Nurses are essential in escalating concerns about patient deterioration – but as a nurse, ensuring you are heard and your concerns are acted on in a timely and effective way is not always straightforward. Complex factors that include staffing, workload, communication method and interpersonal relationships can help or hamper this process. Tools such as NEWS2, ABCDE and SBAR have made it easier for nurses and other staff to escalate concerns and structure the information they need to share with medical and other clinical colleagues. Nurses are in closest contact with patients and so should feel empowered to advocate for them