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Empowering New Nurses to Speak Up

Keith Carlson, RN, BSN, NC-BC - 04/27/19

When new graduate nurses begin working as nursing professionals in the worlds of healthcare and medicine, learning communication skills is a crucial task. However, speaking up to physicians and other powerful or influential colleagues isn’t always easy to do without an enormous lump in the throat and a terrible feeling in the pit of the stomach. What’s a new nurse to do?

Finding Your Voice

During the nursing school experience, student nurses may or may not have opportunities to speak with physicians, surgeons, nurse practitioners, and other providers to whom they report and from whom they receive orders. They likely interact with managers, supervisors, and charge nurses regularly, so this is where they’re most likely to begin honing the skill of questioning accepted practices from the perspective of a novice.

For the anxious new nurse whose communication skills and self-confidence are weaker than desired, questioning an order or pushing back may not seem even remotely possible.

For a nurse to find their voice, they must first know what they believe, think, and feel. Of course, a newer nurse won’t have the clinical experience and knowledge of a seasoned veteran, but they can still use their own life experience, intelligence, and intuition when reacting to circumstances that necessitate speaking up.

Do Age and Life Experience Matter?

We must acknowledge that, at this time in healthcare history, we frequently encounter new nurses who are in their 30s, 40s, or even 50s; some of these individuals come from equally stressful prior careers that have taught them much. These slightly older individuals may have fewer qualms about speaking out and may have had plenty of practice in their former professional lives. Novice nurses who have significant life experience may simply be more self-confident and willing to go to bat for what they believe. 

For the younger novice who pursued nursing directly after high school, that relative lack of life experience may be the largest hurdle when it comes to forthright communication.

No matter the nurse’s age or previous encounters with powerful colleagues, doctors and surgeons can exude such an air of unassailable authority that standing up to them or engaging in a conflictual debate may be too much for even the most self-confident new nurse to handle, especially in a workplace culture where staying quiet is the expected norm.

How to Raise Your Voice

Learning to raise your voice and speak up for what you believe is a lifelong process. There may be days when you feel utterly confident, and others when you’d rather crawl under a rock. The following are strategies and techniques for taking your communication and confidence to the next level:

  • Develop your emotional, relational, and behavioral intelligence; these skills can be learned through assiduous study and practice. Skills in conflict resolution and Non-Violent Communication (NVC) are essential.
  • Use psychotherapy, counseling, or coaching to explore your tendency towards conflict avoidance or not using your voice. There may be underlying experiences or thought patterns that can change.
  • Begin by questioning the small things that are less consequential but still in need of addressing. When these experiences result in positive outcomes, you’ll feel emboldened to use your voice more frequently and in more crucial situations.
  • Identify and understand your values. Know what values and ethics you refuse to compromise in your work and personal life, and then use those values and ethics as your litmus test for when you need to step up and speak out.
  • Engage in activities, study, and experiences that increase your self-knowledge and personal growth. Workshops, books, articles, podcasts, and seminars geared towards self-development and personal insight can empower you to act and speak in accordance with your beliefs and values.
  • Emulate the behavior and attitudes of professionals who know how to effectively use their voices for positive change.
  • Consciously choose to be a change agent, fully understanding that those who prefer the status quo will resist your efforts. Accept that not everyone will be happy with your outspoken nature. 

Overcome Your Fear

If you grew up in a family or culture where silence and obedience are highly valued, being a rabble-rouser at work may feel very much outside the box. However, remember that, especially in the case of ethical dilemmas or situations where you feel your license and/or your patient is in jeopardy, it’s your professional responsibility to share your opinion and possibly refuse to carry out a questionable order. Such dilemmas are common in healthcare, thus most nurses eventually face them at some point. How will you fare when your time comes?

Overcoming your fear of speaking out is an important aspect of personal and professional maturation. Not everyone needs to be an activist nurse, but every nurse needs to be an advocate for the profession, for his or her license, and for the patients being served.

Developing your ability to make your opinions known is paramount, and those who choose to ignore this part of their growth are truly missing out. Your opinion and your voice matter; will you allow them to be heard?