Given their 24 hour responsibility for care in many settings, nurses are the main arbiters of the privacy afforded or denied to patients. In this article the author delineates four aspects of privacy, namely: bodily privacy, space privacy, information privacy, and privacy of individual behaviour. He draws on a range of recent evidence that points to people's experiences of health care being unsatisfactory in terms of privacy, and offers explanations as to why much patient privacy is impossible. He argues that the patients' need for privacy is to a large extent in competition with the professional need for surveillance, noting that while nurses and others do maintain some patient expectations of privacy, these expectations are artificially low on the part of nurses, who are predisposed to invade privacy as an unconscious aspect of their maintenance of professional power. The author provides a discussion of the theoretical basis of this viewpoint, drawing on important insights from Foucault and Goffman, and concludes that an awareness of these issues can help to re-balance the tension between the need for privacy and the need for surveillance.