At Bundaberg Hospital, what stopped Dr Jayant Patel was not a new computer system, it was not an updated reporting mechanism, it was not visits from external regulators, it was not another reorganization, it was not a new management theory. It was the bulldog advocacy and persistence of ICU Nurse Toni Hoffmann in the face of managerial inactivity and intimidation [28] . Toni was recognised for her role with an Australian Local Hero Award in 2006 and an Order of Australia in 2007. Is Toni Hoffmann a 21 st Century nurse hero? Without a shadow of doubt.