The literature reports conflicting evidence regarding the effectiveness of any single intervention, including bed exit alarms, in preventing falls. Yet bed exit alarms are widely used in healthcare settings as part of comprehensive fall-prevention programs even though no large-scale randomized controlled trials have demonstrated their effectiveness. As a part of a quality improvement project, bed alarms were piloted on two nursing units in a Level I trauma center. Nurses' patterns of use, their experiences and beliefs about bed alarms, and the literature regarding bed exit alarms were explored. Alarms were used with confused and agitated patients who did not fall. Nurses said that bed alarms may have helped prevent falls, but, even with bed alarms in use, nurses still needed to monitor their patients hourly. The conflicting experiences of nurses using the alarms, combined with nurses' comments and literature both supporting and not supporting bed alarms, shed light on the dilemma nurses face when prioritizing safe patient care and the ambivalence some nurses experience regarding bed alarms.