The ripple effect of speaking honestly in nursing. (Inspired by a nursing colleague)

By Anonymous

Throughout my 20 plus years of experience in nursing, I have been inspired every day by the colleagues I work with – the skills and the care they demonstrate and the thoughtful way my nursing colleagues are with our patients, families and each other has always been clear…

Recently, I learnt so much from witnessing a colleague who didn’t hold back as they advocated for a patient: they significantly changed the outcome and treatment plan for that patient.

Whilst outcomes for our patients are important, what I really observed and appreciated was how this simple action created a ripple effect within the broader local nursing community.

In this particular instance a doctor was going to proceed with a certain course of action for a patient. My colleague at the time had concerns with the approach and hence asked what was the rationale, so they could understand the doctor’s reasoning. As a result it became clear that the original course of action was not in the best interests of the patient. So the plan of care was changed.

The thing that is very important to highlight here is the way that my colleague spoke to the doctor. They spoke to the doctor to highlight concerns, so that everyone came to a new level of understanding. It was not about proving anyone right or wrong. What was said was said with great care, knowing that the original plan, albeit not correct, was made from a place of caring for the patient and wanting to provide relief of symptoms.

Through one nurse’s choice to not hold back and action what they felt to be true, all other nurses now know that they too can speak honestly about what they are observing and what they also know to be true.

When we allow ourselves to speak up with honesty, we put a stop to sitting on the back fence, fuelling thoughts that we can’t do or say anything, speaking up empowers us and also means that there are no regrets felt for not speaking up later on.

The nurses could now also see that communicating what is needed, with care and respect at the time, is supportive for everyone involved, even if there is a difference of opinion. Nurses are professionals of equal standing with all other health professionals,and because we get to know our patients very well, we have the knowing and the ability to support not only each other but also other health professionals, whilst recognising and honouring the particular skills of each professional, and that what we have to say and how it is presented matters.

Advocating for the patient in this instance was not easy for my colleague and I observed the conversations that they were having with other trusted colleagues afterwards. With this my colleague ensured they also received the support they needed through this process.

To speak up may not always be an easy thing to do but it does allow for further communication and important considerations to be shared, and what I saw was this particular conversation has had a ripple effect across the workplace for many other nurses.

It is important to appreciate far beyond what a person has done or offered, for there is always more we may not even consider. The ripple effect means when we respond in such a way, we may never know who has been touched or inspired by our words or actions, regardless of the outcome; but we can feel solid in the knowing that we have not held back from expressing what we feel is needed at the time.


Read more:

  1. When work hurts.
  2. Expression is everything – feeling anxious much? 

70 thoughts on “The ripple effect of speaking honestly in nursing. (Inspired by a nursing colleague)

  1. ‘Through one nurse’s choice to not hold back and action what they felt to be true, all other nurses now know that they too can speak honestly about what they are observing and what they also know to be true.’ I love this. The effect that one person can have in their choice to do something not only plays out for them at that time but has this ripple effect that spreads to affect many more people.

  2. After spending many hours a day in hospital with my wife it is super important for the patient to feel the Love that they can be held in by those who are their carer.

  3. I have found the culture of your hospital plays a big role in how these situations play out. I have worked in environments where every inquiry from an RN was seen by the MD as a challenge. Thankfully my current hospital has a more inclusive environment where RNs can respectfully question a physician and it is seen as a collaborative teaching moment. Doctors and nurses exchange their ideas and the MD gives his or her reasoning for the chosen course of action. They also, in most cases, value the nurses’ opinions.

  4. There’s a huge difference between truly wanting to know why – and looking to be the victor in a debate or a fight. So often we think we are asking but it comes with a goal and not so subtle agenda.

  5. I was involved recently in a situation that required me speaking up, which I did; I expressed to the group I was in what I felt was occurring. Sometime afterwards I was having a conversation with someone from the group who questioned my actions. As they were speaking I felt my body and how solid it felt and that what transpired was what was needed at the time. I am discovering that my body is in constant communication with me and I need to respond to it and not what society expects or doesn’t expect of me.

  6. I have always liked the definition of a professional as a farmer! Is he not a man who is outstanding in his field? When we bring the authority of practised ability from any job we do, are we not a professional?! The other day I was at the till of the grocery store and there was an item without the bar code, so out came the dog-eared book with codes. The search was taking time to find the item, so I was helping her to look. The handy reference book was listed numerically and not alphabetically, that made the search tedious. We found the item and I told the clerk that an accountant must have made the list or someone that has never worked the tills and she said it has always been that way. It was one of those golden moments for her to speak up for something, no one had questioned.

    1. Tilling the field of regrets gives us no gain as does sowing the field with doubt but fill your life with Love will bear the fruits of what we have sown and thus stand out in any field, as this is a “golden moment” in everyone life.

  7. When someone speaks the truth we all recognise it instantly and equally when someone lies we all know it’s a lie, the trouble is we routinely don’t call out the lies and more often than not don’t acknowledge the truth.

  8. ‘Honesty is the best policy’ supposedly and yet we can struggle to speak up and be honest. It highlights that there is a suppressive dishonesty around if we fear speaking up. An everyday suppression that hasn’t yet fully been addressed.

  9. Responding to life and situations without reaction, but from the deepest knowing inside of what is needed to be shared is a way of communicating that each of us is capable of.

  10. ‘Nurses are professionals of equal standing with all other health professionals,’ Yes that is what we need to see and feel as nurses, our value in the whole process of caring and will make us nurses speak up more and more.

  11. Getting ourselves out of the way and choosing to speak up goes a long way to the making of true change. So many of us are conditioned from childhood to not speak up or feel that our opinions are not valid that we hold back from expressing and then this becomes an entrenched pattern which plays out in every area of our life.

  12. I love the ripple effect from your colleague. We definitely need more honesty, clarity and care in our expression and relationships.

  13. There are still many walls that stand in the way and stop us from being heard in many professions. As long as we support and feed this type of hierarchy, we will stay locked into Plato’s cave. Years ago, when I was in the Military, I had bought a T-shirt that said, ‘Question Authority’. I had a medical appointment and was wearing the T-shirt and got into a lift that had three officer doctors and one read my shirt and said, you could get in trouble for wearing that! I just replied, ‘Yes, I know’. What happens if we never speak up?

  14. Speaking up when it feels true with loving intent applies to every area of life. This blog confirms that what is on offer for others when expanding enquiries are made with love and care of another as the focus, many gain in the outcome. Beautiful to read about this ripple affect.

    1. What I have found is that by becoming much more honest with myself (what I am truly feeling, what I am truly thinking, what I am truly seeing etc) it has enabled me to become much more honest across all of my environments which feels incredibly refreshing to the point of being revitalising. There is a solidness to being honest because honesty just is, it stands there with no fear of being called out because it’s got nothing to hide.

  15. Having recently spent a couple of weeks in hospital I deeply appreciated the sense of teamwork that I felt – it was beautiful to observe. I was also amazed at how open the staff were to letting the wisdom flow through them – it was a joy to be part of this ward as each day I was presented with a new gem. What a glorious learning and humility I felt from the whole of my stay.

    1. Wisdom has the potential to flow through us all, old, young, able bodied, disabled, European, African, Asian. We are not the origin of the wisdom, we are merely the portals through which it travels. If we get caught up in thinking that it’s us that are espousing the wisdom then it’s not wisdom that we’re espousing.

  16. There are many systems that will make us feel that we can’t speak up – even if it is the obvious that we want to state. There are systems where the people working on the ground – who have a great, even the best insight to what people need, do not value and appreciate their wisdom enough to speak up. This is a really great example of speaking up as there would have been many reasons for your colleague to doubt the value of what they were saying I’m sure because of the hierarchy within medicine.

  17. I am learning more and more the importance of questioning things we are not sure of. And as you have shown here with the example of your colleague, when we do this it can highlight something that was missed, bring a better clarity and understanding, bring about true change and of course support another or others in a way they would not be supported before the questioning.

  18. Speaking up always makes the difference. When I think about it, that seems more difficult than what it really is.. in fact it’s just open my mouth and let what I feel be expressed without reservations. This is freeing.

  19. I loved what has been shared here, especially working in the health care professional industry for two decades. I can recall being an advocate for women, but I recall it being from an aggressive consciousness, a role enforced upon us from something else, instead of the true and empowering way. When reading this, it makes me appreciate, there is another way and don’t get me wrong, I have spoken up when it was needed, but there is another way to communicating to others, that equally empowers another to work together – how teams should and could work together.

  20. ‘To speak up may not always be an easy thing to do but it does allow for further communication and important considerations to be shared.’ Agreed, there were many times growing up I felt stifled and could not express what I was feeling .. hence a lot of throat problems! However through loving myself more and deepening my relationship with both myself and my body and with the support of Universal Medicine I now have far more body confidence and love for myself meaning it is so much easier to express, with care and consideration, to others what it is that I am feeling.

  21. When we can model speaking up and doing it in such a way as to make others feel like they are not being judged, but respected for all that they are, it is much easier to hear the truth.

    1. Michelle when we model not only speaking or communicating that is non judgmental and emotion free, it gives the other person, and the opportunity for them to be reflected upon – the ripple effect…

  22. What has been shared is amazing because there is a hierarchal system within the Medical profession so for a nurse to speak up and then to be heard is astounding. I’m sure this would not have been possible a few years ago, but I have observed it is the nurses who see to the daily care of the patients and so it would make sense that they have an understanding for the patient and their needs.

    1. I agree Mary it also shows the willingness and openness of the doctor to actually listen to and take note of what the nurse was sharing and not dismissing her as being lesser but instead treating her as a valuable equal. Something we need in every single industry and group within the world .. to value and treat all others as an equal ✨

    2. To me, it would make sense if all doctors made it a policy to consult with nurses over care plans and treatments for patients, given the relationships the nurses get to form with them. The fact that this is not always the norm says much about the hierarchical system we have allowed and the dismissal of nurses as not being equal we have allowed also.

  23. Speaking up without personal investment for the benefit of all, takes courage to begin in the first place, yet it is amazing when the truth is expressed for the benefit of all, patient, nurses and doctors.

  24. An organisation that works with young people where they can walk in off the street to speak with someone recently shared with me 2 years ago a young person walked in and spoke with a member of staff for not even an hour, they never heard from him again. That is until recently when he recently came back to thank them as he said that moment with them had really helped and supported him and changed everything for him. We may not be fully aware of the power or support of what we express but you clearly show here of such a ripple effect and also the importance of speaking up.

  25. The world is slowly changing, where women, now are heard through the old values and beliefs. There is no betterment in these actions or belittling of another. Truth is a ripple that touches everyone equally.

  26. Honesty is something that if applied would have the power to turn our world upside down. If we were all to get honest then there would not be one relationship, one workplace, one institution, one industry or one government that would not be shaken to the core. Everything would be in turmoil because currently the status quo is maintained by our steady stream of lies. We lie without even acknowledging that that is what we’re doing. Lies are part of our culture and part of our heritage, they hold our everyday behaviour together, they are our social norm. Lies keep the world as it is.

    1. There is something you are saying here Alexis that feels very old and it has to do with the lies we peddle to each other every day, it seems to me that lies are the glue that keep our society stuck in the rut we are all in. We are all colluding together in this and as you say keeps the world as it is.

      1. And God forbid anyone who stands up against those lies because they will be shut down, history is proof of that, which is partly why we all toe the line, we know that if we stick our heads up then we’ll get shot at. But there comes a point where it feels better to get shot at than to be an active part of keeping the world as it is by perpetuating the lies.

  27. A beautifull observation and appreciation for your colleague highlighting the importance of the way we respect and communicate with one another is for the benefit of all.

  28. What really stood out for me when reading this article was how the nurse that spoke up was able to do this despite the ingrained hierarchical ladder that exists within medical professions. Traditionally and to this day specialists and doctors are seen as the ones who make the bigger decisions about patient care and the nurses are the ones who carry out that care. And so for a nurse to question a doctors decision takes a definite dedication to patient care, a deep connection to truth and a strong sense of self. The fact that it was done with such care and respect for the doctor shows a great depth of sensitivity and understanding. And this for me is how the world should operate, no one ‘above’ another in such a way that they are aloof and unapproachable, we should all feel free to contribute in all situations in any that’s genuinely supportive.

    1. Doctors have been called to have God-like powers for their ability to hold life or death in their hands. What kind of arrogance could this allow some to believe? We know from history what happened in the Spanish inquisition and what they did to people that did not respect God. These are ingrained beliefs that have been around since we have had Doctors so, to stand up and challenge this system comes from the foundation of a person that calls out, what is no longer acceptable. When these actions cause a wave to affect everyone equally, it fortifies the fact; we are all equal.

  29. Sitting back and staying quiet appears to harmonise and provide a level of Dacorum. But all it truly does is let falsehoods flow and so what we are left with is of no true value. That’s the irony – we sit on the fence but in doing this rot away all the wood underneath – eventually it falls down and we are forced to wake up.

  30. The medical profession is about caring for the patient and everyone has an equal voice in deciding the most appropriate way to treat each person at any given moment.

  31. An article yesterday stated that nurses in the UK have increased by 4.6% in the last five years, but admissions have jumped by 12.3%. Last year there were 12.2m hospital admissions. What pressure is there to do one’s job, let alone speak up with this tide of patients. Nurses are the ones at the coal face that never ends, but our disregard is overshadowing their numbers, and we are becoming the coal face.

    1. Often in nursing adequate nurse to patient ratios are often discussed by unions and governments as a way to obtain more nurses. Your comment “but our disregard is overshadowing their numbers” reflects what I ponder on and that is will we ever have enough nurses? Even if we employ more, given our level of illness and disease; the chronicity of ill health, the psychosocial components (which are huge by the way) that affect health, will we ever have enough? Unless something changes with how we care for ourselves and our own health and wellbeing, I doubt it.

    2. Gosh 12.2 million hospital admissions in 1 year!!! Just in the UK. That is a lot and I am sure this number is rising.

  32. We often have this idea that one person cannot make a difference and that speaking up is futile because it won’t change anything but here is a clear example that it can make a difference.

    1. The apathy that allows for being given up is completely eroding. When we take Brexit, for example, we can see that all those people who thought that the remain vote was bound to win, without making sure of it by using their own vote shows that every voice counts. Every vote has mattered in parliament over every issue that has been debated and it is clear that with just one person speaking out, we can raise awareness for all.

    2. Even when one person speaks up and nothing changes outwardly then energetically something has shifted. Words, like everything are energetic, therefore when we speak we affect the energetic fabric of the All, we can’t not. And so it’s not necessarily about winning people over but more about expressing the truth and so there are more and more drops of truth in the world, which will be felt by everyone regardless of their stand point.

  33. When we can get rank out of the way as we can value our equal input and see that everything is team work. Everyone is doing the best they can and positions within the ranking systems at work (and within other hierarchical structures) do not mean perfection – everyone has something valuable to express and our equal input is often very necessary.

    1. I agree Melinda. Someone might be ranked ‘above another’ due to certain skills that they possess, such as ability to lead a team or ability to come up with innovative ideas but their qualities and skills won’t be the qualities and skills that are needed in all situations and so everyone should be free and indeed encouraged to jump in when they feel to and contribute their insights and strengths ay any given time. So much is held back with our hierarchical ladders both at work and socially, people are kept down and kept small and as a result all of us are kept down and kept small. Every single one of us should be actively encouraged to bring our all to the table all of the time.

  34. Great example of how it is not ever about right or wrong – unless we make it so, of course, and to the detriment of all.

  35. ‘Nurses are professionals of equal standing with all other health professionals,’ Failing to speak up when we feel we are in a ‘lesser’ role exposes just how divided we are and how much we play into the feeling of being lesser and so behaving lesser. Acknowledging that we are equal and that our roles, whilst they may not garner so much status or pay, are nonetheless vital for the whole means that we begin to really value and appreciate what we bring. When we can do this, that feeling is invited in by others too. I am sure the doctor in question really valued the input of your colleague and was grateful that it was handled so professionally and with such integrity.

    1. Great comment Michelle, and what a great line “we play into the feeling of being lesser and so behaving lesser.” I can see this okay out in my own life when I hold someone on a pedestal and then can hold back my equal expression.

      1. Yes – and then we keep the whole system turning as it is, as there is no example of anyone holding their own as an equal in so called ‘inferior’ positions. It is not the norm yet to see everyone living as equals as we still have to get to the point where it is considered at all.

    2. Great that the doctor was able to see that it was about the best outcome for the patient and not about him being ‘wrong’. Had the nurse brought it up in another way, perhaps with a hint of criticism, ridicule or even scorn then the doctor might have clamped down and insisted on his original course of action purely so that he wasn’t seen to be undermined. This goes on all of the time, we’re hungry for power and identity and often make those things our priority.

      1. Absolutely Alexis. Within myself I have had to really look at my motives for opening my mouth. If the expression of truth is laced with any form or need for recognition or has an ounce of self it it, then it is not true and is simply heard and received in a way that invites defence. However if we speak the truth with nothing laced and the other reacts, we need to be able to read it for what it is.

    3. Nurses are a critical component in the health care system, and the same is true for teachers. But, often both seen as lesser in importance. What would the world look like without nurses and teachers? Why should they have to roar to be heard when a whisper should be all that was needed for us to listen.

      1. I couldn’t agree more Steve! Mind you having said that, so many teachers are leaving the profession in the UK at the moment, that quite soon the country will have to be experiencing what it is like without them, in all reality.

      2. I studied Early Childhood Teaching (Kindergarten) over 20 years ago and one of the topics we looked at in our studies was inequality in pay, and that areas of low pay were often deemed “women’s work” such a teaching, nursing and childcare. Those pay inequalities are still present, as are other ways we attribute value and rank to people erroneously because of position. How joyful it will be when we can let these things go and embrace each other unconditionally as equals, and value equally each contribution we make regardless of our work.

  36. Speaking up brings a light feeling in the body, holding back feels stuffy and draining, holding back then speaking up comes with relief but also a drained feeling.

    1. Leigh these are things that I’m learning at the moment. I am doing a managerial role for the first time in my life and I am becoming acutely aware of all of the reasons why I hold back from expressing the truth with others. There are a lot of old patterns that need addressing, wanting to be ‘mates’ with people is just one example but being ‘matey’ with someone doesn’t support either them or me to evolve and I need to remember that we’re here to evolve and not be mates. That’s not to say that I have to be harsh and can’t have deep relationships with my work colleagues, it’s just to say that I need to examine my motivation behind not speaking up.

    1. It’s usually us that get in the way of true purpose. Our need for identification, our addiction to emotions, our lack of honesty, our dedication to distorting the clarity of our bodies and our alignment to an energy that avoids true purpose like the plague all contribute to a lack of true purpose in our lives. Many of us think that we have true purpose, especially those of us who are dedicated to ‘saving the planet’ in some way or invested in charitable crusades but unless the energy that is fuelling those ventures comes straight from Heaven then it’s corrupted. Corrupted to the core.

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