Find your voice and trust your instincts.
- Actively engaged nurses experience less burnout and contribute to better patient care.
- Active engagement requires champions with nursing and administration.
- Achieving active engagement requires that nurses find their voices and participate in ongoing profession and personal development.
In my more than 26 years as a nurse and several years as a nursing education specialist, I’ve never seen a time when actively engaged nurses have been more critical to our communities and organizations. Actively engaged nurses burnout less, contribute to better patient care, and level up our organizations. To become actively engaged, nurses and their administrative champions must focus on three areas: voice development and ongoing professional and personal growth.
Develop your voice
Experience matters. However, even new nurses can speak up when something doesn’t feel right or isn’t right. In addition to making communication as easy and transparent as possible, organizations must prioritize nurses voicing their concerns effectively and to the right people.
Developing a professional voice isn’t always easy, but it’s our responsibility as nurses. I’ve frequently used and taught five strategies central to developing the skills for speaking up: recognize the fear, trust yourself, mentoring, clear and concise communication, and listen to understand.
Recognize the fear
Fear remains one of the most significant barriers to speaking up. We fear being wrong, being rejected, creating conflict, being chastised, and much more. Name your fears and be willing to move past them. By acknowledging your fears, they become less intimidating and less of a barrier over time. Speaking up will soon become more valuable than any of your worries.
As you learn to trust your instincts, your confidence in speaking up will grow. Many nurses (including myself) hear intuition letting them know that something is wrong, yet they quickly push it aside, assuming that someone else will speak up or that they must be wrong. Your intuition is one of your most valuable possessions. Listen to it and act on it.
Developing your professional voice requires a network of people you can turn to for reassurance and advice. Have you listened to a colleague have a difficult conversation with another colleague, a physician, a patient, or a family member? Were you impressed by how someone spoke up in a meeting? If so, consider them informal mentors. Observe them. Talk to them. Ask them how they developed their voice and about the specific communication skills they use.
Clear, concise communication
Finding the right words isn’t always easy. That’s why I use CUS statements: I have a Concern. I’m Uncomfortable. This is a Safety issue. Not only does the CUS tool provide a clear and concise means of communicating something important, but the use of “I” statements empowers us to own our concern. Another communication tool you probably already use, SBAR (Situation, Background, Assessment, Recommendation), allows you to introduce yourself and the current issue, provide background, articulate your assessment of the situation, and offer recommendations to resolve the problem or concern. When assessing a situation and preparing to offer a solution, consider seeking feedback or another opinion. SBAR and CUS tools allow us to effectively organize what we need to say and present it confidently, concretely, and concisely.
Listen to understand
Sometimes we get so invested in the point we want to make that we forget the other side of the conversation. Developing your voice requires developing your ability to listen. Listening to understand means you don’t formulate your response while the other person is speaking. Instead, listen, ask questions, restate what you know, and take time to pause and reflect on what’s being said. This skill helps across the board, including in brief, casual, high-stakes, and conflict resolution conversations.
Whether you’re a novice or expert nurse, room to grow always exists. You may decide to participate in unit practice councils, act as a committee member, attend professional conferences, or continue your education. Whatever you choose, make sure it’s your choice. Passions, strengths, and a desire to make a difference drive professional development
Identify your why
Your why is the foundation of your career, so ask yourself these questions:
- Why did you choose to become a nurse?
- What inspires you?
- What are you passionate about?
- What are your strengths?
Identifying your why can help prevent burnout, support you during hard days, and aid deciding how you want to participate in the nursing profession.
Find where you belong
Based on your why, determine your place in the organization. If you want to become more involved, what would you like to do? Do you aspire to a leadership position? Would you like to get involved in a committee? Is mentoring your strength? What nursing organizations or committees would you’d like to participate in? You’ll always find opportunities to grow and get involved. Speak with your manager, director, and chief nursing officer about your vision, and ask for their help in finding meaningful ways you can contribute. Also, look at options in your community. Many boards can benefit from nurse membership.
Becoming involved helps you find where you belong in your organization and your profession. Once you start looking for opportunities, they may find you.
Knowledge is power. In nursing, learning can enhance professional confidence and your ability to make informed contributions to the profession. Every healthcare organization needs nurses who are passionate about learning and growing. The best part is that an option exists for every interest and passion.
Start by deciding where your interests and passions lie, and then choose a topic for further education. Find out if your organization will reimburse for certification, conference attendance, or a professional journal subscription. If you’re considering advancing your degree but don’t know where to start, identify your priorities; research online, in-person, and hybrid options; and then decide what best fits your preferences.
Enhance personal development
No one else can define what you need for personal development. Ultimately, it’s up to you to discover. Developing the right mindset, choosing people you can depend on, empowering yourself, and trusting your instincts can help you in this journey.
Establish the right mindset
When confronted with challenges, it’s not enough to just be positive. Your mindset isn’t only about being optimistic. A healthy mindset requires self-reflection, being open to learning, engaging with those around us, and facing our individual and collective hurdles. To change your mindset, start by reflecting on what’s within your control, acting to the best of your ability, and then turning everything into an opportunity to learn and improve. These steps aren’t simple, but they have the power to change how you engage with everyone, including patients, colleagues, physicians, and yourself.
Choose yourself and the people you can depend on
Self-care isn’t selfish. As a nurse, your ability to actively engage with every patient relies on your ability to give yourself the highest level of care possible. Ways to prioritize your well-being include spending time on a hobby; reading; listening to music, books, and podcasts; exercising; resting; volunteering; and taking a class that interests you. Choosing yourself will positively impact all others area of your life.
In addition, connect with people who know how to support you. Take a few minutes and write down the names of the people who will be completely honest with you, who you can call on good days and bad, and who you know will always have your back. Prioritize identifying and counting on your support network when your bucket is empty.
We’ve all encountered and worked with people who exude confidence and power. We might wonder how to sample that for ourselves and try it on just for the day. The good news is that confidence is a muscle you can build. Make developing your version of empowerment a daily practice.
Trust your instincts and honor your voice. If something doesn’t seem right to you, speak up without fear of being wrong or needing validation from others before you act. Validation from others is a bonus, but validating yourself is empowering. Trusting your instincts and acting on them is like push-ups for your confidence—the more you do it, the more the muscle will grow and the better you’ll feel.
Identify and cultivate active values. In her book, Emotional Intelligence, Susan David writes about recognizing values and acting on them. For example, I value seeing and hearing people from their perspectives. I also value being listened to and understood. With this information, I can choose actions (listening to understand, asking questions for clarification, and speaking clearly) that prioritize those values. Other values that guide my professional voice include trusting my intuition, gaining knowledge and experience, being open to others’ points of view, letting go of the need to be correct, and not being afraid to be wrong. I know this because I’ve spent significant time thinking about my values and figuring out how to act on them. Yours may be different, but what will always be the same is that values, backed by action, create confidence and authenticity.
Practice supportive self-talk. Talk to yourself like you would a friend. Ask yourself, “Would I talk to a friend or colleague like I talk to myself?” If the answer is “no,” start speaking kindly to yourself right now. Give yourself a break and offer yourself compassion. When you learn how to show compassion to yourself, you can show it to others genuinely.
Own how you feel. Own your feelings—discomfort, anger, sadness, fear, happiness, melancholy—when you experience them. It’s easy to blame someone else for how you feel, or even to blame yourself for feeling a way that you view as unacceptable, unproductive, or simply uncomfortable. However, personal growth depends on owning how you feel, not needing to know precisely why you feel the way you do, and allowing yourself time to process your feelings without blame.
Focus on solutions. Becoming solution-oriented is integral to a healthy mindset. As you move from blaming and catastrophizing, you can look for plausible solutions. If you identify a problem, chances are you’re not the only one. Brainstorm solutions on your own, with another person, or with a group. Searching for answers is more empowering than staying stuck in a problem. Being solution-focused allows you to contribute ideas that can lead to positive change and build healthy professional relationships.
Active engagement can help address increasing burnout rates among nurses and improve their overall well-being. Find opportunities to cultivate your voice and enhance professional and personal development. The results will have a positive impact on patients, your organization, and your community. (See Applying engagement strategies.)
Editor’s note: To learn how to address nurse disengagement, click here.
Jodi Waddoups is a division clinical specialty educator – medical/surgical at the HCA Healthcare Mountain Division – Center for Clinical Advancement in Cottonwood Heights, Utah.
Agency for Healthcare Research and Quality. TeamSTEPPS.
Brown B. Dare to Lead. New York, NY: Penguin Random House; 2018.
Brown B. Rising Strong. New York, NY; Penguin Random House; 2017.
David S. Emotional Agility: Get Unstuck, Embrace Change, and Thrive in Work and Life. New York, NY; Penguin Random House; 2016.
Fotuhi O, Gouravajhala R, Barnett C. Session 1 – Intro to the unwritten curriculum: Improving student success outcomes during the first year. October 28, 2021.
Nembhard IM, Edmondson AC. Making it safe: The effects of leader inclusiveness and professional status on psychological safety and improvement efforts in health care teams. J Org Behav. 2006;27(7):941-66. doi:10.1002/job.413
Neff KD. Self‐compassion, self‐esteem, and well‐being. Social Personal Psychol Compass. 2011;5(1):1-12. doi:10.1111/j.1751-9004.2010.00330.x
Key words: nurse engagement, communication, mentoring, professional development