Background Patient involvement is essential for promoting health literacy and enabling informed decision-making in primary care. When individuals are actively engaged, they are better equipped to manage their health, adhere to treatment, and participate in preventive care contributing to improved quality of life. Aim The study aims to explore how registered nurses’ communication practices support patient involvement in decision-making, thereby contributing to knowledge on person-centred communication in primary care. Methods This qualitative study is based on the analysis of 148 audio-recorded consultations between patients and registered nurses (n = 30). The analysis was conducted deductively, using a framework of nursing voices, task oriented, nursing, pedagogical, and power voices to examine how nurses involve patients in decision-making during healthcare encounters Findings Preliminary findings indicate that communication between registered nurses and patients plays a significant role in patient involvement in decision-making. In most consultations, registered nurses presented treatment plans without actively engaging patients in the decision-making process. However, the availability of limited treatment options led to mutual confirmation and agreement between the patient and the nurse, rather than shared decision-making. Additional findings will be presented at the upcoming conference. Discussion The findings from this study underscore the need for a comprehensive understanding of how nurses’ communication strategies facilitate patient involvement and shared decision-making, thereby contributing to person-centred care. By examining real-time interactions between patients and registered nurses in primary care, this study adds to the evidence base with high ecological validity and offers insights into everyday clinical communication practices.