This case study details the use of non-participant observation to explore how nurses recognize when patients in an acute medical hospital ward are dying and how they respond in terms of the care they provide. This study was conducted in 2011 in two wards in one metropolitan acute care hospital in Melbourne, Australia. The complexities, merits, and challenges of using non-participant observation in a clinical setting will be discussed. A detailed research protocol was developed to define the observation field and participants and the process of consent and how data were recorded. Challenges faced in this study included staying true to the purpose of the study when other opportunities existed, developing and ensuring positive relationships to safeguard the success of the study, and being prepared for occurrences or actions not anticipated in the study protocol. Despite the complexity of undertaking research using non-participant observation, the richness and the depth of data collected make it a highly valuable research method.