Receiving Feedback
- naomi620
- Dec 26, 2025
- 3 min read
The Choreography of Care: Reimagining Feedback
In the hushed anticipation of the Sydney Opera House, watching the Australian Ballet rehearsal offers a revelation that feels almost foreign to the clinical floor. The dancers, elite athletes of their craft, move with precision. When the choreographer steps in, the music stops. The feedback is immediate, public, and incredibly specific.
Crucially, the dancers do not crumble. They do not retreat to the dressing room in tears, nor do they file a grievance about the tone of the correction. They simply nod, adjust their bodies, and the art improves instantly. For these professionals, feedback is not a weapon or a wound; it is the very oxygen of their excellence. It is the mechanism by which they achieve the dream they have chased since childhood.
Contrast this with the average Tuesday morning handover in an Australian hospital. A Nursing Unit Manager pulls a staff member aside: "Can I give you some feedback?" The physiological reaction is immediate and visceral. It is not the focused attention of the ballet dancer; it is the panicked scatter of prey. The heart rate spikes, the face flushes, and the "lizard brain" (amygdala) hijacks the prefrontal cortex. In healthcare, feedback has become synonymous with trouble—a "paper trail" for performance management, a prelude to a difficult conversation, or a "pebble in the shoe" that grinds away at morale shift after shift.
To shift this narrative, we must first understand neuroscience of how we receive feedback and identify our own feedback profiles.
To move from fear to psychological safety, we must recognize that everyone has a unique feedback profile determined by three key variables:
Baseline/Set Point: This is your "emotional home," or how you generally feel about your life. A low baseline can actually muffle positive feedback, making it harder to hear praise even when it is sincere.
Swing: This measures how far off your baseline a piece of feedback knocks you. A negative swing can distort or "supersize" the feedback, making you feel incompetent over a minor data point.
Residue: This is how long it takes for you to return to your baseline after the "swing". Some people bounce back in minutes, while others may feel the "residue" of a difficult conversation for days.
The Physiology of Feedback: Why It Hurts
Nursing is a profession of high identity; we don't just do nursing, we are nurses. This deep fusion of self and work makes feedback volatile, triggering the "Amygdala Hijack" or "Lizard Brain" on Shift
When a Nurse Unit Manager says, "I need to talk to you about the roster," or a medical director questions a decision in ED, the recipient’s brain does not immediately process the logic. Instead, the amygdala—the ancient "lizard brain" responsible for survival—scans for threat. Evolutionarily, being cast out of the tribe meant death by exposure or predation, leading to fight (defensiveness), flight (withdrawal) or freeze (cognitive paralysis). Today, professional criticism triggers the exact same neural circuitry. When a staff member is in lizard brain mode the prefrontal cortex - the centre of logic and patient safety- is offline.
The Tension of Two Core Human Needs
Underpinning this physiological storm is a paradox identified by Heen and Stone. We have two core human needs that are often at war during feedback conversations:
The Need to Learn and Grow: We want to be better. We want to be the "best possible practitioner," just like the ballet dancers. We crave mastery and competence.
The Need for Acceptance: We yearn to be loved, respected, and accepted exactly as we are, right now.
Feedback lands painfully at the intersection of these two needs. The suggestion that we need to grow implies that we are currently insufficient, which threatens our need for acceptance. Navigating this tension is the primary work of the "Better Every Shift" leader.
Many of the people providing us with feedback fail to appreciate how unhelpful vague feedback is and as we move into more senior roles the vagueness increases with terms like "be more strategic", or be a "better leader". These nebulous concepts sound great and yet when we hear them we don't know if that means shout more, listen more describe the detail more clearly or say less.
By being aware of our profiles and being specific about the feedback we need and asking for feedback more often, will improve the quality of feedback we receive and improve the willingness of our team to embrace feedback, provided we respond with humility, curiosity and a desire to be better.
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