Reciprocal power : nurse-patient interactions in primary care

Abstract

Nurses are often perceived as dominant figures in patient interactions due to their specialised knowledge and institutional authority, particularly in hospital settings. This article challenges that perspective by examining nurse–patient dynamics in primary care through the lens of reciprocity—a relational concept centred on mutual exchange and interdependence. Drawing on an interpretive case study conducted in Shenzhen, China, involving 18 community nurses and 20 patients with chronic conditions, the study identifies two key dimensions of reciprocity: expertise–trust and social networking. These are supported by three mechanisms: reciprocal recognition as an antecedent, a policy-driven culture of reciprocity and perceived equivalence in interactions. While acknowledging the persistence of asymmetry, we argue that reciprocity fosters more collaborative and responsive exchanges in community settings. This perspective offers a more nuanced and balanced understanding of power in healthcare, re-framing nurse–patient relationships as interdependent rather than unidirectional. Findings highlight the importance of nurse education that integrates relational and technical skills, and of policies that promote community-based care and sustained interactions to build trust and reciprocity—while also advancing theory by framing power as dynamic and negotiated.