When people hear psychological safety, they sometimes assume it means avoiding hard conversations or never holding anyone accountable - like making the workplace overly “cozy.” But that’s a misconception.

True psychological safety is about creating a culture where it’s okay to make mistakes and learn from them. It’s about building an environment where team members feel safe enough to speak up, ask questions, and take risks without fear of being punished, embarrassed, or ignored.

And here’s the catch: it’s rare.

Too many workplaces operate from a place of fear or silence. People may avoid sharing feedback or raising concerns, especially if they’ve learned that doing so leads to judgment or dismissal. But silence is not safety.  It is a breeding ground for burnout, resentment, and in some cases, serious consequences.

Take Wells Fargo, for example. Stretch goals led to unethical behavior because employees didn’t feel safe pushing back. They tried to speak up, but leadership didn’t listen. The result? Fake accounts, $3 billion in fines, and a massive loss of public trust.

Even in smaller organizations like private practices, the absence of psychological safety can be costly:  missed opportunities, poor decision-making, high turnover, and a culture that slowly erodes trust.

So, how do we create a culture where speaking up is the norm?

It starts with three ongoing actions:

1. Set the Stage:  Clarify expectations and acknowledge complexity. Let your team know that mistakes will happen and that the goal isn’t perfection, but continuous learning. Especially in healthcare, where decisions can carry weight, your team needs to know it’s okay to ask for help.
   
   

2. Invite Engagement:  Make space for input. Ask, “What’s your take?” or “What are we missing here?” Show that you value different perspectives, and then actually listen to them.
   
   

3. Respond Productively:  This is where trust is won or lost. If someone shares a mistake or concern and is met with anger, defensiveness, or silence, that’s probably the last time they’ll speak up. Respond with curiosity and grace. Model what it looks like to own your own mistakes.

Psychological safety and trust are deeply connected. Without one, the other can’t flourish. If your team isn’t asking for help or giving honest feedback, it may not be a people problem - it might be a culture problem.

Reflection Question: Does your team feel safe asking for help or admitting mistakes? If not, what needs to change?

References

HBR IdeaCast - Creating Psychological Safety in the Workplace

Edmondson, A. C. (2018). The fearless organization. John Wiley & Sons.