Have you ever watched a team start to misfire and wondered, What happened?
The people are the same. The skills are still there. The commitment has not disappeared. The clinical expertise remains. And yet, somehow, misunderstandings are on the rise. Mistakes are happening.
Someone’s silence is interpreted as judgment. Someone’s urgency is interpreted as disrespect. Conversations feel more tense. A neutral comment lands as criticism. A brief response feels dismissive.
What’s happening?
Our brains are hardwired to perceive threat. And survive. Rapid fire, our senses are activated. We listen, look, touch, notice. In an instant, we interpret. We act — run, fight, get very quiet. These survival response strategies worked pretty well when it came to venomous snakes, leopards, and forest fires. Then wind down by the campfire with our tribe. Assuming we survived.
In the world most of us inhabit today, the stressors are of an entirely different nature. Exhaustion and psychological stressors are many. How will I get all of this work done? Will there be enough money to pay the bills? Are my children really okay? Is our country falling apart? The list goes on, as we all well know from our lived experience.
With a brain working at warp speed to process the next threat we perceive, under stress, we may not interpret the cues right every time. We can misread context, facial expressions, silence, timing, and intent.
The Same Team Can Function Very Differently Under Stress
In healthcare, we often look at team challenges through the lens of performance.
Did someone follow the process? Did the handoff happen? Was the patient updated? Was the task completed? Were the expectations clear?
Those questions matter. They are necessary. But they may not tell the whole story.
Under sustained pressure, the same team can produce very different outcomes. Not because the people have suddenly become less capable, but because stress changes how people process information and interpret each other.
A team that usually collaborates well may begin to feel guarded. A team that usually moves quickly and efficiently may begin to stumble over small misunderstandings. A team that normally gives each other the benefit of the doubt may start assuming negative intent.
That shift can be subtle at first.
No one comes in one day and says, “Our perception of each other has changed.” Instead, people start saying things like:
“She seemed annoyed.”
“He was short with me.”
“They don’t respect what we do.”
“I can’t say anything without someone getting defensive.”
“No one listens anymore.”
Sometimes these statements reflect real behavior that needs to be addressed. But sometimes they reflect the way our own stress response is filtering through the lens of all the large and small tense and difficult moments that we somehow survived — last time.
When people are under pressure, their attention narrows. Their nervous system scans for threat more quickly. They may hear irritation in a neutral tone or assume criticism where clarification was intended. They may interpret a delay, a facial expression, or a lack of warmth as evidence that something is wrong.
In other words, the facts of the interaction may be fairly simple. The meaning assigned to the interaction may be much more complicated.
And once meaning gets assigned, the human mind filters our further responses through that interpretation.
When Neutral Starts Feeling Negative
A manager, worried that he’ll get it wrong, asks a follow-up question — again — to clarify next steps. A team member hears, “You don’t trust me.”
A co-worker walks past a nurse without saying hello, absorbed in worries about her ailing parent. The anxious new hire thinks, “She didn’t say hello. She doesn’t like me.”
A nurse — who experienced a child dying last week — pauses before answering because she is thinking through the safest next step. The new resident interprets the pause as resistance.
None of these moments may be dramatic by themselves. But under pressure, small interpretations and misinterpretations accumulate. People start bracing for each other.
They become more careful, more guarded, or more reactive. They may stop asking questions because they do not want to “bother” anyone. They may avoid giving feedback because they expect defensiveness. They may pull back from collaboration because it no longer feels safe or easy.
This is one way good teams begin to misfire.
The problem is not always that someone said something clearly inappropriate. Sometimes the problem is that everyone is operating with less emotional margin. When that happens, neutral interactions can start to feel negative.
How This Shows Up Across Teams
Stress-triggered perception does not always look like open conflict. Sometimes it is quieter.
It may look like fewer questions being asked during handoffs. Less warmth between people who used to work well together. More side conversations. More assumptions. Less benefit of the doubt.
It may show up as disengagement.
People stop offering ideas. They stop volunteering. They do only what is required because participating more fully feels emotionally risky.
It may show up as conflict.
Small issues escalate quickly. People react to tone instead of content. Clarifying questions are interpreted as challenges. Feedback conversations become emotionally charged.
It may show up as turnover.
People may leave not because of one terrible event, but because the environment has started to feel tense, unpredictable, or personally draining. They may not even have language for what changed. They may simply say, “The culture is different now,” or “It’s not the same team anymore.”
And they may be right.
But the change may not have started with poor intentions or lack of professionalism. It may have started with a cascade of stress triggered reactions, one interaction at a time.
Over time and hundreds of interactions, unhelpful patterns of response among co-workers may start to feel like the “way we do things here,” negatively impacting unit culture. That’s a big topic for another day.
A Different Question for Leaders
When teams are struggling, it is natural to ask, “Who is not performing?”
Sometimes that is the right question.
But there is another question worth asking at the same time:
Is this really a performance problem, or has the stress we are all experiencing changed how this team is hearing and communicating with one another?
That question creates more room for curiosity. It does not excuse harmful behavior. It does not ignore accountability. But it does help leaders look beneath the surface, and lead in a different way.
In health settings, leaders are making huddles and check-ins a regular practice. It gives an opportunity to clarify, to explore a transaction that resulted in disagreement, and to simply ask “Did I get that right”?
It’s a solid step forward, but for many people experiencing stress and distress in the workplace and at home, especially early career care team members, huddles won’t be enough.
Self-care agency — an acquired ability — essential for sustaining professional efficacy and reducing risk of burnout
That is where psychological flexibility becomes so important.
Psychological flexibility is the capacity to notice what is happening inside us, when we are triggered, and choose a response that is more workable, especially in difficult moments.
It’s a learned capacity, which can deteriorate under persistent stress, but with exposure to evidence-based cognitive defusion strategies, this capacity can strengthen.
The science is well-established that the brain’s capacity to adapt, to be psychologically flexible, is protective of our resilience. Which in turn is protective against spiraling, negative stress responses, and burnout.
Good advice, and age-old tips about breathing and relaxing are not enough.
A number of studies have demonstrated that mindfulness-based approaches with nurses and clinicians resulted in lower stress and other positive change. We are glad to share citations with our readers on request.
Most healthcare workers do not have access to 1:1 or small group sessions with skilled clinicians, knowledgeable in leading methodologies (such as Acceptance and Commitment Therapy, Mindfulness-Based Stress Reduction, Cognitive Behavioral Therapy, and others), to increase psychological flexibility and self-care our resilience. This is part of the access problem StressPal was designed to address.
StressPal offers a multi-media, digital intervention that’s confidential and easy for health organizations to implement. It’s grounded in leading process-based and mindfulness methodologies. In just minutes a day, participants acquire skills they can use immediately and return to over time. At an experiential level, what we are hearing from health professionals is that these changes, in turn, are resulting in positive changes in communication, pausing before reacting, and catching oneself sooner in patterned stress behaviors that lead to overreacting.
Across care teams nationally, 97% of participants report they feel better able to defuse stress-triggered responses and communicate more effectively with others. It goes without saying that better communication, team-building, and patient care are supported by arming ourselves with the competencies we need to mindfully self-care our foundational resilience, as well as our physical well-being.
Because the goal is not simply to be calmer. We also want to stay connected, effective, and aligned with the values that brought us into the work in the first place.
If you are a healthcare leader noticing more tension, withdrawal, or miscommunication on your teams, it may be worth asking not only what is happening, but how What has worked so far in arming your co-workers and teams with best practices strategies for resilience self-care?
Connect with Pennie to learn more about how StressPal can support healthcare teams in building practical, science-grounded skills for resilience, communication, and values-aligned care.
Authored by Pennie Sempell, J.D, Co-founder and co-author of StressPal Frontline: Essential Resilience Self-Care and Burnout Intervention, an innovative professional development intervention specifically developed for healthcare and allied frontline workers.
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