Abstract This paper examines the concept of empowerment and how it relates to nursing. It notes that empowerment is a concept used to describe most human activities. The fact that empowerment applies to almost any activity denotes its ambiguity rather than its parsimony. To clarify the concept a definition is offered together with some suggestions for its origin. Some examples of empowerment programmes are given, including the Freirian empowerment philosophy that has had a profound effect in Brazil. The paper then focuses on nursing and discusses whether or not nursing can empower patients. It is argued that nursing cannot empower patients, at least at the present time. Two specific problems are identified as the main reasons why nursing cannot empower patients. It is argued that the first problem or reason is a philosophical one explored using the philosophy of existentialism. The second problem is the nurse–patient interaction and the psychological dynamics involved within such interaction. For example, the continued use of the term ‘patient’ by nurses and other healthcare professionals is seen as militating against empowerment. This is because of the traditional conception of a patient, which invariably assumes not only the patient's sick role but also the passivity associated with being a patient. Furthermore, the hierarchical nature of the profession makes it difficult to empower others. The paper examines some research studies related to patient empowerment. The findings suggest there are problems and some of them stem from the hierarchical and authoritarian nature of nursing. The paper concludes by suggesting ways by which the ideals of patient empowerment may be turned into reality.