As nurse workloads increase, nurse burnout and job dissatisfaction become greater factors in the voluntary turnover that leads to understaffing of hospitals. Healthcare consumers rank this understaffing as a major threat to patient safety. As a contribution to the understanding of how to reverse this trend and improve patient satisfaction, the authors examine the association between nurse burnout and patient satisfaction and explore whether factors in nurse burnout also figure in patient dissatisfaction. With support in part from the Robert Wood Johnson Foundation's Investigator Award in Health Policy Research, this study uses data collected in 1991 as part of a study of urban hospital organization and staffing and AIDS care outcomes. Eight hundred and twenty nurses were surveyed and 621 AIDS patients from the nurses' units were interviewed. Nurses answered questions regarding staffing adequacy, administrative support, nurse-physician relations and intention to leave their current position. Patients answered items on a modified version of the La Monica-Oberst Patient Satisfaction Scale. In terms of results, nurses working in units they rated as "good environments" were less likely to suffer emotional exhaustion or above-average depersonalization (elements of nurse burnout); and patients in units with nurses who reported higher levels of personal accomplishment were more than twice as likely to be highly satisfied with their care. This study is unique in the literature in that it illustrates empirical evidence that nurse burnout is a significant factor influencing patient satisfaction with care, and it identifies modifiable characteristics of nurses' work environments that contribute to nurse burnout.