This study is an historical analysis of the evolution of phenomenological empathy in nursing covering the period from 1861 through 1981. This period represents the birth of modern American nursing during the Civil War and a time span of 120 years hence. The conceptual categories patient cues, empathy, nursing interventions, and patient responses were applied to the qualitative data. The findings demonstrated that patient cues were not a factor in the precipitation of nurse empathy. A model of phenomenological empathy was derived from the data that was comprised of four major concepts and eighteen subconcepts. The temporal, linear occurrence of the major concepts support their relationship. The explicit nature of the subconcepts supports the constitutive delineation of the major concepts. Analysis of the Civil War data generated 114 instances of phenomenological empathy while the period between 1900 and 1981 demonstrated only five instances. The model remained consistent over time. In addition, the findings indicated an ideological and conceptual evolution in nursing resulting in refinement of the professional, instrumental, and expressive role of the nurse.