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John Hopkins recently released a study identifying preventable medical error as the third leading cause of death. Did that statement immediately make you feel angry or conflicted? Not because you believe it's untrue but instead your experience as a hospital nurse may have proven to you it's true.Nurses struggle every day to put their patients first in unsafe environments often permeated with the threat of intimidation, bullying, and retaliation if they speak up. Nurses predominantly live in a culture of fear. We know why patients are often placed at risk. We are the eye witnesses to acts of negligence. Sleepless nights, fear, anxiety disorders. Do you find yourself trapped in a cycle of anxiety knowing what your Nurse Practice Act holds you independently accountable to and yet hospital administration putting you in a position where you can't adhere to your NPA by charting contemperaneosly, giving medications on time, finding someone available to waste controlled substances at the time you withdraw them, preventing failures to rescue, preventing that confused patient from falling while you are beyond busy with a completely unmanageable assignment, or forbid, forbid reporting as is your duty to do a Physcian who consistently practices with reckless disregard? We know the truth. Yet we are afraid to speak up. Afraid of loosing our job or worse finding ourselves charged with a felony like nurses in Texas found themselves when they dared to report a Doctor they had documented evidence of a pattern of malpractice. Years later, their lives destroyed they were vindicated. The end result, securing the cult of silence, changes were made by the Texas Medical Board forbidding anonymous reporting of impaired or dangerous practitioners. You do what you have a duty to do and report and you can be assured of having your career wiped out, blackballed (common practice by hospitals in Texas.) IT MUST STOP, WE MUST START TELLING OUR STORIES ABOUT WHY PATIENTS ARE HARMED OR KILLED IN HOSPITALS while nurses daily try to keep our patients safe. Let's start the conversation now. Tell me your stories. Our patients deserve that we start the conversation.