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In this paper, a model describing nurses’ responses to patients who are suffering is presented The nurse's level of engagement with the patient is affected by whether the caregiver is focused on him-/herself or on the sufferer (i e embodied with the patient) and whether the caregiver is responding reflexively or with a learned response Four types of communication patterns are identified engaged responses (first-level) are used in a connected relationship, when the nurse responses reflexively and is focused on him-/herself, the response is reflected, when the caregiver is patient-focused, a learned response is labelled a professional response, and a self-focused, learned response is labelled detached Examples of each type of response are provided