Dr. Sunita Sah asked nurses in a large hospital what stopped them from speaking up about medical errors. They gave her two answers. They were afraid of the repercussions, and they had learned that speaking up changed nothing. Then she asked their managers the same question. The managers did not name fear or effectiveness. They said the nurses were not taking responsibility, and did not have the skill set. Same floor, two completely different stories.

That gap is why near misses go unreported in your plant.

Sunita is a physician turned organizational psychologist, a professor at Cornell, and the author of Defy, a USA Today national bestseller. She joins Trevor to talk about insinuation anxiety, the reason we go quiet because speaking up would imply someone else is wrong, and about the piece almost every plant skips. We train for safety and we never practice the conversation. As she puts it, under duress you do not rise to the level of your expectations, you fall to the level of your practice.

Trevor tells the story of a termination he carried out because he did not say no, and it is still the worst one of his career.

Her line to sit with: compliance might be our default, but it is not our destiny.

Defy is available in hardcover as Defy: The Power of No in a World That Demands Yes and in paperback as Defy: How to Speak Up When It Matters. Find Sunita at sunitasah.com.

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