Avoiding a false sense of security

One of the most complex aspects of nursing leadership, in my experience, is truly understanding the quality, safety, and experience of the services we lead. This demands the cultivation of a safety culture–one that embraces openness and transparency to foster a learning environment and anticipate risks before they escalate. Such an approach should mitigate harm to individual patients or broader patient groups.

James Titcombe, a passionate advocate and advisor for patient safety, highlighted this issue in April 2025 following media coverage of a recent healthcare failure. He stated that the failure was:

‘More than just a tragic failing – it's a mirror held up to a deeper, persistent issue within our healthcare system, reflecting a culture where the primary concern is often not “what might be going wrong?” but “how can we show that everything is okay?”’

Titcombe (2025) reminded us of the influential work by Dixon-Woods and Martin (2023), who differentiated between ‘problem-sensing’ and ‘comfort-seeking’ behaviours, and called attention to the dangers of structural complacency and a reluctance to use both hard and soft intelligence in the pursuit of openness.