When the patient causes the problem: the effect of patient responsibility on the nurse-patient relationship

J Adv Nurs. 1997 Sep;26(3):515-22. doi: 10.1046/j.1365-2648.1997.t01-11-00999.x.


A positive connection to the patient as a person within a nurse-patient relationship provides the context for ethical treatment. The relationship characterized by caring concern for the patient is also a clinically effective resource. Ethical analysis shows that a nurse's caring and other health care resources should not be allocated based on the degree to which the patient is responsible for the clinical condition. Interviews were conducted with 51 nursing students and nurses about their feelings toward hypothetical patients. The theme of 'patient responsibility for causing the clinical problem affecting the nurse-patient relationship' was identified and responses were categorized according to how the theme was illustrated. The categorization of the responses was validated by two nurse experts. When asked to briefly compare reactions to the vignettes 25 (49%) of the participants connected their feelings towards the patient with their perception of the patient's responsibility.

MeSH terms

  • Adult
  • Alcoholism
  • Attitude of Health Personnel*
  • Cocaine-Related Disorders
  • Empathy
  • Ethics, Nursing*
  • Female
  • Homosexuality, Male
  • Humans
  • Male
  • Middle Aged
  • Nurse-Patient Relations*
  • United States