The practice of health care currently reflects a constant tension between to be and should be, in other words, between what actually the care is and what it should be, up to limits in which people can speak of dehumanization . This tension is evident in areas such as the relationship between the medical and nursing staff, the patients and their families, mediated by labor conditions, the use of technology and health administration often guided by reductionist criteria that have limited the interaction that underlies human care.
For some authors, the interest in current profit in the health system and health institutions has deeply penetrated into the staff providing care in a greater extent than their interest in respecting and defending the rights of people to the point that "militate in charge of the institutions in their interest to obtain better economic performance"  and turn to the side of the patients to facilitate the resolution of their problems, for this reason is not difficult to get refused the minimum necessary conditions for the effective care of health problems what goes against the nature of social practice oriented by ethical codes that governing the social exercise as the case of nursing.
Not surprisingly, it is found that patients want nurses to become humanitarian, friendly, available, receptive and willing to listen to them and likewise they are seeking to resolve the inconsistency between the view of nurses about their professionalism and what patients actually want from them and between theoretical approaches about nurse-patient interaction and what actually takes place with patients according to their age, health condition and culture . This interaction is therapeutic in nature, aimed to meet the problems of patients  and nurses require adequate spiritual and emotional as well as intellectual development .
Nursing care is not limited only to satisfying the needs of physical nature or the implementation of prescriptions or the use of technological elements to measure and intervene physiological variables, but must be comprehensive, holistic and consider the charge of feelings such as frustration and uncertainty that patients may present due to illness sets them aside of everyday life, their context and cultural practices and leads them to be confined in a hospital ward, where everything is different and routine and where them could be subject to interventions, medications, procedures, tests and diets that can also cause anxiety and rejection.
Nursing care is personalized and has as the crucial strategy the nurse-patient interaction, in which the nurse is involved in the immediate context of the individual, while respecting their world, feelings, beliefs and meanings; it should also be focused on patients considering as ends and not as simple means for gain and profit under the premise that the starring role in care is assigned to the patient  and not the procedure, to the technique or those who hold the power on institutions and exert their dominance over nurses misrepresenting their work with the indiscriminate assignment of functions unrelated to the caring practice.
All these situations related to care, in summary, reflect the gap between the theoretical approaches that aim to orientate towards a humanized, responsible and high quality practice and actually, in which prevail personal and economic interests and the dominance of other professions which have led the care practiced by the nurses remarkable far from what is nursing care; also have shown that the context established in hospitals for patients with the participation of nurses and other professionals is not the expected context and yet has a strong importance on the meanings of the experiences of illness and care that patients developed.
In the resolution of this situation have a major participation nurse educators promoting research and the adoption of new knowledge, research consultants and evaluators promoting problem solving and knowledge creation and journal publishers disseminating and publicizing revisions and formulations of theories to allow the discipline advancement.