Although the importance of patient participation is acknowledged in today’s healthcare, many challenges remain beforepatient participation can become an integral part of care provision. The ward round has traditionally been the forum forcrucial decisions about patient care, but often with limited possibilities for patient participation. As part of the process ofimproving patient participation, the round in the present study has been replaced by a team meeting (TM) to which thepatient has been invited. The aim of this study is to highlight nurses’ experiences of older patients’ participation in TMs.The research process was guided by the principles of phenomenological reflective life world research. Data were collected in a Swedish hospital, in a ward specializing in older patients. Nine nurses, who had invited and planned for a patient toparticipate in TMs and/or had experienced TMs in which patients participated, were interviewed. The essential meaning ofpatient participation in the TM, as experienced by the nurses, is that patient participation can be supported by a saferelationship in which the patient can make his or her voice heard. Participation is challenged by the patients’ vulnerability and by the subordinated role assigned to the patient. The essential meaning is further described by its constituents: ‘‘the need for a guide,’’ ‘‘patient participation challenged by structures,’’ and ‘‘creating space for the whole human being.’’ In conclusion, the nurse plays a core role in guiding the patient in an unfamiliar situation. The meaning of patient participationin the TM needs to be discussed by professionals so that the patient perspective is present.