I knew since I was a youngster that I wanted to become a nurse.
At the precocious age of 2 1/2, I received the most valuable Christmas gift ever: a mini nursing "kit" with a stethoscope and nursing cap. The photographs taken that holiday season show a toddler beaming with delight as she "assessed" dolls for illness, sustaining them as only a nurse would do.
My conviction that I would become a nurse never wavered, and years later, I achieved my goal, despite (or perhaps a result of) losing my father during my first semester in school.
Hardship did not sway my resolve; instead it fortified the strength of my convictions. Long before I knew what "moral courage" might be, I had it in spades. I just did not realize how important this type of resilience would be to the nursing process.
What is moral courage?
Moral courage is the integrity to do what is believed to be a choice of veracity, even in the face of adversity. It is stopping to assist the victim of a vehicular accident, knowing the delay will result in arriving late to work. It is pausing in the hallway to comfort a patient/visitor who is distraught, knowing that you are deferring a break for a colleague who is working overtime. It is turning to face the angry spouse who displays rage at every visit, when instinct instructs you to find something easier to do. It is answering questions with truthfulness when a kind lie might be more comfortable for everyone involved.
It is showing up to nurture and comfort a colleague when death is near and they have asked for you, knowing there is little to offer that might relieve pain and/or offer solace to the soul. It is guiding a peer toward a gentler passing when sobbing outside the room might be simpler.
Several times throughout my career I have lost a close colleague to cancer. I have also lost one peer to COVID.
These nurses exhibited resilience and moral courage past diagnosis, through grueling complications, and into the final phase of their time on Earth. I share their stories to honor them, and to encourage nurses to stay strong despite tumultuous times, unrelenting hardship, and unprecedented stress.
These nurses were heroes long before we saluted caregivers each evening with clapping and respect.
They were the kind of nurses we strive to become. They were angels guiding me through when resolve began to fray.
The first colleague passed when she was in her 30s. She died after receiving one chemotherapy treatment, spiraling down with a massive infection that precluded a brain bleed. During a procedure, she asked me to stay and hold her hand for strength. She asked repeatedly if I believed she would be okay. I answered in the affirmative, as we frequently do, hoping to support her during a stressful time.
I have never forgotten her grateful smile, although my reassurance was for naught. Ultimately, I believe my presence was helpful, although the painful memory of her loss stays with me.
Another colleague had asked me to be available for an intravenous start as her body began to fail. She asked early, knowing her veins would be challenging. I had days to pray that I would be successful. She was becoming critically ill, and her implanted port was no longer working.
She needed an intravenous line to be transferred to a higher level of care. Although I could visualize nothing, the IV seemed to slide into position. We cried together in relief, knowing that was our last visit. A beautiful nurse to the end, she appeared more worried about me than about her outcome. She patted my hand, offering comfort and a sweet smile.
She exemplified the idea of moral courage; knowing to ask for help is often the hardest task for nurses.
The last colleague I choose to mention was lost during the early days of the pandemic, when PPE was scarce and frequently reused. She was bright and personable and everything I hoped to see when I mentored a young nurse. She was exceptional, but like many caregivers in those early months, she was gone in a flash, working extra shifts to assist overwrought peers. That kind of courage is worth honoring in whatever way we can, without hesitation.
Moral courage, when you think about the concept, appears to be the heart and backbone of nursing.
Do you possess this type of courage? Could you hold the hand of a dying colleague, hoping to lend them fortitude, knowing that strength alone will not sustain them?
Losing these colleagues proved to be some of the most challenging days of my career, but I could not turn away. The 2 1/2-year-old who had known she wanted to be a nurse provided the moral courage to stay, knowing heartbreak would remain. Despite the distress, I would not have it any other way. Would you?
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Cite this: Diane M. Goodman. Moral Courage in Nursing: Do You Have It? - Medscape - Mar 31, 2022.
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