My article considers elements of the philosophy of Buber and Marcel in relation to recent changes in nurse education which have potential for limiting the clinical contact time for student nurses. Under three headings, the nurse-patient relationship is discussed: time limitations, I-thou and I-It forms of relating, and the nature of presence. The literature supports the view that a nurse's openness or permeability in relating to patients in their real needs, is of major importance in meeting the patient's needs. The concept of presence indicates that changes occur in both parties in relationships in the influx of each other's presence. Being closed to the other's influx renders the relationship one of I-It in which objectification of the patient can occur--he or she is seen as a 'case'. Even counselling skills could fall into this category in a 'double glance'.
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