This study, published in the International Journal of Nursing Studies, sought to demonstrate how rates of burnout, intention to leave, and job dissatisfaction changed in a panel of hospitals over time, and to explore whether these outcomes were associated with changes in nurse work environments. Survey data collected from large random samples of registered nurses employed in Pennsylvania hospitals in 1999 and 2006 were used to derive hospital-level rates of burnout, intentions to leave current positions, and job dissatisfaction, and to classify the quality of nurses’ work environments at both points in time. Results indicated that nurse outcomes improved between 1999 and 2006, with fewer nurses reporting burnout, intentions to leave, and job dissatisfaction in 2006 as compared to 1999. Additionally, improvements in work environment had a strong negative association with changes in rates of burnout, intentions to leave current positions, and job dissatisfaction.