This study consist of reflexions about dilemmas and controversies of nursing practice, in a such way interralated that the principal focal point foresees changes to the nursing profession in the XXI century. It relates about Biomedical Model dominant in the contemporany world (that overvalues the cientific method in detriment of man's humanist vision and holistic of health). The search for overcoming this model has been providing alternative practices among different professionals in the health area. Practice that is supported by government already denotes changes in knowledge and power in the professional practice, their relations with the graduation process that little has contibuted to nurses' formation with critical conscience. To get over these impasses it will be necessary the redimencionament of the work process, organization, mobilization and collective actions of category