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Patient satisfaction, an important measurable outcome, allows nurses to assess what can be improved in nursing practice. The purpose of this study is to compare expectations of patients and nurses using 3 nursing care attributes: 1) friendliness, courtesy, and respectfulness; 2) comfort measures; and 3) degree of information sharing.This is an Institutional Review Board-exempt survey of paired patients’ and nurses’ perceptions of nursing care in a 50-bed emergency department of a level 1 trauma center.The survey consists of questions that addressed 3 performance attributes of nursing care. The respondent circled their responses in a Likert scale of 5 choices from 1: “way below expectation” to 5: “way above expectation.” An open-ended comment section followed each question; the last survey item asked for recommendations on how to make nursing care extraordinary.Nineteen males and 30 female patients, ages 18-89 participated. Of the nurse participants, 20% had <5 years ED experience, 22% had 5-10 years, and 52% had >10 years.The patients rated the care they received consistently higher than nurses. The difference in the average patient ratings vs. the average nurse’s rating was significant. (P = < 0.002, paired T test and Sign test).Patient ratings were also consistently higher when patients either knew their nurse’s name or were able to identify them by sight. The higher average rating was significant in all 3 attributes (P = 0.02, Wilcoxon Rank-sum test).The unexpected highly positive patient rating did not identify specific areas for practice improvement; it did provide positive feedback for excellent care, reinforcing good nursing practice.