Recipients of nursing care should be referred to as "patients." For many years I have been using the term "patient" to describe those for whom I provide care; likewise, patients have referred to me as "nurse" and not as "provider" or "health professional." As the relationship between nurses and patients has evolved, there has been an ongoing debate about the appropriateness of the term "patient," but in my opinion, acceptance of the term "patient" has important implications for the nursing practice.

The word "patient" is derived from the Latin word patiens, meaning "to endure" or "to suffer." A patient is an individual who receives medical treatment, or a person who suffers from an injury or disease. The use of this word dates back to Chaucer, near the end of the fourteenth century (Pearsall, 2001). In the mid-1880s, Florence Nightingale expressed her firm conviction that individuals for whom nurses care are patients. She described a nurse's proper function as putting "the patient" in the best condition for nature to act upon them (Nightingale, 1859/1992). As this term has been in use since the beginning of modern nursing, it does seem unnecessary to use any other term to describe those for whom we care.

"Client," however, is defined as a person who uses the services of a business, lawyer, architect, or professional person; a client is a customer (Pearsall, 2001). The word is derived from the Latin word meaning "to hear or obey." The first known use of the term in a health-related manner was in 1925 when the term was coined by social workers (Pearsall, 2001). It seems that the term was first used in nursing in 1970, when it was determined that "client" was more a universal term to be used with both healthy individuals and those with illness (Keaney et al., 2004). The term is now frequently used in the nursing and medical literature, and advocates of the term feel that by using it, they are avoiding the impression of dependence that surrounds the use of the term "patient." They also have proposed that the term does not have the same connotations of illness that is associated with the term "patient." In my opinion, using the term "client" removes an essential core from our practice; without patients, nursing does not exist.

An interesting point is that a number of surveys have been conducted to determine if individuals have a preference for the term used to describe them when they seek healthcare. In all of the surveys, the term "patient" was overwhelmingly preferred over the terms "client," "consumer," or "survivor" (Keaney et al., 2004). If individuals prefer to be referred to as patients, then why should we choose to call them something else?

Nurse-patient relationships are viewed as partnerships, the foundation of which is mutual trust, respect, and openness. Referring to individuals as "patients" does not deny them their autonomy, and it does not negate their health or their illness. Patients are no more empowered because we refer to them as clients. They continue to expect that nurses will assist them in their quest for better health. Perhaps a more important issue is whether our attitudes and behaviors about caring for individuals are influenced by our use of a particular term. Do we care for people differently depending on what they are called? Surely the answer to that is no, for we develop a caring relationship with individuals to facilitate health and healing. We use judgment and critical thinking in the process of designing interventions to overcome the real or potential health problems of our patients. We appreciate patients for what they bring to our interactions with them, and we acknowledge the importance of their physical and social environments in the care we provide. "Patient" care is what we do.

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