In the past decade concerns related to the incidence of preventable adverse events resulting from poor clinical practice have escalated in Australia and overseas. Inadequacy of institutional responses to reported adverse clinical events in acute health services has also been debated. There is mounting evidence that professional self regulation, intra-institutional reporting structures and even the development of accredited national safety and quality processes often fail to ensure that problems concerning patient safety and quality care are uncovered in a timely and appropriate manner. In some cases, the failure of an organisation’s internal quality processes has lead some clinicians (nurses and doctors alike) to resort to raising substantial allegations of unethical clinical practice outside the institution, (‘blow the whistle’) in order to have their concerns heard. This paper will provide a definition of whistleblowing and examine the potential dichotomy of accountability faced by nurses’ who report concerns of adverse clinical events or unethical clinical behaviour. It will briefly discuss some important organisational structures that contribute to health professionals resorting to whistleblowing and finally it will profile steps recommended in the literature to protect potential whistleblowers.