Today started emotionally with the Lewis Blackman film. So many errors were seen within the medical system but I have sadly seen many similar cases. From a nursing prospective I have seen incredible changes over my 10 year career. Today hospitals empower bedside nurses to speak up and even start the early detection of a patient’s decline. When I first started nursing I was never taught to speak up when doctors rounded or even challenge patient care/ orders. Today I see major changes in hospital culture. Medstudents start their day finding the nurse on my unit and asking how the previous shift went and what problems we anticipate or encounter. We preform daily rounding with a multi disciplinary team including the nurse and charge nurse for input. Specifically for the Lewis Blackman case, his vitals today would have prompted a SIRs or SEPIS alert and a nurse would then draw a lactic acid which doesn’t need to be ordered by a physician. We also can call the resource nurse to come and lay eyes on the patient who we think is a high risk for declining. I believe these nurse driven protocols do save lives and gives patients better outcomes. I hope I continue to see positive changes in my career to improve patient safety.