Background: Many countries have seen the introduction of telephone nursing call centres expected to provide accessible, trusted, quality health information and advice. Studies of patient satisfaction with telephone nursing can provide a better understanding of callers’ needs and inform the improvement of services. Purpose: This study aimed to describe patients’ experiences and perceptions of satisfaction with telephone nursing. Methods: The design was non-experimental and descriptive, with an inductive approach. Data were collected using open-ended questions in a questionnaire that was dispatched to 500 randomly selected callers to the Swedish Healthcare Direct in Northern Sweden. Results: Patients’ satisfaction with telephone nursing was related to calm, clarity and competence. Calm referred to the nurse remaining calm and composed during the call. Clarity was described as distinct, concrete and practical advice on how to act, what to observe, and where to seek further assistance. Competence referred to both medical knowledge and caring skills. Receiving a careful examination and an accurate assessment by a skilled nurse with high medical competence produced a feeling of comfort and safety after the call. Being welcomed in a caring, kind and friendly manner generated satisfaction, and being met with compassion produced a feeling of safety as it was perceived as the nurse genuinely cared about the care-seeker and wanted to help. Conclusion: These aspects of nursing are dependent on each other and on-call telephone nursing services which value patient satisfaction need to target all three. . In the clinical setting this implies that the nurse need to convey a sense of calm, as well as communicating with the caller in a clear and understandable manner. The nurses need high medical knowledge as well as a caring competence to adequately address patients’ needs. In order to identify and meet patients’ needs, nurses must embrace the relational and emotional aspects of care.