Do You Have Moral Courage?

Presented by Georgia Dinndorf-Hogenson, PhD, RN, CNOR on December 8th, 2017
Article written by Leah VanGorp

Georgie is an Assistant Professor in the Department of Nursing at the College of St. Benedict/St. John’s University and also works as a part-time Charge Nurse for St. Cloud Hospital in Surgery. I previously had heard Georgie speak on the topic of Moral Courage in Boston last April at AORN’s National Conference and Expo. I left the education session feeling inspired and challenged as a peri-operative nurse. It was moving to hear her describe stories of when nurses stepped up and faced fear on behalf of their patients. It was also heart-breaking to hear of stories when nurses wanted to speak up for their patient but didn’t for whatever reason.

The purpose of her research study was to understand how and which factors influence the peri-operative nurse’s moral courage in the OR. The focus was to explore the associations of institutional culture, fear, previous experience, peer support, motivational value systems and the report of intensity and frequency of occurrence of moral courage among peri-operative nurses currently working in the Midwest & Western states of the U.S. Focus was also given to explore the peri-operative nurse’s likelihood to exhibit moral courage when faced with a hypothetical preventable patient harm event. The obstacles to speaking up that were identified in her research were: fear, institutional culture, smaller institutional size, rural institution, less years of OR experience, lack of nursing leadership/management support, and lack of
peer support.

Georgie stated that “if fear is high, then moral distress is high.” Nurses have fear of reprisal (both unofficial and official), fear of job loss, and fear of retaliation. Fear can be decreased if a nurse feels he/she is supported by their institution and listens to employee concerns.

When leadership ignores staff who speak up it creates a barrier, which in turn increases moral distress and conflict and affects staff retention. Georgie stated “Listen to the complainers or they will leave.” There are many reasons nurses speak up, and it is essential that nurses feel supported to intervene on behalf of their patients without having fear or lack of leadership support. So as you go back to work next time, remember the importance of moral courage and what it means for each one of your patients that day.

Your patients are counting on you and trust you to speak up for them with integrity as their advocate.