The nurse-patient relationship: theme and variations

The nurse-patient relationship traditionally has been thought central to professional practice. For several decades, nurse theorists have explored the communication processes which mediate clinical practice and the variously described outcomes of these processes. Yet while interpersonal skills and personal attributes have been considered integral to professional bonding, and while outcomes of the process are widely discussed, clinically based validation of theorized process components has not been definitively accomplished. To this end, 67 critical incidents concerning experienced clinicians' perceptions of their closest professional relationships were analysed. The perceived professional bond was demonstrated to be a cumulative process of attachment with three qualitatively different levels of involvement and two impasse states. The most intense levels of attachment were perceived to be the most beneficial by the nurses who described relationships characterized by mutuality and reciprocity. This level was not, however, achieved by all nurses in the sample. Implications of the perceived outcomes of the most intimate professional relationships were discussed.