"Knowing the patient" is an emerging concept in nursing that appears to be a central aspect of practice. "Knowing the patient" encompasses the complex process whereby the nurse acquires understanding of a specific patient as a unique individual, which subsequently enhances clinical decision-making, selection of optimal nursing interventions, and patient outcomes. Despite these heralded benefits, "knowing the patient" is severely undervalued in contemporary health care. Organizational arrangements, economic restraints, and efficiency of healthcare systems currently are of top priority. The potential effect on nursing practice is disconcerting; the effect on the discipline and the patient potentially devastating. This article explores the specific bureaucratic obstacles that impinge on "knowing the patient" within the context of nursing practice. It is hoped that illumination of the issues will beget viable alternative solutions, facilitating the transformation of awareness into action.