Bold Voices: What Stops Us From Speaking Up?
By Connie Barden, RN, MSN, CCNS, CCRN
Most of the time, the issues that rally us to use our bold voices
are clear-doing the right thing for patients, defending families' rights,
speaking up for each other, advocating for high-quality patient care. We speak
up courageously, regardless of potential risks or consequences.
Sometimes, however, something stops us. We recognize the need to
dissent, take a stand, ask a question, challenge an action, and yet, we don't.
It happens to all of us.
We feel uncomfortable, even distressed when we choose not to act.
Maybe we could have. Maybe we should have. Maybe we might have made a difference
and did not.
In talking with thousands of nurses around the country this year
about using a bold voice, I've been moved by countless examples of courageous
speaking. I've also heard that often an honest and straightforward voice was not
used, and I have talked with many of you about why. Each scenario plays a little
differently, because each person's unique view of the situation and knowledge
about the players factor into the equation. Yet, there are countless, shared
reasons that we all use for not speaking boldly, even when something important
to us is at stake.
As I've reflected on this, it seems that the real issue is
usually one of two things: fear or resignation. Although the details of the
story may vary, what often stops us seems to go something like this.
I'm not saying anything. I'm better off if I just keep my
This is one of the most common scenarios in aborted
communication, whether at work or at home. Keep quiet. Stay out of it. Suppress
what you think and feel. Don't get involved. For most of us, this is our
automatic, first response when we encounter a difficult situation, especially
when we believe that the other person has more authority or power than we do. It
reveals our fear of the consequences of speaking up, which seems like too much
of a gamble with unknown results.
When I find myself silenced by my fears, I ask: Even if I feel
better keeping silent, is it worth the risk? Will I truly be better off? Will my
patients? My coworkers? My unit? Does the "safety" of not speaking up outweigh
the cost of maintaining the status quo? Without dialogue around challenges,
nothing at work will ever change.
If I do speak up, I will appear disrespectful and be seen as a
This is one of the most common themes I hear from nurses. We fear
being labeled as loudmouths-disrespectful, disloyal troublemakers-labels that
might jeopardize our standing at work. If speaking with a bold voice means
looking for solutions to what we know and care about, then our boldness cannot
include a blaming, insulting, accusing or disrespectful approach.
When this fear arises in me, I ask: Am I being disrespectful of
others or just stirring up trouble? If I answer "yes," then the consequences are
unpredictable, and my actions will indeed be risky. An honest appraisal of my
methods and motives is mandatory. If we notice ourselves being anything other
than collaborative and furthering the good of the issue, we must stop and
reassess the situation. People who genuinely seek solutions are heroes, not
Why should I speak up? It's not worth the trouble, because
nothing will ever change around here.
Everyone in healthcare has at some time thought that things will
never change. Some days, it's easy to feel defeated. Systems that don't work,
abusive behaviors, uninspiring workplaces, chronic shortages of resources-the
list is endless-all seem to be symptoms of "that's just the way things are." But
resigning ourselves to this way of thinking is dangerous, because so many people
agree, and it is easier to just go along and accept the status quo.
Ignoring circumstances or behaviors that aren't in the best
interest of patients, nurses, families or others doesn't make them cease to
exist. Staying quiet at best maintains circumstances as they are, leaving no
room for creative and inspired solutions.
Fear and resignation are the enemies of inspired work that makes
us feel enlivened by what we do. They thrive in large systems and maintain the
status quo. They keep us mired in the daily grind of recurring problems. They
are traps we can fall into, causing us to lose touch with our purpose and forget
our ideals and vision. They cause us to forfeit accountability for the world
around us, as if we are unable to cause any change or make any improvements. If
we want a healthy and inspiring workplace that produces the best possible
outcomes for patients, families, nurses and the entire healthcare team, we must
be the ones to create it. The first step is your bold voice-speaking your vision
and taking a stand for how it will be.
It has been said that courage is not the absence of fear. It is
the willingness to take action even in the presence of fear.
I invite you to notice when fear stops you, when resignation says
you're too tired. Then notice that, instead, you can choose to speak of the
vision that inspires you with a message that will make a difference.
Resignation will always whisper that speaking up won't make a
difference. I truly believe, however, that it is the only thing that will.