Nursing, safety, and rebuilding trust
Safety in healthcare starts with people—their voices, their experiences, their leadership. Technology and innovation will accelerate progress. But achieving zero harm requires investing in those closest to care delivery. It means investing in nursing.
Nurses are both central to the patient experience and critical to safety and quality. Yet too often they’re left navigating an increasingly complex landscape without adequate voice, visibility, or support. That disconnect puts care quality, workforce well-being, and trust at risk. Across generations and roles, nurses are asking to be seen as partners in transformation. A call for purpose, and a professional environment that matches the demands and the dignity of their work.
New data in Press Ganey’s "Nurse experience 2025” report delivers a clear message: Nurses are ready to lead real change. And the organizations that meet nurses where they are will deliver safer care, build stronger teams, and, ultimately, realize better outcomes.
No physical safety without psychological safety
Safety culture is built through the relationships and routines that define daily practice. Nurses are uniquely positioned to shape that culture. They create the conditions where compassion, trust, and psychological safety can take root—and flourish.
Psychological safety is the foundation of high-performing, high reliability teams. In psychologically safe environments, caregivers feel confident raising concerns, sharing ideas, and learning from mistakes without fear or blame.
But we’re seeing signs that safety culture is slipping. Only 74% of employees say mistakes are treated as learning opportunities—a decline from 77%—pointing to an erosion of psychological safety and trust in the systems meant to support them. To reverse this trend, we must strengthen the everyday practices that build trust—and act quickly when that trust is put to the test.
Because when nurses feel empowered to speak up for safety without fear of repercussions—when they have the resources they need and the respect they deserve—outcomes for patients and their care teams improve.
Teamwork as a safety lever and retention strategy
Teamwork has emerged as a powerful driver of safety, patient experience, and retention. Care units where nurses report strong teamwork consistently see better clinical outcomes and performance on key safety indicators:
- 80% more likely to be in the top quartile for preventing pressure injuries
- 70% more likely to reduce central line infections (CLABSI)
- 3x more likely to excel in preventing falls with injury
Strong teamwork among care teams also translates directly to a better patient experience. When collaboration is high, patients "Likelihood to Recommend” (LTR) increases by:
- +9.23% when nurses report a strong safety culture
- +7.79% when nurses report adequate resources and staffing
- +6.12% when nurses report strong interprofessional relationships
- +5.99% when nurses report having autonomy in their role
In other words: When nurses thrive, safety and a culture of excellence follow.
Social capital as infrastructure for safety
Too often, we treat safety as a standalone initiative. But the foundation of safety is social capital—i.e., the trust, connection, and collaboration that let teams operate with agility and thrive under pressure.
Social capital is built in moments. How leaders respond to feedback. How conflict is navigated. How people show up for one another. It’s what determines whether someone raises concerns or remains silent—and whether a new hire feels like they belong or questions their choice. And it's what allows high reliability to take root across teams and settings.
Listening to lead
We don’t need more top-down directives. We need leadership that’s present and curious, responsive and proactive. Nurses thrive when their leaders walk the floor, close the loop on feedback, and create room for decompression as well as purpose. Rounding for safety, safety huddles, and shared governance are proven tools for trust-building and resilience.
Investing in nurse managers, early-career leaders, and interprofessional team dynamics delivers measurable returns in retention, quality, and financial performance. Culture isn't a soft metric. It’s a core driver of outcomes, and must be embedded into leadership development, operational strategy, and system design.
A blueprint for nurse-led transformation
The good news is nurses are ready to drive the change they need. What they need now are structures that amplify their voice, align with their values, and unlock their full potential to lead safer, more equitable care.
- Invest in leaders as culture builders. Leadership is about presence over hierarchy. Showing up when it matters. Safety huddles and purposeful rounding create daily opportunities to strengthen trust.
- Co-create with nurses. Shared decision-making isn’t an extra step—it’s foundational to better outcomes. Nurses and APPs bring critical insight and expertise, but too often they’re asked to execute, not contribute. Co-creating with them shifts the dynamic from compliance to collaboration—and that’s where real change begins.
- Redefine resilience. Supporting decompression, recovery, and purpose is how we sustain a workforce that wants to stay—and lead. And real resilience is about creating the conditions where people can heal, grow, and do their best work together.
Safety, equity, and workforce well-being are deeply interconnected—and nurses are essential architects of all three.
We have an opportunity to design systems that prevent harm and elevate joy in work. To not just keep nurses, but to build cultures where they stay with pride and purpose.
Download “Nurse experience 2025” for more insights, or reach out to a member of our safety team.