The Case for Courageous Leadership

by Susan Sportsman, PhD, RN, ANEF, FAAN and Cathy Converse

“Courage is the first of human qualities because it’s the quality that guarantees the others.” –Aristotle


Leadership is on the hearts and minds of most of us as we navigate the complexities of our personal and professional lives. Although volumes have been written about effective leadership using a variety of perspectives, the need for courage in times of conflict and discord, particularly in situations of perceived high risk, seems particularly relevant. Few environments represent higher risk than health care.

Why we decided to focus on Courageous Leadership

Providing nurses and others with skills to make the best decisions to support safe and effective care delivery is a core mission of Collaborative Momentum Consulting. Courage as a component of leadership is an important competency in today’s health care environment.

We’ve both been interested in leadership for a long time. We had the opportunity to be leaders in our own careers, and we’ve seen the impact strong, positive leadership can have on institutions, those who are led, and on the leaders themselves. Stimulated to learn more, we explored the health care and business literature to evaluate others’ ideas of the relationship between courage and leadership. As we reviewed the literature and reflected on what we’ve learned in our own careers, we saw a theme develop: leaders who were truly successful, who gained the respect of those they led and the confidence of those they reported to, were the ones who were courageous in their approach to leadership. They shared a common set of behaviors or values that required courage to exhibit consistently. And they won the trust and loyalty of their teams as a result. This courageous style of leadership was consistent with our values and we want to share what we’ve learned with the world. We are very passionate about courageous leadership.

What is Courageous Leadership?

We define courageous leadership as the heart to step up front and transform vision into reality. Notice that the first word in this definition is “heart.” This is fitting because the word “courage” is derived from the Latin word “cor,” which means heart. Many people think that the mind is the domain of leadership, not the heart. We disagree. We are human beings, and we’re leading human beings, and humans are thinking AND feeling beings, no matter how hard we try to avoid the messy feeling part. The Buddhist monk Thich Nhat Hanh says, “The longest journey you will ever take is the eighteen inches from your head to your heart.” We believe that great leadership—courageous leadership—requires both the mind and the heart to be engaged.

How does Courageous Leadership compare to traditional leadership styles?

Whereas traditional leadership styles tend to use a “top-down” approach where control, information, and decisions are made by senior leaders or “bosses” who direct their employees in the execution of directives, courageous leadership is very different. Courageous leaders take a collaborative approach: they share information, value diversity and inclusion, and enable everyone to contribute and take a leadership role at some time on some initiative.

Why Courageous Leadership is needed in today’s environment

There are several reasons why courageous leadership is important. For one thing, Millennials and the generations coming behind them expect a more egalitarian, participatory, and less pyramid-like leadership style. And the qualities linked to courageous leadership are tied to reduced turnover, greater creativity, increased productivity, and a more engaged team. In an environment of trust and mutual respect workers are able to focus their efforts on their work rather than protecting their backs or advancing their careers. Courageous leaders beget more courageous leaders.

One of the most important reasons why Courageous Leadership is important, and one that is especially relevant to health care settings, is that the more complex the environment, the more important the skills of a courageous leader are. Complex environments have more potential for misunderstanding, confusion, stress, and time or resource constraints. As the knowledge and skills necessary for health care excellence and the resulting roles in health care have expanded and overlapped, the view of one leader directing  all other members’ actions is not practical. Health care has become a team sport; each discipline has a part to play in achieving a satisfactory outcome. This requires the collaborative approach found in Courageous Leadership.

However, the complexity brought about by the expansion of multiple health care roles often brings conflict in opinion. These conflicts, coupled with less time to interact with co-workers and ensure continuity of care, escalates the discord. Moreover, the technology utilized in health care is so complex that it requires a lot of focus from health care providers, which can cause them to lose focus on collaborating with their colleagues. Such an environment sets the stage where courage is necessary to resolve these conflicts.

How to become a Courageous Leader

As we reviewed the literature on leadership, we wanted to identify the characteristics, attributes, or skills that set courageous leaders apart from more traditional leaders. We identified ten that were repeatedly found at the intersection of courage and leadership.

  1. Risk-taking. Courageous leaders know that an environment that has no tolerance for failure is also one devoid of innovation or creativity, both of which are essential for success in our complex and fast-moving world.
  2. Honesty. Honesty is the foundation of trust, another component of courageous leadership. Honesty goes beyond telling the truth to include an acknowledgement of the reality of a situation—both the good and the bad—and a willingness to address difficult situations.
  3. Trustworthiness. People who trust their leaders feel safe asking for advice or help and telling their leader the whole truth, not just what they want to hear. Without this information, leaders cannot be effective.
  4. Communication. Strong, clear, consistent communication is absolutely essential to effective leadership and a successful work environment. Especially in times of stress, for example when going through a period of change, leaders need to communicate even more. (Kaplan, 2011)
  5. Connectivity. Courageous leaders develop genuine connections with their teams, their peers, and their superiors. Our literature review indicated that the key to authentic connectivity is to go beyond work topics and get to know team members as people.
  6. Decisiveness. The plethora of information available today can make it difficult to make decisions, because we feel like we need to “know it all” before we act. Yet studies have shown that the ability to make decisions quickly and with conviction is one of the most important qualities of successful leadership. (Botelho, 2017)
  7. Self-awareness. Studies indicate that companies with self-aware leaders have better outcomes. Cashman (2014) interviewed Dana Landis, one of the researchers who studied this phenomenon, who said “self-awareness is not a soft skill, a nice-to-have. It’s playing out in your bottom line. This is about leadership effectiveness.” Routinely seeking out honest feedback and knowing how you respond to stress are two important ways for leaders to increase self-awareness.
  8. Empowerment. Empowerment is the antithesis of the traditional, hierarchical approach to leading. Enabling everyone to take a leadership role in some capacity is not only motivating and fulfilling for team members, it also helps them develop important skills that lead to successful outcomes in the long term.
  9. Resilience. Leaders who see failure as a temporary setback and find a way to get the job done despite challenges are powerful role models who keep the entire team moving forward.
  10. Persistence. Leaders who don’t give up—or change course—during difficult times instill this characteristic in those around them.

Challenges to becoming a courageous leader

As in any worthwhile endeavor, it can be challenging to become a courageous leader. Some common barriers include:

  • Organizations with a hierarchical, top-down leadership culture may not understand this leadership style
  • Fear of being more open, honest, and genuine in a leadership position
  • Feeling overwhelmed by making a significant change to your leadership style

Our advice is to start small. Here are some things you can do right now to become a courageous leader:

  • Review the list of characteristics/skills. Which ones are you good at? Which do you find hard? Can you think of an example when you exhibited each of these characteristics? (It doesn’t have to be in the workplace.)
  • Think about leaders you’ve had, either now or in the past. What differentiated the good ones from the less effective ones? Can you identify courageous leadership skills that they did or didn’t do well? How did that impact you—your work, your motivation, your ability to get the job done?
  • Identify which of these characteristics you think would make the biggest difference in your ability to lead, if you were to develop them.
  • Select one or two of these skills to develop. Even if you don’t think you’re naturally good at it, chances are you’ve exhibited that skill before. What is one thing that you can do this week to be more courageous?
  • Overcome your fear. All change is scary. But ask yourself, “Do I want to be a leader people want to follow, or a leader people have to follow?” We find these words from Zig Ziglar helpful when faced with challenges:

F.E.A.R. has two meanings:
Forget Everything And Run
Or Face Everything And Rise
The choice is yours.

A Word of Caution

Being a Courageous Leadership requires us to be  authentic. The ways in which we act must be based upon values we hold. Often, differences in values among those in the workplace are the root of conflicts in health care.  As a result, we must be clear about what we believe, yet be willing to listen to another perspective.

Regardless of the challenges, we believe becoming a courageous leader is worth it. Your team will be happier and more productive, and people will be drawn to you as a leader. This is likely to get noticed by those above you. Who knows, perhaps you can be the catalyst to change the culture in your organization to a more courageous one!


Botelho, E.L., Powell, K.R., Kincaid, S., Wang, D. What Sets Successful CEOs Apart, Harvard Business Review, May-June, 2017. Last accessed, December 2019.

Cashman, K. (2014) Return on self-awareness: Research validates the bottom line of leadership.  Forbes.  March, 12. Accessed, December, 2019.

Kaplan, S. What to Ask the Person in the Mirror. Harvard Business School Press, 2011.

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