As leaders, one of the most challenging yet rewarding skills we must develop is having courageous conversations with our employees. These are the conversations we dread—the ones that make our stomachs flip. But when we avoid these discussions, we trade short-term discomfort for long-term dysfunction.
Diane Salter, one of our brilliant consultants at the Healthy Workforce Institute, recently shared her strategies for tackling tough talks during a live call with our team champions in our Department Culture Change Initiative program. Her expertise in fostering respectful workplaces inspired this post, and I’m excited to share her insights with you.
Why Courageous Conversations Matter
When we avoid tough conversations, we enable a culture of dysfunction, gossip, and toxicity. Studies have shown that incivility and unresolved conflict in healthcare can hinder relationships, clinical performance, and ultimately patient care.
As Diane shared during the call, courageous conversations are high-stakes interactions where opinions differ, emotions run high, and relationships are at risk. Yet, these moments are critical for creating a healthy workplace culture.
Here’s the key takeaway: your team’s success often depends on how well you handle difficult conversations.
What Are Some Strategies for Handling Tough Talks and Having Courageous Conversations
Diane provided actionable strategies that leaders can implement immediately. Here are her top recommendations:
-
Self-Reflection is Essential
Before addressing a tough topic, take a moment to reflect. What’s making this conversation hard for you? Is it fear of confrontation? Worry about damaging the relationship? Clarifying your emotions and intent beforehand ensures you approach the discussion with focus and empathy.
-
Prepare Your Message
It is important to be clear on what you want to say. Write down your key points and anticipate potential reactions. Preparation helps you deliver your message confidently without getting derailed by emotions.
-
Open with Empathy and Assertiveness
Start the conversation by acknowledging the other person’s contributions or strengths. Then, calmly share your concern without using the word “but,” which can negate the positives. Diane recommends saying, “That’s why I’m concerned about…” and pausing to let the message sink in.
-
Stay Focused on Behavior, Not Personality
Instead of labeling someone as “mean” or “lazy,” focus on specific behaviors and their impact. For example, “I’ve noticed that during handoffs, there’s often incomplete information. This affects patient care and team efficiency.” This approach makes it easier for the person to understand and act on your feedback.
-
Create a Collaborative Plan
Involve the other person in creating a solution. Ask, “How do you see this? What steps can we take together to improve?” Engaging them in problem-solving fosters accountability and trust.
The Power of Courage
Every workplace interaction is an opportunity to build or erode trust. When you engage in courageous conversations, you demonstrate respect and care for your team, even when the message is difficult to hear.
Like Peter Bromberg says (Diane’s favorite quote):
“When we avoid difficult conversations, we trade short-term discomfort for long-term dysfunction.”
If we want to create a healthy workforce, we must lean into discomfort, address issues head-on, and lead with empathy and clarity.
Courageous conversations are hard, but they’re also necessary for cultivating a healthy work culture. Start small, be intentional, and use these strategies to tackle tough talks with confidence.



