Samantha, a 23-year-old nursing student preparing for her first full-time job, knows she may someday need to advocate for a patient. She is less certain what to do when the problem involves a coworker, a supervisor, or the workplace itself.

During clinical training, Samantha has seen how stressful healthcare workplaces can become. Staff are sometimes stretched thin. People become frustrated. Someone may keep accepting more work even when they are clearly overwhelmed. And concerns that are discussed quietly among coworkers do not always get raised with the people who have the authority to address them.

Samantha wonders how she will respond as a brand-new nurse. What if she thinks a workload has become unsafe? What if she notices burnout or behavior that raises an ethical concern? Speaking up may be the responsible thing to do—but she worries about being seen as difficult before she has even established herself.

When should a new professional speak up, even if doing so could affect how others see them? How does someone learn to distinguish a serious concern from something they simply do not yet understand? And can employers expect new workers to show courage if the workplace makes speaking up risky?