From Silence to Shared Understanding

In the fast-paced world of healthcare, silence can sometimes feel safer for employees than speaking up. Yet, unspoken concerns and missed opportunities can quietly undermine teamwork and patient care.

Nurse leaders, more than most, carry the weight of balancing staff well-being, organizational priorities, and patient outcomes. One deceptively simple but powerful question can break through the silence and open the door to clarity and collaboration:

“What does success look like for all of us?”

Why asking "What does success look like?" matters for nurse leaders

This question invites focus and imagination at the same time. It helps people name the concrete outcomes they’re working toward—better communication, safer handoffs, stronger patient satisfaction scores—while also sparking images of a workplace where patients feel cared for and staff feel proud of their contributions.

The shift is subtle but powerful: from isolated perspectives to shared understanding, from uncertainty to possibility.

A story from Conversations Worth Having: raising patient satisfaction

In Conversations Worth Having, we share the story of a nurse leader who faced declining patient satisfaction scores in a unit she had been pulled into lead after the nurse manager quit. Instead of relying solely on data dashboards or directives from above, she brought her team together for a different kind of conversation. 

She sent a copy of the patient satisfaction report to the nurses in the unit along with an assignment for their meeting:

“Pay attention. Look for what staff members are doing that contributes to patient satisfaction. Come prepared to share a story of a best practice you’ve seen during the week.”

Her staff lit up as they shared examples, and instead of seeing the staff themselves as problems, she was able to clearly see their actions as possibilities. They had discovered real experiences the team could build on. By amplifying what was already working, the team created practices together that they could replicate consistently. Patient satisfaction scores rose steadily. Even more importantly, staff engagement increased, and the culture shifted from burnout to pride. (You can learn more about Alisha's story starting on page 13 in Conversations Worth Having: Using Appreciative Inquiry to Fuel Productive and Meaningful Engagement, 2nd edition)

Three ways nurse leaders can create shared understanding:

1. Start with a question, not a directive.
   Before setting expectations, try asking:
   “What does success look like for all of us on this shift?”
   “When have we worked together at our best, and what made that possible?”
2. Blend metrics with meaning.
   Quantifiable metrics matter as well as the stories and moments that shine a spotlight on meaningful outcomes. Holding both side by side creates goals people can measure along with a vision people can believe in.
3. Notice and name what works.
   When you see small wins, celebrate them out loud. These moments become the seeds for long-term cultural change.

Moving forward from silence to action in nursing leadership

In healthcare silence can be costly. Shared understanding, on the other hand, is energizing and protective—it guards against burnout, strengthens resilience, and lifts patient care.

The next time you feel a difficult conversation coming on, try starting with:
“What does success look like for all of us?”

You may be surprised how quickly silence turns into ideas, and ideas into action.

If you’d like to explore more stories and practices like these, you can find them in Conversations Worth Having. You can find other resources to turn any conversation into an opportunity for connection and success here.