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On Leadership
LEADERS have the obligation to their people and the consumers of health care services to establish cultures of integrity. For patients, integrity means we are always accountable and truthful even when we have not done the right thing. For staff, it means always being accountable and truthful to each other and to hold those same standards for the community we serve.
However, cultures of integrity are difficult to develop and maintain. It takes tremendous courage to always do the right thing and act with integrity. Integrity is impossible without a highly developed sense of courage. It takes tremendous courage to tell a patient that something we have done has not gone as planned or to confront a peer with evidence of her drug or alcohol dependency. Cowards cannot always act with integrity. But courageous people can.
We all know what should be done in difficult situations. However, the right thing will not happen without a highly developed sense of courage and a culture that fosters and supports courage. Where there are dysfunctional levels of fear, courage cannot exist. Cultures of courage don't just happen, they are carefully planned and built. This is the leader's responsibility: to insure that integrity is fostered on the foundation of a culture of courage and an environment that drives fear out of the workplace.
Routinely, clinicians are faced with dilemmas and ethical issues that require high levels of courage to do the right thing. An addicted patient suffering from the withdrawal of pain medication will test the nurse's courage. Being with a patient who is dying a difficult death takes high levels of courage for the nurse. Advocating for the patient's right to die takes courage. And telling a mother the truth that her child received the wrong medication -- requires tremendous courage and a strong commitment to integrity.
It takes courage to stop a physician...