ABSTRACT
Michael Kelly and David May wrote a very comprehensive review of the 'good and bad patients' literature in 1982. Papper argues that patients may be undesirable on physical grounds such as the absence of physical illness, or the presence of illness which shows the physician's initial diagnosis to be in error. Papper's views are consistent with the predominantly patient traits explanations which have been and still are popular and to which he arguably makes a limited contribution. Jeffery argues that some patients become defined as good because they allow medical staff to practise skills necessary for passing their examinations, they allow staff to practise their chosen speciality, and they test the skills and maturity of the staff. Where the patient's actions challenge the nurses' right to use skill and knowledge in therapeutic endeavour, then the nurse will be frustrated at the challenge to an already fragile authority.
