title: Relationship-based nursing care and destructive demands.
abstract: BACKGROUND
  The relationship between the nurse and the patient is understood as fundamental in nursing care. However, numerous challenges can be related to the provision of relationship-based nursing care. Challenges exist when nurses do not respond adequately to the patient's appeal for help. Moreover, challenges arising in the nurse-patient relationship can be understood as more destructive demands from the patient to the nurse, thus begging inquiry into such a relationship.
  
  
  OBJECTIVE
  The overall aim is to explore and argue the relevance of problematizing destructive demands evident within relationship-based nursing care.
  
  
  METHODS
  This theoretical article explores destructive demands based on the phenomenological philosophy of the Danish theologian and philosopher Knud E. Løgstrup and provides examples of nurses' experiences in everyday nursing care. The examples are drawn from a Norwegian empirical study based on a hermeneutical research design. Participants and research context: Data consisted of qualitative interviews and qualitative follow-up interviews with 13 nurses with varying work experience within the primary and secondary somatic and psychiatric health service, from inside as well as outside institutions. Ethical consideration: The original empirical study was approved by the Norwegian Social Science Data Services. Information was given and consent was obtained from the participants.
  
  
  RESULTS
  Two themes are described: strong impressions formed in meetings with patients and persistent concern over the burden of work and ability to endure.
  
  
  CONCLUSIONS
  Destructive demands related to relationship-based nursing care are discussed along two lines, first, by further elucidating nurses' everyday experiences connected to destructive demands and, second, by highlighting the significance of including destructive demands within the relationship-based nursing care.
  
  
  CONCLUSIONS
  Including destructive demands related to relationship-based nursing care is of particular significance in enabling the proposition that radical, one-sided demands are based on relationality, reciprocity and thereby expectations of life. In short, both the nurse and the patient are human beings in need of love and goodness.
authors.forename: Margareth
authors.initials: M
authors.lastname: Kristoffersen
authors.affiliation: University of Stavanger, Norway.
authors.forename: Febe
authors.initials: F
authors.lastname: Friberg
mesh_terms: D003220:Conflict, Psychological; D004993:Ethics, Nursing; D006801:Humans; D009664:Norway; D024802:Nurse's Role / Q000523:psychology*; D009723:Nurse-Patient Relations / Q000941:ethics*; D009726:Nurses / Q000523:psychology; D010361:Patients / Q000523:psychology; D036301:Qualitative Research; D017132:Workplace / Q000523:psychology
keywords: Destructive demand; ethical demand; one-sidedness; radicality; reciprocity; relationality; relationship-based nursing care