Previous studies of the attitudes of nursing staff towards patients in hospitals have suggested that those who were mentally alert, young, acutely ill and in need of medical (not custodial) care, middle class, appreciative and co-operative were labelled ‘good’. Conversely the old, the poor, the chronically ill and the mentally disturbed were labelled ‘bad’. In the study reported here, of a single nursing home situated in the American midwest, these stereotypes are shown not to operate. A subset of these attitudes is none the less to be found which rewards cheerfulness, wittiness and appreciativeness. Favouritism amongst patients is examined as a significant influence on the care of residents who are all elderly and long-term sick.