A 97% pulse ox can lull anyone into a false sense of safety, until ventilation fails and the patient quietly slips into danger. That tension between what looks stable and what is actually happening runs through our conversation with Dr. Julie Siemers, whose 46 years in nursing span ICU, trauma, helicopter medicine, academia, and leadership. We explore the moments that forged her commitment to advocacy (like the 90‑year‑old man without a family voice) and unpack why preventable harm is not just tragic, but systemic and solvable. We walk through failure to rescue in plain language: failure to recognize, failure to act, and failure to communicate. Julie shares her “seven pillars” that anchor clinical judgment: vital signs, neuro assessment, labs and critical values, hydration and intake/output, diagnostics, communication, and escalation, showing how small signals add up hours before a crash. We dig into oxygenation versus ventilation, why respiratory rate is an early warning sign, and how opioids and sleep apnea can create a perfect storm, even when SpO2 looks good. Culture matters as much as protocols. From air medical missions where airway and safety beat speed, to interprofessional exercises where authority gradients surface early, Julie argues that respect, clarity, and closed‑loop communication are life‑saving tools. We talk about simulation that builds confidence under pressure, Lifebeat Solutions focused courses that retrain judgment in one‑hour bites, and the readiness gap across professions that puts patients at risk. Families are part of the safety team. You’ll learn how to ask sharper questions, use CUS words (Concerned, Uncomfortable, Safety issue), work the chain of command, and even choose safer hospitals with public safety grades. It’s a practical, human roadmap for anyone who wants to catch deterioration sooner, speak up with impact, and make care safer shift by shift, conversation by conversation. To learn more, please visit: drjuliesiemers.com Virtual shadowing is an important tool to use when planning your medical career. At Shadow Me Next! we want to provide you with the resources you need to find your role in healthcare and secure your place in medicine. Check out our pre-health resources. Great for pre-med, pre-PA, pre-nursing, pre-therapy students or anyone else with an upcoming interview! Mock Interviews: shadowmenext.com/mock-interviews Personal Statement Review: shadowmenext.com/personal-statement Free Downloads: shadowmenext.com/free-downloads Want to be a guest on Shadow Me Next!? Send Ashley Love a message on PodMatch, here: https://www.podmatch.com/hostdetailpreview/175073392605879105bc831fc