Our View of Courageous Care

T he AACN National Teaching Institute (NTI) is held annually in May, and provides an opportunity for critical care nurses to refresh their knowledge, recharge their enthusiasm, and reconnect with the national critical care nursing community. NTI is also the time when the AACN president-elect unveils the theme that will frame the upcoming year. This year, incoming president Karen McQuillan has chosen “Courageous Care” as the AACN theme. In her keynote address at NTI, McQuillan said, “We nurses show courage daily. To me, we demonstrate Courageous Care each time we step up and challenge ‘the way we’ve always done things’ — because it’s what is needed. We demonstrate Courageous Care when we say we don’t understand something and then go and learn about it in order to gain the knowledge to care for complex patients.”1 Courageous care is at the heart of both quality improvement efforts and research, and knowledge is its foundation. It takes courage to challenge established practices, even when evidence for improvement is strong. It takes courage to discover new knowledge to guide care. It also takes courage to engage our colleagues and initiate improvements in the work environment. In some instances, the information needed to improve outcomes for critically ill patients is already available, but has not been incorporated into local practice. Nurses who challenge the status quo and seek to replace comfortable old practices with new evidence-based practices exhibit courageous care. The barriers to implementing changes in the clinical setting can be significant. Hurdles may include financial constraints and administrative concerns. The culture of the unit and resistance of individuals to suggested changes can impede introduction of new practices in the unit even when evidence for change is substantial. Courageous care requires that nurses understand the barriers and persevere in addressing them. Individual nurses may be champions of change in their units, but in order for change to be effective, these individual champions must be able to engage others in enacting and sustaining new practices.