For hospital charge nurses: why nurses go quiet around their colleagues

One person, two experiences

On a ward, a nurse may readily raise a concern with the charge nurse yet fall silent around colleagues for fear of being ridiculed. It is worth asking her for two specific examples: a conversation with her supervisor and one with the group, ideally about a similar issue. A positive view of management does not tell you how colleagues respond during a shift. Psychological safety describes the norms that allow a team to learn and talk about difficulties. Early work on the concept involved 51 teams at a manufacturing company, so that study alone does not establish that the same relationships hold in hospitals. Separate studies of care teams support the concept’s relevance to medicine. Ask not only whether people can speak up, but also who they can speak up around and what they can discuss.

The social cost of asking colleagues

A new staff member may be encouraged by her supervisor to ask questions and still hesitate to ask colleagues. It is worth checking what happens afterward: do people comment on her lack of knowledge after the shift, or does she get the answer she needs to do her job? The group’s response can raise the social cost of asking again, even when her supervisor remains encouraging. But not every oversight should be called deliberate ostracism; a one-off lapse in attention is different from persistent exclusion. A meta-analysis of 95 samples involving 26,767 people links workplace exclusion to various attitudes and aspects of well-being. It is not direct evidence of an effect on patient safety, nor does it establish what happened on a particular ward.

Status is not the only difference

In care teams, both professional status and an inclusive leader’s approach may matter. That does not mean only someone with a formal title shapes the conditions for discussion. An experienced colleague whom others listen to can set an informal norm: whether a question gets an answer or is dismissed. During a handover, notice who interrupts a new staff member, who sums up what she has said, and whether others return to the issue she raised. A meta-analysis of 136 samples points to the importance of psychological safety for team learning, but a good relationship with one supervisor does not determine how colleagues will respond. Watching these interactions helps reveal influence that an organizational chart will not show.

Talking with the team leader

A conversation with the team leader is best grounded in one handover, rather than a general accusation that the team does not listen. You can ask how she responds to a question in front of others and what she does when someone interrupts the person asking it. Then agree on a specific change: stop the interruption, give the speaker the floor and return to her question before the handover ends. There is no need to name the person who described the difficulty if doing so is not necessary for action. Collecting questions anonymously can also help at the start of the improvement process. It creates an opportunity to discuss how questions are answered before staff feel ready to ask them in front of the whole group. An invitation to ask questions should therefore be paired with a response the team can see.

Working among peers

Among peers, a simple rule is needed: answer a patient-related question in a way that provides the knowledge needed for the job, regardless of personal feelings. At a handover, counting the questions asked is not enough. You also need to see whether the person asking can finish speaking and whether colleagues explain the issue without making her feel foolish. If someone jokes about her lack of knowledge, a witness can stop the mockery immediately, bring the discussion back to the question and invite others to work through the task together. That response does not require publicly singling out the person responsible. It does show how the team intends to respond next time. The rule needs to hold even when the charge nurse is busy with something else.

A framework for assessing your ward

Start a local assessment with two separate questions: is it easy to raise a concern with a supervisor, and is it just as easy to ask colleagues on the same shift? Alongside a rating scale, leave room for an account of a specific handover or shift. You can then compare anonymous accounts for recurring responses to questions, rather than rank individuals on the basis of one opinion. A meta-analysis of 136 samples, covering more than 22,000 people and nearly 5,000 groups, shows the broad importance of psychological safety and the need to distinguish between the individual and team levels. Because many of the studies included are correlational, it does not prove that a single change in behavior will produce a particular outcome on this ward.

How to tell whether things have changed

The best place to check for change is where the difficulty arose. If a nurse was afraid to ask a colleague, follow up with her to find out whether a similar question now received a useful answer without later mockery or another social penalty. An assurance that the atmosphere has improved is no substitute for an example. Observe both shifts and times when the charge nurse is not there: do colleagues let someone finish asking and help clarify the issue then, too? Comparing similar events in different circumstances helps show whether the new rule is becoming a team practice rather than merely a response to the supervisor’s presence. If a question still goes unanswered, ask again what is getting in the way instead of treating the matter as settled.

A good conversation with the charge nurse does not necessarily mean nurses feel safe asking their colleagues questions. It helps to look at specific handovers, shifts and responses to questions.

Empatyzer and helping nurses speak up on the ward

A charge nurse notices that new staff ask her about everything but avoid asking colleagues questions during a shift. In a conversation with Em about herself, she can prepare a short phrase to stop mockery and invite the team to work through the task together. She can then use the “You and the team” view to explore differences in preferences for open disagreement. That is a starting point for discussing how to answer questions, not a judgment about who is at fault. If she wants to speak with a particular person, Em can help her frame a question about a specific situation and need without attributing motives. Micro-lessons can reinforce kind, helpful responses to colleagues’ questions. The charge nurse can also use Em to prepare a conversation about norms among peers: how to let someone finish a question, how to answer it and how to respond to a joke. Then she can check during a shift whether the agreed approach really makes it easier to ask questions even when she is absent.