this theoretical reflection intends to show the inter-subjective relationship that takes place in health and nursing practices under the following theoretical perspectives: institutional analysis, psychodynamics of labor and the theory of communicative action, with an emphasis on the latter. linking these concepts to the marxist approach to work in the field of health emerges from recognizing the need for its continuous reconstruction-in this case, with a view to understand the interaction and communication intrinsic to work in action. the theory of communicative action seeks to consider these two inextricable dimensions: work as productive action and as interaction. the first corresponds to instrumental action based on technical rules with a production-guided rationale. the second refers to the interaction that takes place as communicative action and seeks understanding among subjects. we assume that adopting this theoretical perspective in the analysis of health and nursing practices opens new possibilities for clarifying its social and historical process and inter-subjective connections.