Difficult conversations in the workplace


By Dani Yeomans | 29 January 2024

In the ever-evolving landscape of healthcare, navigating difficult conversations is essential. It requires a delicate blend of empathy and transparency. By embracing these conversations, healthcare professionals can contribute to creating adaptive learning environments. In this blog, you can read about the importance of timely, inclusive, and considerate communication, and how this helps promote a culture of continuous development.

Working amidst complexity

In the modern workplace, opportunities for impactful, challenging conversations crop up time and time again. Healthcare, sadly, will be no stranger to the need for these conversations, particularly when communicating information to patients and families with a compassionate and person-centred approach. It is no secret that in recent years the NHS system has been pushed to the edges of its capabilities and challenged in ways that were unexpected by many, not just throughout the covid pandemic but in the post pandemic world too. The NHS, along with many other public sector services, continues to recover and rebuild with the support of the skills and dedication of its people. Amid the turmoil, it has become clear that organisations and namely the people within them have little choice but to adapt and overcome hurdles that present themselves in a complex and dynamic environment.

Difficult conversations present themselves in all shapes and sizes, including but not limited to:

  • Giving effective feedback (peer, colleague, line manager or direct report).
  • Performance reviews.
  • Presenting new developments that affect others.

Consider the occasions where you have sat with the decision to either walk away or lean into tough conversations boldly and bravely. There will likely be a few times that you can recount, some that were avoided, others that went well and perhaps a handful that didn’t go as hoped. Nonetheless, adequately named, these necessary interactions can be difficult for both the persons initiating and receiving the message.

Why do conversations matter?

The act of preparing and engaging well in these conversations is a nuanced and often undervalued people and leadership skill that has the potential to influence employee experience and organisational culture. Research such as the recent meta-analysis of 30,000 plus workers by Katz et al., (2021) indicates the power of setting up these conversations well e.g., quality, delivery, and support. These factors can influence receptivity, levels of comfort engaging in conversation and how proactive an employee becomes in seeking feedback in the future.

At an individual level, these conversations can increase job satisfaction, engagement, psychological empowerment and decrease burnout and intentions of leaving a role. Whether these interactions are with colleagues or clients, they can provide a chance to build and enhance healthy working relationships. It is no surprise that this contributes towards healthy teams and organisations who are open to learning and shifting priorities in response to the ever-changing landscape.

How to approach a difficult conversation

Research suggests to us that receivers are open to these conversations when they perceive that the interaction was delivered by a credible source with quality in mind and in a considerate manner. Although, there is no one solution or panacea for approaching all difficult conversations, guidance can be adapted so that you maintain individuality and authenticity in your communication style. It is fundamental to recognise and respect diversity in our teams and organisations and to adopt an inclusive and person-centred approach.

  1. Act in a timely manner whilst also balancing the needs of the individual.
  2. Take into consideration individual preference for communication and apply this wherever possible. Prepare in advance.
  3. Create a psychologically safe environment (Edmondson, 2018)
    • Ensure that your environment is appropriate and confidential.
    • Role model integrity and be open about your own fallibility.
  4. Demonstrate compassion. Michael West emphasises Compassionate Leadership (West, 2020) in which leaders demonstrate empathy and understanding in their interactions.
    • Listen with curiosity to the perspective of the individual.
    • Summarise and reflect key points to ensure you have understood correctly.
  5. Be clear and transparent in your communication.
    • Get to the point using non-jargon, accessible language.
    • Illustrate with specific examples to enhance understanding.
    • Give the individual ample opportunity to ask questions and clarify their understanding to ensure alignment.
    • Share written communication as good practice and amend as appropriate to ensure accuracy.
  6. Offer support. This may look like:
    • Proactively setting time aside to discuss further, if helpful.
    • Inviting the individual to continue the conversation in the future.
    • Offering practical information or suggestions moving forwards.

Final thoughts

Challenging conversations may be tempting to avoid at work, especially alongside the pressures of the role and complex environment. However, the risk of choosing not to engage in difficult conversations can act as a vote for a culture that remains static and safe, whereby glazing over opportunities to identify areas for positive development and creative problem-solving— skills required to navigate the complexity and uncertainty of the modern world.

The more people across healthcare that can embrace and role model healthy developmental conversations, the more likely we are to promote learning cultures that can adapt to our environment.

Difficult conversations not only have the potential to enhance working lives but ultimately, in the case of healthcare, save lives too.

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Dani Yeomans is a Practice Consultant at Skills for Health bringing an Occupational Psychology perspective. She has a psychology background and experience across public and third sector organisations. As a certified coach, Dani has coached over 100+ emerging and established leaders from diverse backgrounds, focusing on wellbeing, impact, and culture change  


Edmondson, A. C. (2018). The fearless organization: Creating psychological safety in the workplace for learning, innovation, and growth. John Wiley & Sons.

Katz, I. M., Rauvola, R. S., & Rudolph, C. W. (2021). Feedback environment: A meta-analysis. International Journal of Selection and Assessment, 29, 305–325. https://doi.org/10.1111/ijsa.12350

West, M.A. (2020). Compassionate and Collective Leadership for Cultures of High-Quality Care. In: Montgomery, A., van der Doef, M., Panagopoulou, E., Leiter, M.P. (eds) Connecting Healthcare Worker Well-Being, Patient Safety and Organisational Change. Aligning Perspectives on Health, Safety and Well-Being. Springer, Cham. https://doi.org/10.1007/978-3-030-60998-6_13


Tam Whipp joins Skills for Health as a Technical Consultant 

Why the NHS Needs Workforce Planning More Than Ever 

Laura Schell appointed as Skills for Health Client Director 

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