Establishing a culture of safety within an organization is essential to the task of continuously improving safety. However, measuring and improving safety culture is challenging, due to documented variation in safety climate perception between units and roles. This survey of medical–surgical nurses at 186 hospitals found that, although the overall organizational commitment to safety was viewed positively, nurses felt their job conditions did not promote safety and also felt reluctant to report errors (a problem noted in prior research). Published recommendations have addressed improving the work environment and safety climate for nurses.