The relationship between the structure of nursing care and patient satisfaction is examined after equalizing the quantity and quality of nursing staff. An all-registerednurse model of primary nursing is compared to team nursing. The nursing competency scores of registered nurses (as measured by the Slater scale) on two patient care units were equalized through 6 months of continuing education and staff development programs. A patient checklist was used to determine satisfaction with care and perceived omissions in care. No significant differences in satisfaction with care were found between the two units. The unit with primary nursing was perceived as having significantly higher omissions in care in three categories: dietary needs, reaction to therapy, and contact with nurses. The results suggest that the effect of nursing care structures on patient perception of care may be contingent upon the efficiency of the support systems and the competency of the nursing staff.