According to Aristotle, it is possible to demonstrate too much courage and be foolhardy, or too little courage and be cowardly. Having moral courage should enable nurses to speak up and challenge unacceptable practices and policies (Gallagher, 2011). However, sometimes organisations are not supportive and may inhibit the demonstration of moral courage by creating a climate of fear, which renders nurses frightened to speak up because they fear retribution. In such cases nurses may experience moral distress when they find themselves in situations where they feel unable to do the right thing (Gallagher, 2011).
Rittman et al (1993) relate stories in which experienced nurses protect patients by clarifying their moral responsibilities to patients and developing the courage to act as patients’ advocates. These are described as ‘never again’ stories which convey experiences in difficult situations when a patient’s treatment does not proceed as a nurse thinks it should (Rittman et al, 1993). Through reflection on these situations and their actions, nurses discovered what was worth preserving in their nursing practice.
‘A moral commitment to care is put into practice in one’s willingness to take action’. (Rittman et al, 1993, p42)
Gallagher, A. (2011) Moral distress and moral courage in everyday nursing practice. Online Journal of Issues in Nursing, 16(2): 8
Rittman, M. R., Nedoma, N., Queensberry, L., Gallimore, I., Cox-Henley, M. and Smith, L. (1993) Learning from ‘Never Again Stories’. American Journal of Nursing, 93(6): 40-43