An integrative review of knowing the patient.

PURPOSE: The purpose of this article is to characterize the concept knowing the patient as reflected in the contemporary nursing literature and to consider implications for nursing practice. ORGANIZING CONSTRUCT: A literature review was conducted to identify primary source publications concerned with knowing the patient within the nursing discipline.
METHODS: Cumulative Index to Nursing and Allied Health, PubMed, and Cochrane Library databases were queried using the phrase knowing the patient to identify relevant peer-reviewed literature from 1996 through 2013.
FINDINGS: The review produced 21 publications; knowing the patient was the topic of inquiry in only 5 of these. Knowing the patient emerged as a finding in 16 investigations and was described as affecting nurses' ability to provide safe care, develop positive relationships, and engage in expert practice. Patterns identified across studies were illustrated in a model representing the process of knowing the patient, including factors of the nurse's internal environment, information practices to develop knowledge and create meaning, and the nurse's response. The process of knowing the patient occurs within the context of relationship with the patient and in an environment that is temporal in nature.
CONCLUSIONS: While knowing the patient continues to be a prominent concept in the nursing literature, practice environments may not provide the conditions necessary to support the process, particularly temporal factors of time availability, sustained contact, continuity, and consistency. CLINICAL RELEVANCE: Findings inform the development of professional practice models that support knowing the patient.