Courage, Leadership, and End-of-Life Care

When Courage Counts

Karlene M. Kerfoot, PhD, RN, CNAA, FAAN


Nurs Econ. 2012;30(3):176-178. 

In This Article

Changing Our Communities and Health Care System

The effective leader is not one who thinks of the unit or organization only. Communities, states, and our nation should ensure patients and families do not suffer and caregivers are supported. It makes no sense to have a best practice in one part of our system and people unwilling to share it with the rest of the world. Leaders must be involved in systems beyond their organizations to create sustainable change. For example, health care leaders in one community have taken the challenge of increasing the number of people with advance directives in their community very seriously. In Lacrosse, WI, the Gunderson Lutheran Health System initiated a program 20 years ago that has raised to 96% the number of people who died with an advance directive in place (Butcher, 2009). Now the program is implemented in many places nationally and internationally as the result of a few courageous leaders who made a commitment to change practice. With health care reform, the nation is crying for leaders who can develop thoughtful and workable solutions to help with individual choice. Now more than ever, it is important for nurses to be politically active to advocate for patients above the polarized views of politicians. Unfortunately, as Byock (2012) notes, the issue of end-of-life care has become politicized. Courageous nurse leaders are well adapted to maneuvering through political traps and advocating for patients and their families.


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