Speaking up and giving voice

FigureLET'S START THIS NEW year with a call to action about speaking up; not only using your own voice but also giving voice to others and promoting healthier conversations at every level of our organizations. This topic consistently emerged during meetings and conferences I attended last year with participants of all backgrounds, from clinical staff through executive leaders. We have a huge role in enabling others to speak up, and an individual responsibility to speak up ourselves. Silence has consequences. Let's amplify our own voices and those of all nurses. Several foundational concepts come to mind about speaking up. Moral courage is one. Not every issue is a profound moral dilemma that requires us to decide if it's a “hill to die on,” although these are important considerations in approach. Advocating for what you believe is right involves understanding all viewpoints on the issue and is a leadership expectation, albeit sometimes fraught with navigation of situational and relational factors. Being mentored or coached can help and, like everything else, practice brings confidence. Psychological safety is another concept that's related to speaking up. Feeling psychologically safe is a ubiquitous need in multiple arenas: patient safety, employee engagement, culture of inquiry, high-performing teams, root cause analyses, and retention, to name a few. It seems that everywhere we turn, when it comes to leadership practices and expected outcomes, psychological safety is a factor. You can't speak up without it. Too often, psychological safety is still a missing piece in our organizations, or perhaps only in some levels of the organization, probably one of the pitfalls of hierarchy and authoritarian-leaning leaders. Lack of psychological safety can be soul-crushing. Even if you don't feel psychologically safe at work, make sure your team does. Ask yourself: Do people feel safe speaking up—even when it's hard? Effective communication is still cited most often as a factor in safety events and in workforce discontent. Speaking up with purpose and intention—clearly, concisely, and assertively, but not aggressively—is vital. Know your facts. And let's not forget “political correctness,” which doesn't mean being limited to pandering or ingratiating dialogue, although it does mean being thoughtful, respectful, inclusive, diplomatic, and considerate. Too often, silence is mistaken for peacekeeping or agreement. Silence isn't neutral; it can undermine trust, teamwork, and influence, sometimes due to fear, insecurity, or lack of knowledge. If we disagree, we can ask questions, acknowledge, and find common ground. If we are unsure, we can say “I'll get back to you; I need to find out more.” If we need practice, we can ask a mentor for guidance or try well-known communication tools. Help others speak up by calling on them, possibly with advanced notice as needed. A colleague once advised me to always speak up at meetings, and if I didn't know what to say, just to agree with what someone else said. Organizations bear weight to offer development programs that foster communication skillfulness for all levels of employees. Effective communication is as important as clinical skills. When we speak up, we're role-modeling and normalizing transparency and accountability. Staff have told us that they want to have voice, and they must have a voice to own their practice. Nursing's voice carries weight—not just in boardrooms and leadership meetings, but in break rooms, huddles, and hallway conversations. I've had great success with significant decision-making and information-sharing in hallway exchanges with colleagues ranging from chairpersons to care teams. Speak up and foster spaces where voices are heard—it's a leadership imperative.Figure