 The sanatorium was in a state of low morale further acerbated by a newspaper scandal and over a three year period, Elliott worked to readdress these issues, establishing a training scheme for all the nurses, affiliating the sanatorium with Belfast City Hospital, as they were previously unable to get recognition outside the hospital.Again somewhat reluctantly, in 1946 she took up the post of Matron at the Royal Victoria Hospital, the first Royal trained nurse as well as the first from Northern Ireland to hold this position, remaining there until retirement in 1966.Whilst at the Royal she ensured that nurses under her charge went on training courses across the UK as well as locally.