title: Nursing students' perspectives on the patient and the impact of the nursing culture: a meta-synthesis.
abstract: OBJECTIVE
  To explore and interpret how nursing students develop their understanding of the patient as a human being.
  
  
  BACKGROUND
  Understanding the patient is the main characteristic of good, caring performance. In addition, nurse leaders play an active role in creating a culture in which nursing students can flourish and improve.
  
  
  METHODS
  This meta-synthesis was based on Noblit and Hare's meta-ethnography.
  
  
  RESULTS
  The overarching metaphor was interpreted as the nursing students' capacity for compassion. Two central metaphors were revealed, based on how nursing students developed their understanding of the patient as a human being. These central metaphors were labelled 'The open door', comprising seven key metaphors and 'The closed door' based on two key metaphors.
  
  
  CONCLUSIONS
  During practical training, the students observed both virtuous and unkind nurses. Virtue is a skill that can be taught, but not all students were able to learn it. Some students acquired the ability to reflect on ethical issues, while others did not. Therefore, good role models are of major importance.
  
  
  CONCLUSIONS
  The nurse leader should function as a facilitator in the students' efforts to gain the capacity to face the suffering patient and to develop an understanding of the patient's situation.
authors.affiliation: Department of Nursing, Health and Culture, University West, Trollhättan, Sweden. gudrun.rudolfsson@hv.se
authors.forename: Gudrun
authors.initials: G
authors.lastname: Rudolfsson
authors.forename: Ingela
authors.initials: I
authors.lastname: Berggren
mesh_terms: D000293:Adolescent; D000328:Adult; D001291:Attitude of Health Personnel; D004645:Empathy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009723:Nurse-Patient Relations; D009732:Nursing Care / Q000458:organization & administration*; D015402:Nursing Education Research; D015403:Nursing Evaluation Research; D015404:Nursing Methodology Research; D015279:Organizational Culture; D036301:Qualitative Research; D013338:Students, Nursing / Q000523:psychology*; D055815:Young Adult