Courage - it’s a virtue which underpins so much of the human experience of life. It’s spoken of grandly, the courage of a lion, and yet it feels like courage in the small moments of our everyday lives has as much potential for great impact too. Last week at Haelo Hosts: Daring Greatly we heard stories of great courage and these have left me reflecting on what courage in improvement looks like. Where do we find courage in the everyday? Courage is fundamental to improvement. I see it as essential in three particular elements of how we improve services day-by-day. It is there in the:
boldness of speaking up about a problem
creativity of testing new solutions
honesty of highlighting success or grappling with failure.
It is part of who we are as people passionate about improving our world but it can be hard to identify and acknowledge our own courageous moments. This, in turn, can make it hard to encourage others.
Speaking up "I learned that courage was not the absence of fear, but the triumph over it. The brave man is not he who does not feel afraid, but he who conquers that fear." [Nelson Mandela]
Speaking up can be terrifying - to express an opinion or speak out exposes us and sets us, for that moment, apart from the people around us. Improvement starts at the point where someone recognises a problem and takes the bold step of speaking up about it. It is far easier to recognise the problem than to take a stand on it but it is in these moments that courage is found.
Clearly identifiable in whistleblowers and Boardrooms, it is also there in the quiet moments when junior staff have a quick word with a colleague, when the patient or carer partner on a committee asks a question, when we write letters and sign petitions and bravely tell a friend about something that worries us. Courage is there when we make an effort to say something, even if doing so challenges us.
Courage in creativity One of the speakers at Haelo Hosts was DeVone Boggan of Richmond, California, who was challenged by local politicians to tackle the epidemic of gun violence in Richmond. Rather than approach it from the traditional law-and-order perspective, he looked at the problem from different angles and tested new ways of getting people to stop shooting each other. His creativity has brought with it sceptics but there is little doubt that he has displayed courage in trying something new.
It takes courage to look at a problem from all angles, to see it from others’ eyes and reflect on your own perspective. It takes even more courage to suggest ideas for improvement that might seem impossible or particularly challenging, where the first response is (in true fast intuitive response style): “no, that won’t work”. It takes courage to try - to put your time and effort behind ideas that might not work. If you’re reading this, chances are you do this every week.
Integrity Integrity is defined as both the quality of being honest and the state of being whole and undivided. All the speakers last week demonstrated integrity through their courage - blending the personal and professional while being incredibly honest about moments of success and failure. Ariadne wrote a great blog about acknowledging failure in October, you should read it if you haven’t already.
In improving in health and care sometimes we succeed brilliantly, sometimes we fail spectacularly, and, quite often, the result is a mixed bag. There is as much, if not more, to learn from the failures than the successes and yet it is difficult to find the courage to be entirely honest when we don’t succeed. Surrounded by people passionate about improvement and with similar experiences, the UK Improvement Alliance should, and will, be a safe place for people to do so.
So what? With the tremendous challenges facing the NHS at the moment, including a record £2.45 billion deficit, it is this very time that requires us to be courageous everyday. Reflecting on courage, it strikes me we perhaps don’t recognise it enough in ourselves. We see courage in others who do things we can not imagine and don’t always see it in the quiet voice that consistently challenges us, and those around us, to make things better.
In my experience, it is easy to remember the things we wished we had more courage to do without necessarily recognising the many things that we have had an impact on - through speaking up, through creative approaches, through our integrity.
The challenging environment we find ourselves in requires an NHS that supports people to be courageous, recognising and rewarding those that try while providing a safe space for people to fail with integrity. Let us all encourage one another on in the everyday as we improve.