The Distance a Voice Can Travel

The part I keep coming back to

Think about a nurse who brings a concern to a meeting. She's thought about how to say it. She knows everyone is busy, and she doesn't want to make the work harder. But something needs attention, so she says it.

Someone listens. Maybe they agree. And then she goes back to the same assignment, with the same concern, not knowing whether anyone else is going to do anything with it.

That's the part I keep coming back to. We can encourage people to speak up, teach them how to have difficult conversations, and tell them their voice matters. But what have we made possible on the other side of that invitation?

I'm not assuming the person who listened doesn't care. They may be carrying their own version of the same problem: responsibility for something they don't have enough time, support, or authority to change. I want to understand what happens between those people, and what the organization makes possible for both of them.

Why I keep thinking about myelin

Myelin is the wrapping around many nerve fibers that helps electrical messages travel efficiently. The fiber carries the message, and the wrapping helps create the conditions for it to move (Harry and Toews).

That relationship caught my attention. I began wondering about the support around a person's voice: the relationships, the time, the permission to name something difficult, and the practical ability to do something once it's been named.

I'm calling this the Myelination Theory of Collective Healing. It's something I'm developing, not something I'm presenting as settled. An organization isn't a nervous system, and I don't need it to be one. The analogy helps me look at what surrounds the message instead of looking only at the person trying to deliver it.

What if we stayed with that a little longer? Before we asked someone to be more confident, more resilient, or better at communicating, what if we followed what they'd already tried to tell us?

What the wrapping means here

I mean ordinary things, although they don't always feel ordinary when they're missing. Someone covers your patients so you can participate. The council has the information it needs and the authority to make the decision in front of it. A leader says they'll find out, and comes back when they said they would.

I mean being able to disagree without wondering what it will cost you. Knowing where a concern goes next. Receiving an honest explanation when something can't change, rather than being left to decide whether anyone remembered.

There's a relational part and a practical part, and I don't think we can separate them very far. A kind conversation matters. So does having enough people on the next shift. Being invited into a decision matters. So does whether your participation can actually affect it.

This is where individual and collective healing begin to meet for me. We can support a person in what they're carrying and still ask why so much of it has been left for them to carry. One doesn't take the place of the other.

The four states

As I've worked with this idea, I've found it helpful to distinguish four different conditions. Something that was never built asks something different of us than something that worked once and was taken away.

You may recognize a team, a particular relationship, or a part of your own experience. These aren't labels for people. They're places to begin looking together.

State One Nothing was ever wrapped People find ways to speak. There isn't a dependable place for what they say to go. Read more + Close −

Sometimes we go looking for what broke and discover that the thing we needed was never really there. There wasn't an agreed place to bring the concern, someone responsible for receiving it, or a way to know what happened afterward.

People still try. They catch someone in the hallway, stay after a meeting, or ask the colleague who seems to know how to get things done. Sometimes that works, which can make the missing structure harder to see.

But what happens when that colleague is off? What happens on nights, or when the person raising the concern is new and doesn't yet know who to ask? I'd want to understand how much depends on knowing the right person rather than having a way that's available to everyone.

You might recognize this

• The answer to “Who do I take this to?” changes depending on who you ask.
• A concern moves only because someone keeps following up.
• A supportive manager wants to help but has no clear way to take it further.

The first work is to build something dependable: a place to bring the concern, someone responsible for the next step, and a way for an answer to come back.

State Two It was wrapped poorly The meetings happen and the minutes are taken. What people brought into the room is still waiting. Read more + Close −

Here, there may be plenty of structure. There's a council, a charter, a survey, a committee. People can point to the places where participation is supposed to happen.

And still, the same concern comes back. The council can discuss it but can't decide anything about it. The people who need to be there can't leave their assignments. The information arrives after the decision has already been made.

I wonder what it's like to keep being invited to contribute under those conditions. At some point, declining another invitation may tell us something about the invitation, not just about the person declining it.

I'd want to ask what people expected would happen when they participated, and what actually happened. That space between the two is worth our attention.

You might recognize this

• Staff are asked for input after the meaningful decisions have been made.
• The same issue appears in meeting minutes month after month.
• Participation means doing the work on your own time or leaving someone else short.

The work may be to make what already exists capable of doing what it promises: real decisions, enough time, practical support, and someone who follows through.

State Three It was wrapped once, then stripped People remember when it worked differently. That memory belongs in the conversation. Read more + Close −

There was someone who came back with an answer. There was time set aside, and it stayed set aside even when the week got difficult. People remember being able to bring something forward without having to start over every time.

Then a leader left, a department changed, or staffing became tighter. Perhaps no one decided to take the support away. It was simply one of the things that didn't survive everything else that was happening.

From the outside, the quiet that follows might look like people have stopped caring. I'd want to know whether they've stopped expecting a response. Those aren't the same thing.

And the loss may not have happened to everyone in the same way. A person can lose their place in a team while the team continues to describe itself as welcoming. We need room to hear that difference without requiring someone to tell more of their story than they choose.

You might recognize this

• People describe a particular time when concerns were taken forward and answered.
• Someone who used to participate now says very little.
• A new initiative is introduced without acknowledging what happened to the last one.

I'd begin by acknowledging what was lost and listening to what it meant. Then we'd need to change something real, rather than ask people to trust another beginning on its own.

State Four It is being wrapped again Something is beginning to work differently. People are noticing, even if they're not ready to trust it yet. Read more + Close −

Maybe it begins with a small concern that receives a different response. Someone takes responsibility, does what they said they would do, and comes back. The person who raised it doesn't have to chase them.

Or a meeting is finally covered, so being there doesn't mean leaving a colleague with more work. A decision is opened to the people who will live with it. A leader acknowledges something that everyone knew had happened but no one had named.

I wouldn't expect one experience to undo a long history. People may notice the change and remain cautious. They may need to see what happens when staffing is tight, when there's disagreement, or when keeping the commitment becomes inconvenient.

That's part of the work too. We can make room for hope without asking people to set aside what they've learned.

You might recognize this

• A concern receives an answer, including an honest explanation of what can and can't change.
• Time and coverage are provided rather than participation being added to a full workload.
• Someone who had become quiet chooses to try again, without being pressured.

The work is to keep going: keep the commitment, notice who still isn't included, and let people discover through experience whether the change will hold.

What happens between us

What interests me isn't simply whether a message gets from one place to another. It's what happens to us in the exchange. Can I bring something I don't yet know how to solve? Can you receive it without having to defend yourself immediately? Can we stay with it long enough to understand what each of us needs in order to act?

That doesn't mean every conversation ends in agreement. Sometimes the answer is no, or not yet, or we need something we don't currently have. But there's a difference between being disappointed by an answer and being left with no answer at all.

I think this is part of what repair asks of an organization. Acknowledgment matters, and so does the next assignment, the next decision, the next time someone needs help. The conversation and the conditions around it have to begin telling the same story.

For me, that's where this becomes more than a communication question. It's a question about how we care for one another while doing work that carries responsibility for other people's lives.

We can begin with one concern

We don't have to decide which state describes your whole organization. We can begin with something specific: a concern that keeps returning, a council that can't move a decision, or a team that remembers when asking for help felt different.

We can follow what happened. Who heard it? What were they able to do? Where did it stop, and what did the person who raised it have to do next? Then we can ask whose experience is missing from that account, including people on other shifts or in roles with less access.

That's the kind of conversation I mean by From Concern to Conditions. Thirty minutes, at no cost, with nothing to prepare. We work with what you're noticing, without needing identifiable patient details or anyone's private history, and you leave with a board that belongs to you whether or not we work together again.

What comes after that depends on what we find. I'd rather understand that with you than assume another program is what you need.

Explore the ways we can work together

Still working this out

I'm still learning what this analogy helps me see and where it stops being useful. I want to leave room for that, and for what people might recognize in it that I haven't considered.

Maybe part of the work is learning to notice what we've been asking people to carry on their own. And then being willing to change how we carry it together.

Read the Theory writing