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Objectives Research was conducted in two teaching hospitals in Australia to collect data on the care of patients dying in the acute care setting. Methodology Non-participant observation of the care of dying patients in medical wards was the primary method of data collection and selected staff were interviewed. Observers collected data on the type of care, who gave the care, and the time given to care. Thematic analysis was applied to both the observational and interview data. Participants Patients selected were over the age of 18 years, with a terminal diagnosis and an estimated six days to live. Results Three major factors emerged from the data to form the context in which patients were cared for and died: 1) the organizational factor, 2) the environmental factor, and 3) the human factor. The presence or absence of family members influenced the amount of care given. If family members were not present, dying could be an isolating experience, with minimal care focused on routine hospital activities. Conclusion This research indicated that the principles of palliative care are yet to be incorporated in the acute care hospital setting.