I am a Nurse Quality Manager for the Emergency Room at a large teaching facility. Our ER sees approx. 60,000 patients a year. Here is my question: It appears that patient satisfaction and patient throughout is a constant issue no matter where you are located. However, some hospitals have experienced a miraculous turn around in these areas. So far I have seen hospital leadership make some good decisions but they appear to be poorly implemented. The action plan does not appear to include the people that do the work everyday. In addition, the ED has been labeled as having a negative attitude... which may be true...but there has to be a reason. With that being said, I am interested in your opinion (good and bad) on how you think Emergency Departments can improve in patient satisfaction and getting patients in and out. Why did you choose to be an Emergency Room Nurse? Do you have good working relationships with the floor staff? Or is it a battle all the way?