This study examines, from the patients’ perspective, what is meant by competent nursing and how, with this perspective in mind, patients would view the prospect of assessing the competence of nurses. There is a little empirical research that clarifies professional competence from the patient’s perspective. Nursing curricula in the UK have shifted attention to ‘competencies’ as the outcome of nurse education and, in an era of patient involvement, their views are important to investigate. The study utilises a grounded theory approach. Data were collected in Central Scotland between 2001 and 2003. Twenty-seven patients participated. Data were analysed, in keeping with the grounded theory tradition, utilising the constant comparative method. Patients described the foundation of competent nursing practice as technical care and nursing knowledge. Patients assume that technical care is competent as safe guards are considered to be in place to protect patients. When technical competence is assumed, interpersonal attributes become the most important indicator of the quality of nursing care. The results of this study highlight uncertainty about whether patients feel able to assess the competence of nurses. The results of this study may have implications for nurses internationally when trying to involve patients in the assessment of nurses