mobile units structured according to the logic of Comprehensive Care Offering (OCI). Method: A descriptive study, with a qualitative approach, in the form of an experience report, based on participant observation and reflective systematization of activities developed between 2025 and 2026 in the municipalities of Humaitá and Lábrea and in the district of Santo Antônio do Matupi, in the municipality of Manicoré (AM). Field records, normative documents, meeting records, institutional instruments, and evidence of formal recognition by local managers were used. Results: The experience highlighted the central role of the nurse as a technical-political articulator in translating national guidelines into territorial practices, emphasizing: the organization of access exclusively through regulation (SISREG/e-SUS Regulation); The adoption of the OCI (consultation, examination, and follow-up) logic; the implementation of mobile units characterized as customized trailers, with waiting rooms, consulting rooms, ultrasound and mammography rooms, an elevator for accessibility, air-conditioned and computerized environment; the coordination with health surveillance and patient safety; and the innovative mobilization strategy through Community Health Agents. It is also worth highlighting the landmark status of Santo Antônio do Matupi as the first district in the state of Amazonas to receive the Program and the replicability of the experience, attested by a formal request for technical support in the municipality of Lábrea. Conclusion: The nurse emerged as a strategic actor in the implementation of the "Now There Are Specialists" Program in the Amazon region, mediating the articulation between public policy, management, and the community, and contributing to the consolidation of a model of regulated, humanized, and quality-oriented specialized care, in accordance with the principles of equity and comprehensiveness of the SUS (Brazilian Unified Health System).