The study described in this paper explored the adult patient’s perspective of quality nursing care in acute-care hospital settings in Western Australia. Using grounded theory methodology, the author sought also to discover factors perceived by patients to influence the delivery of high quality nursing care. The findings revealed that patients perceived different levels, in terms of quality, of the care delivered. The level of quality of care was found to depend on certain contextual and intervening conditions pertaining to the broader environment, the organisation and personal factors of the nurse and patient. Variations in patient satisfaction and patients’ feelings of vulnerability were related to the levels of care they received. The factors perceived by patients as either inhibiting or enhancing the quality of nursing care are the focus of this paper.