Reviewing the patient’s chart, the nurse notes the patient is thrombocytopenic and anemic. A liver biopsy places the patient at an increased risk for hemorrhage, especially in the setting of thrombocytopenia. The most appropriate initial statement is, “I’m concerned this patient is at an increased risk for bleeding.” The word, “concern,” cues the provider that this is a serious situation and the nurse succinctly states the reason for the concern. Once the nurse has the provider’s attention, additional information can be provided. Although a time-out before the procedure is required, this procedure is unsafe. Asking if the provider is sure about the procedure is not helpful. If the provider does not respond to the nurse’s initial statement, the nurse can follow up with, “I’m uncomfortable with this procedure. This is a safety issue for the patient.” This is not an appropriate initial statement because it does not provide information about why the nurse is concerned.