Although many hospitals do encourage employees to stop the line, the practice isn't as prevalent as it should be, Papa says. And nurses often have trouble questioning physicians.
"There's often the belief that the nurse and the physician are not on a level playing field," Papa says. "They're afraid they'll get in trouble because the physician got angry with them."
Hospitals that prioritize patient safety and have a culture of respect and regard will be able to successfully make stop the line routine, says Papa.
Although most hospital leaders would say that their organizations fit that description, Papa says the truth soon becomes evident in hospitals where that's not really the case.
"You'll find out the underlying culture if you go in and just even question somebody," she says.
Once a stop-the-line commitment is made in a hospital, nurse leaders must encourage staff to speak up whenever they have a concern, whether someone is about to hang the wrong blood type for a patient, or a physician is about to enter the trauma bay without being properly garbed.
Papa suggests practicing stop the line during mock codes and encouraging nurse leaders to debrief with their staff whenever a nurse stops the line, just to talk about how it went.
"They're going to be afraid, they're going to be hesitant, and they're going to be nervous the first time that they have to do it," Papa says. "It never hurts to stop for a minute. And it really doesn't even take a minute; often it takes 30 seconds. And that 30 seconds can save a life and save a career."