When nurses feel safe with their supervisor, they are more likely to report medical errors – creating a stronger commitment to safer practices and lower future error rates, study results suggest.

Deirdre McCaughey, PhD, an assistant professor of health policy and administration at Penn State and colleagues looked at whether the leadership actions of head nurses were aligned with the verbal expectations conveyed to their staff nurses, in order to better understand the relationship between what nurse supervisors say and what they do, and how that affects their staff. The study was published in the Journal of Applied Psychology.

Specifically examining the potential conflict between enforcing strict safety protocols and the need to admit to errors, the researchers administered surveys to 54 nursing teams made up of a head nurse and at least three staff nurses at four hospitals in Belgium.

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Participants were asked to agree or disagree with certain statements, such as “my head nurse always practices the safety protocols he/she preaches,” and if you make a mistake on this team, it is often held against you,” which were designed to examine the head nurses’ behavioral integrity, as well as the psychological safety felt by staff nurses.

When nurse supervisors had spoken expectations that matched their commitment to safety, their teams had a stronger commitment to acting safely in practice as well as a greater rate of reporting medical errors that did happen, the researchers found.

“These results suggest that although adhering to safety protocols and admitting mistakes against those protocols show opposite relations to reported treatment errors, both are important to improving patient safety and both are fostered by leaders who walk their safety talk,” they wrote.


  1. Hannes L et al. J Appl Psychol. 2012; doi: 10.1037/a0030076.