This article aims to inspire nurses to recognise how human factors affect individual and team performance. Use of a case study and learning derived from a subsequent independent inquiry exposes the dynamics that can affect teamwork and inhibit effective communication with devastating consequences. The contribution of situational awareness and the importance of nurses speaking up when they have concerns are demonstrated as vital components in the delivery of safe patient care.
Nursing Standard. 26, 35, 35-40. doi: 10.7748/ns2012.05.26.35.35.c9084
Peer reviewThis article has been subject to double blind peer review
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