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THE LEADERSHIP ACADEMY

Have the courage to challenge others

  • 11 Comments

Stand up for your beliefs and values and you’ll improve care and gain peace of mind

One of the main qualities a leader must possess is courage. It is not by chance that one of the chief nursing officer’s 6Cs in the Compassion in Practice strategy is courage and it is a core value of my own organisation.

For nurses with true leadership qualities, this will include having the courage to challenge people when they see wrongdoing. It is about showing that there is another way to do things, thinking in extraordinary ways and finding solutions to challenges.

If you think that doesn’t sound like you, well, most people are ordinary and ordinary people only become extraordinary through their actions.

To speak out when you see something that is unkind, unjust or plain wrong is not extraordinary - it is the right thing to do. However, it requires courage.

If we have learnt nothing else from recent events it is that bad things happen when good people don’t speak out and doing nothing is not a neutral act.

How to be C for courageous

● You know what is good care and what is not
● Speak out when you see bad care, and challenge something that you know makes you feel uncomfortable
● Don’t worry about the people who don’t like you as a result of speaking out
● Having the courage to stand up will see you recognised as a nurse leader

Being brave does not make you popular with some people because it exposes their weakness and their desire to be a little bit braver themselves. I prefer to do the right thing for patients or my colleagues, rather than be popular. It is a choice.

As a first-year student, I witnessed healthcare assistants lining up older patients to be bathed, and drinking tea while patients were bathing - a bit like a conveyer belt.

My job was to help them but I kept thinking this could be my mum one day, so I refused to help and complained to the sister. It didn’t change anything immediately, apart from ensuring I had a difficult time on the ward, but it did raise questions about the quality of the care and I felt peace of mind that I stood up for my belief and values.

In my second year, I was helping to put in a chest drain for a patient. I had been taught that if it drains too much fluid at one time, the patient can go into shock.

The fluid kept pouring out so I asked politely if the doctor wanted the clamp; he said no. I waited another moment then clamped the drain. He was angry with me for undermining him. He complained about me and I had to report to the ward manager.

My defence? I was doing the right thing to safeguard the patient. No case to answer was the outcome. The doctor didn’t speak to me again, but I learnt to live with that.

As a trust director my heart still races, my palms still sweat and I say: “I don’t agree.” It is still uncomfortable and it still makes me unpopular, but I know it is the times I didn’t speak out, when I wasn’t quite brave enough, that keep me awake at night - not the times when I did.

 

Helen Lockett is trust director of Liverpool Community Health Trust. She started her career as an acute nurse then was a health visitor, before taking a number of operational and strategic posts in nursing and management

 

  • 11 Comments

Readers' comments (11)

  • Brilliant article well done Helen. I agree with every word and it is lovely to read it. I'm not in my job to make friends and be liked or be popular, I'm here to do my best for my clients and their families, and that ruffles feathers every now and then. Courage and challenge are exactly the right words for when this happens.

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  • "I asked politely if the doctor wanted the clamp; he said no. I waited another moment then clamped the drain."

    as one example of speaking out given above, after the doctor's refusal but before going ahead and taking the initiative to clamp the drain would it not have helped first to have suggested or even said the drain had to be clamped before too much fluid was lost? the doctor, who may have been lacking in experience or self-confidence, would have saved face and it might not have led to damaging future working relations with him, although such a discussion may not always be easy in front of the patient although openness is perhaps the best way.

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  • Re. last comment: Helen said she asked first, said why, gave the doctor the chance to 'save face' which he ignored. If he was so lacking in experience or confidence for something so basic he shouldn't have been unsupervised. Helen did nothing wrong, and in fact may have saved the patient's life. If there isn't time to moddycoddle someone then have the courage to do it yourself if it clearly needs to be done.

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  • so helen, how does being prepared to be unpopular fit with the 360 degree appraisal system? how might the official incorporation of colleagues' opinions of our performance affect our choice to be brave?

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  • Helen's view seems unnecessarily confrontational and almost abrasive, in my opinion. It is all very well being "courageous" IF you are right, but I think you have to be 100% correct in such instances. Standing up for your position when there is the slightest chance of putting the patient (not client) at risk, is simply not sensible or logical. I am confident of my own abilities but I don't know it all, and have never met anyone who did.

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  • Dreadful arrogant article. Nothing to do with leadership or courage. What else can we expect from someone who aligns herself with the ridiculous 6 Cs? As a lesson on how to express yourself poorly, whilst blowing your own trumpet, it is pretty effective.

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  • "Being brave does not make you popular with some people because it exposes their weakness and their desire to be a little bit braver themselves. I prefer to do the right thing for patients or my colleagues, rather than be popular. It is a choice."

    But as per the SOS campaign - you can have the courage, speak out, but whether "Stand(ing) up for your beliefs and values and you’ll (will) improve care and gain peace of mind depends on response of person you say it to. I've stood by my values, but I'd doubt it changed care as the response of the 'hearers' wwas to be so desperate to protect themselves and their jobs I'm now jobless, reference-less & due to health impact may never work again.

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  • No wonder people are afraid to speak out when this is the reaction they get when they do. Goodness me, Helen is talking about being brave and having courage not who to behead! Everyone is entitled to an opinion; we all know right from wrong; none of us is perfect; but we are all supposed to be ADULTS so should be able to speak honestly, have a mature debate if necessary, and even agree to disagree without squabbling or throwing insults around! I for one applaud her. You might not like how the article is written but at least she was brave enough to write it. Give her a break.

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  • we are all potential patients and have the right to expect that our care will be beneficial to us. why then is it not in everybody's best interests to speak about the positives and negatives and what needs to be improved. and how we will achieve it and what further resources we may need to this end.

    we need to listen to and speak to each other and to staff of all levels, to the patients and to visitors and everybody else who is involved.

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  • Anonymous | 18-Apr-2013 11:45 am

    "Everyone is entitled to an opinion..."

    By all means join this individual's fan club. You are entitled to do so. But you too should have respect for the views of others.

    Be careful not to confuse being strong and courageous with the grandstanding hubris on show in this article. I work with some genuinely courageous, smart and insightful nurses who are fantasic and effective practitioners of great care and its advancement. Not a boaster or self-promoter amongst them. I know who I want looking after my loved ones. I am in agreement with several other posters. This is a terrible article and how it is written IS very important.

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