A Health Affairs study comparing patient-satisfaction scores with HCAHPS surveys of almost 100,000 nurses showed that a better nurse work environment was associated with higher scores on every patient-satisfaction survey question.

Nurses look for environments to work where they're valued and respected and they look for an environment where they can participate and be involved in decision-making. We have a strong physician-nurse relationship. Our physicians highly regard our nursing staff.

Your health care plan should be portable. And that would promote a better work environment.

When Department of Health and Human Services administrators decided to base 30 percent of hospitals' Medicare reimbursement on patient satisfaction survey scores, they likely figured that transparency and accountability would improve healthcare.

I have to be tough in my work environment and tough in the world.

It's just going to be a lot nicer, and a lot better environment to work in for the maintenance staff.