This qualitative study was designed to gain insight into nurses' perceptions of patients' feelings and needs with specific reference to breast surgery. A grounded theory approach was adopted, based on in-depth, unstructured interviews with eight trained nurses working on surgical wards in a district general hospital. It emerged that the informants believed breast surgery patients to be very vulnerable and to be suffering from extreme stress and trauma. Patients were thought to lack knowledge regarding their treatment and condition. The nurses thought it to be their moral and professional duty to act as advocates for the patient and the family. Imposed restrictions on their advocacy role were found to cause a sense of frustration and powerlessness which appeared to be compounded by the nurses' perceived lack of counselling skills and the absence of a readily available counsellor or specialist nurse. Recommendations for improvements in the care of patients undergoing breast surgery are based upon these findings.
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