Comment on Alhojairi et al. (2024) ‘Assessment of nurses’ workplace silence behavior motives: A cross-sectional study’

Dear Editor,

I am writing in response to the article “Assessment of nurses’ workplace silence behavior motives: A cross-sectional study” by Alhojairi et al. published in the September 2024 issue of the International Journal of Nursing Sciences [1]. This is a letter written by a nurse with 10 years of clinical work experience and a personal interest in team dynamics. I appreciate the authors' recommendations on mitigating workplace silence among nurses to enhance clinical work development, and I believe their proposals could be expanded further.

First, it is widely acknowledged that nurses with higher work engagement are more likely to contribute to workplace development. Involving nurses in decision-making processes increases their engagement, which, in turn, fosters commitment to the work community [2]. This process can be supported through mechanisms like anonymous feedback systems and encouraging respectful, open dialogue between management and staff, as proposed by Alhojairi et al. (2024) [1]. However, anonymous feedback often lacks credibility and influence compared to identified feedback [3]. Therefore, while anonymity has its place, it should not be over-relied upon.

As the authors discuss, nurses are traditionally perceived as conflict-averse, a trait that contributes positively to team dynamics [4,5]. However, as they note, this trait can sometimes lead to silence. Conflict avoidance, while beneficial in maintaining harmony, can impede a shared understanding of governance and administrative practices, ultimately affecting collaboration [6]. Despite this, nurses often demonstrate a strong willingness to learn and can benefit from training in providing respectful feedback, thus contributing to healthier team dynamics.

I agree with Alhojairi et al. suggestion for regular meetings where nurses can address critical issues related to their work environment and patient care. To effectively integrate nurse-driven decision-making into workplace practices, such activities must be integrated into shift planning to avoid increasing workloads unnecessarily, which could inadvertently perpetuate workplace silence. Feedback mechanisms such as polls and weekly meetings are helpful but must be supported by adequate resources. Structural adjustments are essential to ensure that nurses can balance daily clinical responsibilities with developmental initiatives. In addition, the recurrent workplace norm is that when proposing a solution, it automatically makes one responsible for implementing it. In workplace improvement, ideas from individual nurses create the foundation for development. However, the implementation should be a team effort, not an individual burden. Additional personnel and education may be necessary to facilitate these changes.

Perhaps one of the most sustainable actions regarding workplace silence behavior mitigation is adopting knowledge management in nursing. For instance, in the study of Mount et al. [7], they utilized the 8-Step Change Model to facilitate change. By using models for change, a few benefits are attained: The framework for development is clearly scoped. In addition, these models highlight stakeholder engagement rather than focusing on blame and negativity. Moreover, while informal feedback might promote alienation between individuals, the models foster teamwork and commitment. Negative feedback alone tends to highlight the problems without solutions, whereas the structured models center on the need for change and solutions. Structured change processes could also help engage short-term employees, who, as the authors note, tend to exhibit higher workplace silence. Further, participation should be an expectation rather than an option or a matter of self-confidence.

To address this, it may be beneficial to survey best practices from other organizations and involve new nurses in decision-making from the outset. Research suggests that some nurses prefer short-term roles to avoid workplace politics and complexity [8]. Engaging these nurses in visible decision-making processes could positively influence workplace norms and employee engagement. Nevertheless, changing attitude towards failure and mistakes, in general, strengthens supportive workplace behavior: Challenges should be normalized instead of seeing them as personal weaknesses; thus, impossible tasks, excessive workload, and ethical burdens should be seen as reflections of a dysfunctional system, not solely the failures of individuals.

Feedback dynamics also warrant attention. While positive feedback is easier to provide [9,10], constructive negative feedback is more likely to be exchanged in deeper, trusting relationships [11]. This underscores the importance of strengthening engagement and rapport within teams. Organizations should aim to balance discussions of positive and critical matters, as this encourages open communication and reduces workplace silence.

Finally, as organizations adopt more open and participatory approaches, middle management must be educated in fostering non-authoritative, inclusive leadership styles. Communicating these leadership changes clearly to staff is crucial to avoid confusion and passivity. Managers should also receive training to create non-judgmental work environments where critical feedback is not stigmatized, enabling nurses to voice concerns confidently.

In conclusion, Alhojairi et al. [1] have effectively identified the motives behind workplace silence and provided recommendations. I propose the following calls to action enhancements to support their findings:

• 1)Nurses should have both the opportunity and the resources to engage in workplace development, alongside a commitment to actively participate in these efforts.
• 2)To underpin this commitment, the workplace must provide an environment that is supportive, respectful and worthy of dedication.
• 3)Knowledge management strategies should be widely implemented across organizational levels.
• 4)Development efforts should focus not only on identifying areas for improvement but also on preserving and enhancing well-functioning processes.

Thank you for the opportunity to contribute to this important discussion. I look forward to further dialogue on nurturing open communication among nurses.

Funding

None.

Declaration of competing interest

The authors have declared no conflict of interest.