Objective The psychiatric intensive care units (PICUs) admit patients who are considered extremely unmanageable within psychosis units or acute psychiatric wards, and who often demonstrate aggressive or other forms of severe behaviors. This raises the question: What is going on in these units and what constitutes nursing care there and how are these patients taking cared of? Is is possible to care and create a safe environment for both the patients and the staff? The findings presented here describe how and when nursing care is provided in PICUs. The findings are presented in relation to themes, as these emerged within the psychiatric intensive nursing care. Since PICUs are able to manage and care for these patients, one can assume that there exists specific cultural knowing among nursing staff working in psychiatric intensive care units and that this warrants further description. Psychiatric inpatient care is a social institution that is not under close social scrutiny, with few people having access to it. We believe that there is a societal interest in observing and describing the care and treatment carried out in these enclosed spaces and how the nurses succeed to create a safe place for both the staff and patients. Methods Spradley’s ethnograp ic methodology was applied. Results Six themes emerged as frames for nursing care in psy- chiatric intensive care: providing surveillance, sooth- ing, being present, trading information, maintaining security and reducing. Conclusions These themes are used to strike a balance between turbulence and stability and to achieve equilibrium. As the nursing care intervenes when turbulence emerges, the PICU becomes a sanctuary that offers tranquility, peace and rest. What the study is adding to the field These units care for the most acutely mental ill people in society. The care does not only create safe for the patients, but also create a safe community.