How to speak up — even when you don’t want to | Sarah Crawford-Bohl

Summary

TED Talks Daily: Episode Summary

Title: How to Speak Up — Even When You Don’t Want To
Speaker: Sarah Crawford-Bohl
Event: TEDxRRU Royal Rhodes University, Victoria, Canada
Release Date: April 25, 2025

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Introduction

In the insightful TED Talk titled "How to Speak Up — Even When You Don’t Want To," healthcare executive Sarah Crawford-Bohl delves into the challenges of voicing concerns in uncomfortable situations. Drawing from personal experiences and professional insights, Sarah offers a compelling case for overcoming the instinct to remain silent, especially in high-stakes environments like healthcare.

The Struggle with Silence

Sarah begins by addressing the common tendency to remain silent during difficult interactions. She states:

“Silence? It can be a needed moment of peace and contemplation. But what happens when silence becomes a barrier, a barrier that muffles the voice of truth, of advocacy, of change?” (02:44)

This highlights the fine line between healthy contemplation and detrimental silence that obstructs necessary dialogue.

Consequences of Silence in the Workplace

Sarah references research from VitalSmarts, emphasizing that many individuals prefer to quit their jobs rather than confront challenging situations (06:15). She explains how this reluctance to engage can be especially harmful in healthcare settings, where effective communication directly impacts patient care and team performance.

“In a world where we are experiencing increasingly rapid cycles of change, we can expect difficult conversations, particularly in the workplace, to happen more often than ever before.” (05:37)

Benefits of Speaking Up

Contrary to the fears associated with speaking out, Sarah underscores the positive outcomes of doing so. She notes that voicing concerns leads to:

• Increased job satisfaction
• Enhanced team morale
• Improved patient outcomes

“When we do speak up, we experience more job satisfaction, increased team morale, and in my world, support better patient outcomes.” (09:12)

Developing Courage and Confidence

Acknowledging the difficulty of speaking up, Sarah likens the process to physical exercise:

“It's a bit like cardio or weightlifting. Well, we feel a bit vulnerable at the time. With practice, we start to experience the benefits, it gets easier and we get better at it.” (10:45)

This analogy serves to reassure listeners that courage can be cultivated through repeated practice.

The Moral Compass Framework

A significant portion of Sarah’s talk revolves around the "Moral Compass" framework she developed, inspired by her late mother—a dedicated intensive care nurse. This framework consists of four key principles:

1. North - North Star:
   Represents guidance towards doing what is right.

   “North Star. What was the good and right thing to do?” (13:22)

2. Support (South):
   Emphasizes the importance of mutual support in conversations.

   “South, Support. When people support me, I feel seen, cared for.” (13:55)

3. Empathy (East):
   Encourages understanding others’ feelings to create a safe communication space.

   “East stands for empathy. Empathy sets the tone for a conversation.” (14:10)

4. Wonder (West):
   Promotes curiosity and active listening before responding.

   “West stands for wonder. Getting curious about what might be going on for the other person.” (14:25)

Practical Application: A Personal Story

Sarah shares a poignant personal anecdote to illustrate the effectiveness of her Moral Compass:

“I was in a change management and communications role for a big project... One day, a physician came into the office... Who is the cheerleader sending out this stuff? ... I needed to own my work, take the feedback. So I said, that would be me.” (11:30)

Despite initial embarrassment, Sarah utilized her framework to navigate the confrontation respectfully. By employing support and empathy, she transformed a potentially negative encounter into a constructive dialogue, ultimately leading to mutual understanding and improved communication.

Paying It Forward

Concluding her talk, Sarah emphasizes the ripple effect of courageous conversations:

“We can be a powerful instrument of change and advocacy, leaving all people involved stronger as a result.” (14:50)

She encourages the audience to adopt the Moral Compass framework to not only find their own voices but also to foster environments where others feel empowered to speak up.

Conclusion

Sarah Crawford-Bohl’s TED Talk serves as a vital reminder of the power and necessity of speaking up, even when it feels daunting. By introducing the Moral Compass framework, she provides a tangible method for individuals to navigate challenging conversations with confidence, empathy, and curiosity. Her message is particularly resonant in high-stakes fields like healthcare, where effective communication can significantly impact outcomes and foster a healthier, more collaborative workplace.

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Notable Quotes with Timestamps

• On Silence as a Barrier:
  “Silence? It can be a needed moment of peace and contemplation. But what happens when silence becomes a barrier, a barrier that muffles the voice of truth, of advocacy, of change?” (02:44)

• On the Necessity of Difficult Conversations:
  “In a world where we are experiencing increasingly rapid cycles of change, we can expect difficult conversations, particularly in the workplace, to happen more often than ever before.” (05:37)

• On Benefits of Speaking Up:
  “When we do speak up, we experience more job satisfaction, increased team morale, and in my world, support better patient outcomes.” (09:12)

• On Developing Courage:
  “It's a bit like cardio or weightlifting. Well, we feel a bit vulnerable at the time. With practice, we start to experience the benefits, it gets easier and we get better at it.” (10:45)

• On the Moral Compass Framework:
  “North Star. What was the good and right thing to do?” (13:22)
  “South, Support. When people support me, I feel seen, cared for.” (13:55)
  “East stands for empathy. Empathy sets the tone for a conversation.” (14:10)
  “West stands for wonder. Getting curious about what might be going on for the other person.” (14:25)

• On Empowerment Through Dialogue:
  “We can be a powerful instrument of change and advocacy, leaving all people involved stronger as a result.” (14:50)

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Final Thoughts

Sarah Crawford-Bohl’s presentation is a powerful blend of personal narrative and actionable strategies. Her emphasis on a structured approach to communication provides valuable tools for anyone looking to enhance their ability to speak up effectively. By fostering environments where difficult conversations are approached with empathy and curiosity, Sarah advocates for stronger, more resilient teams capable of navigating the complexities of today’s fast-paced world.

Transcript

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[Elise Hu]

You'Re listening to TED Talks Daily, where we bring you new ideas and conversations to spark your curiosity every day. I'm your host, Elise Hu. Why is it that for so many of us, silence in the face of an uncomfortable interaction feels like the easier path forward, even when we're dying to speak up? In her talk, healthcare executive Sarah Crawford Bohl shares why we often struggle with confidence in challenging situations and offers steps for finding the courage to lean into tricky conversations.

[Sarah Crawford Bohl]

Silence? It can be a needed moment of peace and contemplation. But what happens when silence becomes a barrier, a barrier that muffles the voice of truth, of advocacy, of change? Speak up. Advocate for yourself. Stand up for what you believe in. That's what they say, right? Well, even though I know they're right, it's easier said then done. I'm sure we can all think of a time when we faced a crossroads. Perhaps the precipice of an uncomfortable conversation, when speaking up felt like the right, if not even essential, path. But silence seemed safer. I can vividly see and feel myself being in those moments, times when I stood red faced, embarrassed or offended, frustrated or angry, with a sinking feeling in my stomach, unable to find my voice and unsure if I had the courage, confidence or will to face the difficult conversation before me. Sound familiar? We're not alone research from VitalSmarts, a global leader in organizational performance and leadership, tells us people would rather quit their jobs than address a challenging situation. In this post pandemic time with baby boomers retiring and a wave of quiet resignation upon us, the world seems to be working short staffed now. I'm a nurse and have worked in healthcare leadership for a long time and I'm here to tell you in this profession we can't risk losing anyone, especially not for the reason of avoiding a challenging conversation. In a world where we are experiencing increasingly rapid cycles of change, we can expect difficult conversations, particularly in the workplace, to happen more often than ever before. Moments such as sharing feedback, identifying mistakes, or calling out disrespect. They're not always easy, but often critical to the performance of both individuals and a team. In healthcare where stakes are high, our willingness to raise concerns can be vital to the quality of care we provide, but also to the safety of patients and the care team. In fact, research also tells us that when we do speak up, we experience more job satisfaction, increased team morale, and in my world, support better patient outcomes. I've experienced this for myself. Now I don't have all the answers and I don't always get it right. In fact, I I make a mess of it sometimes, but often I've found it's a bit like cardio or weightlifting. Well, we feel a bit vulnerable at the time. With practice, we start to experience the benefits, it gets easier and we get better at it. We need to find a path to help us get past that initial fight, flight or freeze response to get us to the table and make leaning into uncomfortable conversations the desired action for our own benefit as well as to benefit those around us. Now, I was fortunate. I had some amazing role modeling by parents who encouraged me to use my voice specifically when I knew I should but didn't want to. My mom, an intensive care nurse for many years Had a special ability to address tough topics, traumas, embarrassing bodily functions or sharing critical feedback. She always created airtime for normally avoided matters with a fierce moral compass that was sometimes incredibly frustrating. She advocated for what was right, showing me the importance of standing up for oneself and others, even when uncomfortable to do so. My mom, she died a long time ago now and I still miss her desperately. Something I think I miss the most though, is her always knowing the right thing to do and the way she guided me with that moral compass. And despite having a couple of degrees under my belt, lessons learned from that moral compass, they guide me more than any of my formal learning. She showed me that as leaders, and I mean all leaders, both formal and informal, we play a pivotal role in leaning into courageous conversations and creating a safe place for others to do the same. There's probably your strong commitment in this area that inspired me to go into healthcare leadership, a path that often puts me in an area of high conflict and tricky conversations, but in doing so exposes me to innovation, change making and meaningful work. It's an incredible career that I'm honored to be a part of and I owe it to my mom and myself to do it well. So when I find myself needing courage and confidence, making that momentous step into the abyss of a difficult conversation, I try to remember my mom's moral compass and the principles she worked so hard to nurture in me. I imagine holding a compass in my hand, the cool metal upon my skin, taking a breath, a moment to pause and ground myself. I see the directions of north, south, east and west as symbols, reminders of her core teachings. North. I think about the North Star, a guide towards the good and right thing to do in tricky situations. I remember my mom's voice. Be the best version of yourself. Take the high road. Say what needs to be said. Sotheby the S in self reminds me of support. When people support me, I feel seen, cared for. When it comes to supporting others, I try to do the same. Leaning into tricky conversations with kindness and an intention of helping people grow. And East. The east stands for empathy. Empathy sets the tone for a conversation. As a leader, I want people to feel safe coming to me. I try to understand their feelings and create a safe place for them to be themselves. And West. The W stands for wonder. Getting curious about what might be going on for the other person. I ask questions and listen so I understand before trying to be understood. When I focus on the principles of the compass, I'm able to move from reactive to proactive. Getting into a mindset where I can be true to my values and share my voice. I recall a situation not long ago where I was able to put the compass to use. I was in a change management and communications role for a big project, and while the work was complex and bumpy, I was proud of myself. I was writing good stuff, inspiring hearts and minds. Or so I thought. One day, a physician came into the office where I was meeting with my boss, my boss's boss, and a number of other leaders. He had one of my newsletters printed out and was waving it in the air. Who is the cheerleader sending out this stuff? As an optimist, sometimes to a fault, I knew right away that cheerleader was me. While I was embarrassed, I had a split second to stay silent or speak up. The compass came in handy in that moment. North Star. What was the good and right thing to do? Well, I needed to own my work, take the feedback. So I said, that would be me. He lowered his arm and said, well, this is too positive. Not an accurate representation of what we're going through. While still defensive, I remembered support and empathy. I wanted to create a safe place where he could feel seen and heard. So I suggested we sit down together so I could better understand his concerns. Next step Wonder. We went to his office and I asked curious questions, and over some tea, he told me his story. He got out a red pen and circled the nine times I'd mentioned something positive in that article. I acknowledged it was too many, understandably devaluing. I then asked if we could look for times I'd mentioned challenges, to his surprise and, frankly, my own. 18 times 18. I'd mentioned things that needed to be fixed. I was able to let him know I was embarrassed by being called out in front of my superiors, and he apologized. You know that time spent together, it was valuable for me, and I think we both took something meaningful away. So I always remember the moral compass. North, North Star. South, Support. East, Empathy. And West Wonder. I know when I'm true to my compass. I'm courageous, confident, the person I want to be and I think the daughter my parents would be proud of. And with my husband and our two daughters, I get the chance to pay it forward. So I hope you'll join me in leaning into tricky conversations, not only finding our voices, but understanding the imperative to use them. Stand up against the wrong, champion the right, and be the voice for those who cannot speak for themselves, no matter how shaky or unsure. We can be a powerful instrument of change and advocacy, leaving all people involved stronger as a result thank you.

[Elise Hu]

That was Sarah Crawford bowl at TEDxRRU Royal Rhodes University in Victoria, Canada in 2024. If you're curious about Ted's curation, find out [e-mail] curationguidelines and that's it for today's show. TED Talks Daily is part of the TED Audio Collective. This episode was produced and edited by our team, Martha Estefanos, Oliver Friedman, Brian Greene, Lucy Little, Alejandra Salazar and Tonsika Sarmarnivon. It was mixed by Christopher Faizy Bogan. Additional support from Emma Tobner and Daniela Balaurazo. I'm Elise Hu. I'll be back tomorrow with a fresh idea for your feed. Thanks for listening.

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