Promoting patient safety and excellence in nursing practice in the interest of protecting the public is central to the mandate of professional nursing associations and colleges at the provincial, territorial and national levels. [...] These threats are related to how the organization is managed, how the workforce is used, work design and the culture of the organization (Institute of Medicine of the National Academies [IOM], 2003). [...] Currently in use is a clearly identifiable bag that alerts nurses to the toxicity of its contents and allows them to translate that to patient safety, without even having to read the name of the drug first (‘safety at a glance’). [...] The report of the inquest by Associate Chief Judge Sinclair included the following findings: “The concerns expressed by some of the cardiac surgical nurses were dismissed as stemming from an inability to deal emotionally with the deaths of some of the patients. [...] Nursing leadership brings a unique perspective to the dialogue on patient safety as “few leaders in health care are better equipped or more knowledgeable of the overall system and how the parts work and relate as a whole.” (Thompson, 2000, p. 509) Hard issues, such as the shortage of nurses and the need for work redesign, raised by nurses and described in this paper need to be addressed.