Perspectives on the Acute Care Continuum

The Acute Care Continuum is the integration of urgent, emergent, inpatient and post-discharge care of patients with acute medical conditions. 

Emotional Courage: A Mindful Virtue in Medicine Today

4/1/2014 8:41:36 PM | 0 comments

Welcome to Mindfulness in Medicine, a monthly column by best-selling author Anne Bruce designed to cultivate leadership and collaborative relationships among hospital leaders, nurses, providers and ancillary staff. Mindfulness is a powerful leadership tool that enhances emotional intelligence in medicine. It is a tool that, when practiced, can help us develop and implement relational coaching skills and illuminate various ways to improve hospital operations and cross-departmental performance. Mindfulness also improves our capacity for decision-making and participatory medicine, all while enhancing our own health and well-being. Your comments and insights on these postings are greatly valued.

Medical professionals are constantly facing complex, emotional and ethical dilemmas in the healthcare environment. Some professionals have learned through experience to easily confront these touchy issues directly, while others may be in denial.

Developing emotional courage is an important tool in any healthcare professional's toolkit. It invites healthcare workers to address ethical issues up front and take action when doing the right thing is not always easy.

Simply defined, emotional courage is what you are called to do when you see or feel a real need to take action but are experiencing an emotional barrier that may be stopping you.

5 reasons why some may have a difficult time implementing emotional courage:

  • A worker may feel like he or she is undermining or betraying authority if they demonstrate the emotional courage to speak up.
  • The subject might be an embarrassing one the worker feels uncomfortable discussing.
  • The situation may cause feelings of disgust that stop a worker from taking action, even though it's the right thing to do.
  • The problem at hand may cause the worker to feel shame or guilt from a past experience, reminding them of a time when they were not mindful of using their emotional courage to take action or do the right thing.
  • Maybe the person is thinking that if they spoke up, it would go against the majority opinion of others in the medical practice or hospital setting (known as group-think). So a worker may feel it's countercultural to voice an opposing opinion.

Emotional courage often comes down to how we "choose to respond" and not "react" to a touchy situation. Therefore, how a healthcare professional responds to these mindful and sometimes ethical dilemmas depends on their previous experiences with unethical behavior, their individual personality traits, their ethical values and their emotional courage to do the right thing.

The point is this: Both emotional and moral courage is needed to confront unacceptable behaviors. Here is a more specific example.

The Price of Demonstrating Emotional Courage on the Job

Jason was brand new to his nursing career at a university medical center in Dallas. His coworkers respected him, calling him "meticulous" and "mindful" of compassionate medical practices.

As time went on, Jason noticed a disturbing behavior in the workplace. The behavior of his team leaders and specifically his supervisor was no longer in alignment with Jason's ethical belief system. He had actually witnessed one leader falsifying the records of training nurses. The records were altered allowing trainees to start working on their own sooner. Doing this satisfied the much-needed staffing levels for a busy medical center. However, these nurses were not fully or adequately trained to work independently just yet, and Jason knew it.

After much soul searching and deliberation, Jason decided to put his emotional courage into play. He knew deep down that he had an ethical responsibility to take action and bring this matter to the attention of the hospital administration. And so he did — but at what cost?

The Upshot of Using Your Emotional Courage

Almost immediately, Jason's supervisor changed his work schedule without any notice. Turns out that this was done purposely to create ongoing difficulty for him — perhaps to ease him out of the unit or even the workplace. The supervisor also began criticizing him in meetings and in front of his colleagues, causing extreme embarrassment and humiliation.

Honoring that nurses and all healthcare professionals have an obligation to always demonstrate the highest professional and ethical standards, Jason sought guidance from the medical university's nurse ethicist. This guidance and support helped him greatly to stay mindful of his emotional courage and remain resolute in his determination to set a good example.

Jason eventually did move to another unit, but has always been held in high regard by his peers and his supervisors for cultivating emotional courage in other staffers.

Be Mindful of Behaviors in Medicine that Could Require Emotional Courage

Emotional courage is easily seen in a novice nurse's career such as in Jason's story above, but here are other examples:

  • Standing up for a coworker who is being abused by a manager who often inflicts mental abuse through tirades and berating the employee to tears.
  • A hospital worker who, when under pressure from administration, refuses to document patient care that wasn't provided.
  • A researcher who declines to engage in scientific misconduct for the purpose of receiving funding to help the organization enjoy better standing in the research community
  • A teaching doctor who chooses to reject ongoing demands to pass failing students despite threats to tenure and his prestigious standing in the physician community.

What's important is to be mindful of, recognize and acknowledge healthcare professionals who exemplify emotional courage when it comes to doing what they believe is ethically correct.

Is It Worth It?

In the real world of medicine, emotional courage can be super tough to muster and mentor. There is almost always a time or place when there could be an elephant in the exam room (pun intended).

Executing emotional courage in healthcare, or any business for that matter, can feel awkward and have you second-guessing whether or not to try and improve a negative situation. Or it could have you thinking, "Is this really worth it?" "Is it worth sticking my neck out?"

It takes strength of character to build emotional courage and even more to demonstrate it, because you never know how it may be interpreted by others. Your actions may be appreciated, valued or possibly rejected. There could be retaliation. Then what?

Emotional courage is worthwhile and important. When have you exhibited emotional courage, either personally or professionally? How will you go about building this trait throughout your career? I invite you to share your stories in the comments section below.

Although mindfulness and emotional courage cannot be taught explicitly, they can be demonstrated by mentors and cultivated in all healthcare environments. Mindfulness and emotional courage should be considered admirable behaviors of good clinical practice, because such behaviors respect and support one’s peers and patients.

Here are two powerful quotes that tie directly to emotional courage. Do you have any quotes you'd like to share regarding this topic?

"The opposite of love is not hate, it's indifference."

—Elie Wiesel

"We can only be said to be alive in those moments when our hearts are conscious of our treasures."

—Thornton Wilder

Anne Bruce has provided training and performance coaching for MedAmerica and CEP America. She also serves as MBSI's Employee Development Coach and Leadership Facilitator. Anne is a bestselling author with more than 20 books published by McGraw-Hill Publishing, New York. She considers her award-winning life-coaching book, Discover True North: A 4-Week Approach to Ignite Passion and Activate Potential (McGraw-Hill Publishing) to be one of her most "mindful" books to date. She also leads a popular Discover True North Expedition group on LinkedIn. Anne can be reached at 214-507-8242 or by writing to her at

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