Managing Our Fears to Improve Patient Safety
Managing Our Fears to Improve Patient Safety
An essential element of professional practice, nurse advocacy for patient safety is embedded in the American Nurses Association's Code of Ethics. Yet evidence suggests nurses and other healthcare professionals don't always speak up with their patient-safety concerns. In 2005, the Silent Treatment Study involving 1,700 nurses, physicians, and other healthcare professionals found that 84% observed fellow clinicians take dangerous shortcuts but fewer than 10% confronted these individuals about their actions.
Why are so few of us willing to speak up on our patients' behalf? Amy C. Edmonson, a social psychologist and professor of leadership and management at Harvard, studied the fears of people working in groups. From her observations in health care and other industries, she found employees believe others in the workplace are constantly evaluating them. For workers in all settings, protecting one's image is important. The added stress of maintaining one's image while under a perceived microscope of scrutiny at work is the main reason clinicians don't speak up; they feel it's not safe to do so.
Edmonson uses the term psychological safety to describe an individual's perception that the practice environment is conducive to taking a potentially image-threatening risk. In psychologically safe environments, healthcare professionals believe they won't suffer adverse consequences if they report a mistake or ask for help, education, or feedback. In environments that lack psychological safety, on the other hand, workers tend to keep their concerns to themselves.
Leaders must develop a structured process for team learning and communication.
Introduction
An essential element of professional practice, nurse advocacy for patient safety is embedded in the American Nurses Association's Code of Ethics. Yet evidence suggests nurses and other healthcare professionals don't always speak up with their patient-safety concerns. In 2005, the Silent Treatment Study involving 1,700 nurses, physicians, and other healthcare professionals found that 84% observed fellow clinicians take dangerous shortcuts but fewer than 10% confronted these individuals about their actions.
Why are so few of us willing to speak up on our patients' behalf? Amy C. Edmonson, a social psychologist and professor of leadership and management at Harvard, studied the fears of people working in groups. From her observations in health care and other industries, she found employees believe others in the workplace are constantly evaluating them. For workers in all settings, protecting one's image is important. The added stress of maintaining one's image while under a perceived microscope of scrutiny at work is the main reason clinicians don't speak up; they feel it's not safe to do so.
Edmonson uses the term psychological safety to describe an individual's perception that the practice environment is conducive to taking a potentially image-threatening risk. In psychologically safe environments, healthcare professionals believe they won't suffer adverse consequences if they report a mistake or ask for help, education, or feedback. In environments that lack psychological safety, on the other hand, workers tend to keep their concerns to themselves.
Leaders must develop a structured process for team learning and communication.
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