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With patient demand exceeding the supply of health care practitioners, reducing turnover and increasing the number of providers in an important issue. Center to this issue is job satisfaction, especially in primary care. This study illustrates how job satisfaction is created through interactions with co-workers, patients, and the organization of work. Data comes from in-depth interviews with 27 Primary Care Nurse Practitioners working in a state that heavily restricts their level of practice. Despite this restriction, participants do not mention these laws as influencing their day to day perceptions of satisfaction. The findings suggest that an ethos of care is created through interactions with patients, support staff, and the organization of work. The resulting culture helps to define what makes for meaningful work and influences perceptions of job satisfaction. Furthermore, this study suggests that deviation from this ethos creates frustration and dissatisfaction. The results from this study contribute to understandings of how job satisfaction is created and provides the potential for adding measures to surveys to further improve policy and retention of these providers.