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To explore and interpret how nursing students develop their understanding of the patient as a human being.Understanding the patient is the main characteristic of good, caring performance. In addition, nurse leaders play an active role in creating a culture in which nursing students can flourish and improve.This meta-synthesis was based on Noblit and Hare's meta-ethnography.The overarching metaphor was interpreted as the nursing students' capacity for compassion. Two central metaphors were revealed, based on how nursing students developed their understanding of the patient as a human being. These central metaphors were labelled ‘The open door’, comprising seven key metaphors and ‘The closed door’ based on two key metaphors.During practical training, the students observed both virtuous and unkind nurses. Virtue is a skill that can be taught, but not all students were able to learn it. Some students acquired the ability to reflect on ethical issues, while others did not. Therefore, good role models are of major importance.The nurse leader should function as a facilitator in the students' efforts to gain the capacity to face the suffering patient and to develop an understanding of the patient's situation.