LAUSR

AIM We aimed to highlight some salient thoughts regarding the importance of addressing the challenges nurses face when speaking up, particularly in situations involving power, hierarchy, fear and threat, and boost scientific and professional debates around this timely topic, starting from the qualitative article published by Abrams et al. (Journal of Advanced Nursing; 2023). BACKGROUND Although acknowledging the contribution of nurses to patient care and their ability to detect and manage potential safety hazards through observations and insights, nurses may encounter challenges in expressing their concerns, particularly in situations that involve power dynamics and hierarchical structures. In this regard, Abrams et al. (Journal of Advanced Nursing; 2023) studied nurse challenges in speaking up during COVID-19, identifying key elements related to speaking up, consequences and responses. Discussing this topic may aid scientific and professional debate. DESIGN Commentary on a qualitative design performed with a social constructionist approach to critically evaluate how nurses spoke up during the COVID-19 pandemic and the resulting outcomes. METHOD Searching for relevant literature to support acknowledging and addressing obstacles nurses face when expressing concerns by speaking up and promoting scholarly and professional discussions on this topic. FINDINGS The challenges faced by nurses when speaking up during the COVID-19 pandemic might reflect broader social, cultural and academic trends: power dynamics, hierarchical structures, deference to authority in healthcare organizations and a lack of attention to nurses' experiences in the literature can make it difficult for nurses to raise their concerns. CONCLUSION Creating a supportive environment that values nurses' perspectives can help healthcare organizations tap into their knowledge and make data-driven decisions leading to better patient outcomes, job satisfaction and organizational performance. Effective policies, best practices and research are necessary to understand nurses' experiences in speaking up and designing strategies to create healthy work environments.