Amanda Goostree

Text version of Amanda Goostree keynote remarks

An intelligent nurse leader once told me, "Courage is not the absence of fear, but choosing to do what is right in spite of the fear." During my nursing career I have had many experiences in which it took courage to do my job. Early in my career as a staff nurse it took courage to sit at the bedside and support a dying patient's family knowing that I couldn't change the outcome for them and that I didn't have any answers for them that would make sense.

Later in my career, while functioning in the role of a house supervisor, it took courage to urge a physician to take the time to speak to a frightened family during a trauma situation. Upon becoming a department director, I learned it took courage to ask a staff person with a behavior problem to choose either to display the values of the organization while on duty or find a new place to work.

I knew in all instances that even though I was not without fear, I had to muster the courage to do what was right for the patients we serve. While I am the nurse who was selected to represent St. Mary's Good Samaritan, Inc., I am by no means the only leader with courage working there. Courage is displayed daily in the work we do.

I accepted the role as Director of Obstetric/Neonatal Services at St. Mary's Good Samaritan, Inc. with the knowledge that I was assuming a difficult role that had many challenges. This particular department had had 32 directors over a 22-year period. I did not want to be another director to come in there and quickly move on out of frustration.

I took some time to really survey the staff there and came to understand they were not a "bad" group of employees; however, they were a group of employees with a "bad" attitude. They lacked confidence. They were almost like children who had been told they would never amount to anything. After being in my new role as Department Leader for only a few weeks, I asked each of them in a staff meeting if they felt proud to come to work in this department everyday. You guessed it. No surprises. Almost 100% said they were not proud to be part of the department. I quoted for them a passage from the Book of Proverbs in the Bible, "Without vision, the people will perish." I asked them if we could work together to develop a vision for our department. I shared with my newly developed team that I believed they had the potential to be clinically extraordinary and excel in patient and physician satisfaction. I knew this staff was delivering some of the very best care rendered in our hospital. My believing it was the easy part; they had to believe it, also. I communicated that my vision was to have a department that we were each proud to be part of. Then I asked them if they would like to be known as one of the best clinical departments in the hospital. Many began to nod their heads in agreement. You could feel the fog begin to lift as the overall spirit in the room began to shift to one of ownership. With our discussion that day, we established some stern ground rules. In order to be the best, we would be accountable to each other, our patients, physicians and other internal and external customers to uphold our Mission, Vision and Values at all times. I told them those who would not or could not be part of this team would need to find another place to work because we WERE going to achieve our goals. I also told them that part of our pursuit to become the best would include a harmonious working relationship with the physicians. Our focus did not need to be on the shortcomings of others on our patient care team. I explained, "My job is to help you all become the best nursing staff you can be." As the year went on, some chose not to be part of our quest to be the best. The relationships with staff and physicians are better today than when we had our vision discussion. Our patients are happy with their care. The staff are much more engaged in the work and much less engaged in non-productive behavior.

I believe this story illustrates why courage is necessary and how courage is beneficial to all that we serve including, our staff, our physicians, and most of all, our patients.