From the ANA SmartBrief-3

Patient satisfaction, safety are top priorities for nurse executives
Nurse executives said patient satisfaction is their first priority for 2011, while patient safety and cost reduction are at the second and third ranks, respectively, according to a HealthLeaders Media poll. The survey also found that among health care CEOs, patient experience and satisfaction was the fourth priority, while cost reduction ranked first in their list. HealthLeaders Media (2/15)

Do you really believe your facility even rates their nurses at fourth?

If cost reduction is First, I will even give the patients second place, then executives and their precarious positions with today's economy third, then doctors, organizations like JACHO, vendors, and plans to implement changes to save healthcare somewhere next in line. I would imagine there are even other considerations, than the nurses who seldom band together for their own safety and improved conditions and rate further possibly eve much further down the line.