Organizational cultures that support moral courage
In an organization whose culture supports moral courage, communication is open at all levels, policies and procedures support ethical practice, and leaders practice staff empowerment. Empowerment creates a positive work environment through such structures as professional practice models and shared governance, as well as participation in ethics committees. Leaders must ensure these structures are used to make individual and organizational accountability expected behaviors. In organizations that advocate accountability, managers must have the moral courage to generate crucial conversations with all healthcare team members. A crucial conversation is a discussion between two or more people where the stakes are high, opinions vary, and emotions run strong. For example, Julie, the charge nurse in our case scenario, role-modeled the needed communication to resolve Susan’s conflict with Dr. Shoen, demonstrating the crucial conversation Susan needed to initiate with Dr. Shoen to make Mr. Yarrow more comfortable.