The paper discusses two conflicting courses of development. One is a course of standardization founded on evidence-based recommendations. The other is a course of democratization based on patients’ involvement in care.

Drawing on our previous empirical research, we provide an exemplary narrative to illustrate how patients have experienced hospital care organized according to evidence-based, fast-track programmes as a set of rules that the patient must follow rigorously.

We argue that, in the current standardized evidence-based practice, the proposed involvement of patients resembles empty rhetoric, and that values from evidence-based medicine are being lost in the transformation into this practice which potentially leads to a McDonaldization of nursing practice reflected as «one best way». To prevent a practice of «McNursing», we argue for reviving ethics of care perspectives in today’s evidence practice, as the fundamental values of nursing may potentially bridge conflicts between evidence-based practice and the ideals of patients’ involvement.

Keywords: evidence-based practice, ethics of care, McDonaldization of nursing, nursing theory, patient involvement