As a surgeon, psychological safety is largely absent from my work environment. As we address the changing landscape of healthcare, what if we really embraced what this essential concept really means? We need to talk more about psychological safety in healthcare, as well as how it relates to moral injury in surgeons.
What is Psychological Safety?
Psychological safety is a feeling that one can be comfortable being oneself, and sharing opinions, concerns and mistakes without fears of shame, blame, or retribution. In essence, a psychologically safe workplace is an environment (or relationship) in which any healthcare professional, trainee, or team member is not afraid to speak their mind and offer honest feedback.
Why is Psychological Safety a Challenge?
Psychological safety has been recognized within areas of patient safety and quality improvement, but more difficult to integrate into medicine for several reasons. Traditionally, medicine (and surgery in particular) holds onto many aspects of hierarchy and professionalism that provide inconsistent protections for quality patient care and teamwork. We have made some progress in recent years with individual leaders and isolated organizations or teams integrating a balanced perspective on psychological safety versus quality of care. We still have a long way to go. Recent research suggests that work satisfaction is not necessarily about the challenges or stresses of a job, but rather the inability to talk about those challenges with a peer who provides psychological safety.
How to Create a Psychologically Safe Workplace
So how do we go about creating workplaces with greater psychological safety? For the most part, the onus is on those in leadership and supervisory roles to develop a work culture in which trainees, healthcare professionals and surgeons feel comfortable speaking their minds. Not every clinical or professional situation will feel safe, particularly given the complexity, uncertainty, and ambiguity of medicine, surgery, healthcare, and patient conditions.
To promote a psychologically safe workplace, healthcare leaders must create opportunities for team members to feel heard. One idea is to host regular “town hall” style meetings with team members and encourage them to offer constructive criticism and suggestions. We need to model constructive feedback and psychological safety as often as we can. Psychological safety exists when individuals feel comfortable taking calculated risks in the interests of patients, raise problems without fear of retribution, disagree but with mutual respect, ask questions to increase understanding, and admit mistakes that make us human.
Coaching and Psychological Safety
Coaching is another avenue to create a psychologically safe space. All too often we’re operating in silos with no one to bounce ideas off of or decompress from the stress and frustrations of the system. The moral injury we face from seemingly small transgressions can build up over time. While coaching can’t turn back the clock, a coach can listen empathically and offer a space to be heard and guide clients to manage moral injury.
Whether you have such a work environment or not, join the SurgeonMasters community which is a psychologically safe place for surgeons to talk and work on solutions.