Have you experienced this familiar feeling?
The feeling when you see a volunteer crossing an unprofessional boundary with a patient by exchanging personal contact information with the family. The feeling when your coworkers start venting about the family in room 11 but conversation quickly turns toxic and degrading of that family. The feeling when you overhear a staff member share about a questionable decision. The feeling when a patient’s mom shares that she refuses to tell her son about his diagnosis and will lie to him instead. The feeling when you see your teammates isolate another “unliked” staff member and constantly gossip and tear her down.
For me, when these situations arise, I get a familiar feeling of: “I probably should do something. The right thing to do is speak up.”
These moments are times when my integrity is tested. And, if I’m being honest, when I am faced with an integrity choice my stomach turns and my heart races.
Integrity is defined as “the quality of being honest and having strong moral principles” or “the state of being whole and undivided.”
That second definition is especially interesting – “whole and undivided.” This means facing tests of integrity is about promoting wholeness and unity within myself, with patients and with colleagues.
But then there is also that first definition of integrity – being honest and having strong moral principles. This is certainly not easy to do daily! Especially since speaking out with integrity usually feels like promoting division and disunity…at first. Speaking out for what is right can feel painful, uncomfortable and tense, but my goodness is it important!
Why?
As child life specialists, one of our most important jobs is to be an advocate. We advocate for patients, but we also advocate for truth. Honesty and encouraging moral principles for patients, families and staff is essential to our and others’ wellbeing. We must be committed to ensuring that ethical and upright practices happen in our hospital.
This means facing tests of integrity is about promoting wholeness and unity within myself, with patients and with colleagues.
I remember a time especially early on in my child life career when I had to face a test of integrity.
I was a child life specialist on an in-patient unit at an inner city hospital. Without a strong family presence during treatment, several of my patients would spend much of their days and nights alone. They did not have anyone there with them. No one was overseeing their care and being the voice for them.
One day, *a patient of mine came blazing into my on-the-unit office. Typically stoic, this young man rushed in with tears streaming down his face.
“Miss Allie. I need to tell you something.”
The patient then shared with me that a particular night nurse had spoken very disrespectfully to him, and had been unnecessarily rough with him when moving him from his bed to his chair. He felt mistreated and alone.
If this mistreatment was true, then this nurse was acting unethically and needed to be stopped immediately.
I was the child life specialist. I was the advocate. In that moment, I was this patient’s only potential voice.
I could either turn a blind eye to the patient’s situation or I could demonstrate integrity. Integrity would mean listening to the inner-prompting – keeping personal wholeness. Moreover, seeking justice for this patient would be promoting a “whole and undivided” team for the patient’s care.
I chose to seek integrity, truth and unity, even if that meant that I would “rock the boat” initially by bringing this concern to staff.
I carefully documented everything the patient had said and informed him that I was obligated to share this with staff in order to ensure that this behavior does not continue to happen to him. He understood, but stressed that he wanted anonymity. I then discussed the situation with a trusted colleague (a child psychologist) to get a better sense of what my next step should be.
With my co-workers affirmation, I then met with the leadership team in person to share with them what the patient had disclosed to me. I sought to stay objective and share only what the patient shared, not my own personal opinions or biases. I also advocated that the leadership address this situation while seeking to maintain anonymity for the patient as best as possible. It was then out of my hands. The leadership team would have to determine next steps.
After a few days of considering my own documentation, the leadership team met privately with the nurse and removed her from the patient’s care.
Meanwhile, I had to face the glaring looks and cold shoulders of all the nurses – they had discovered I was the “snitch”.
However, my job was not to be liked by everyone. My job was to stand in the gap for this patient and to advocate for moral principles. I had to do so with confidence.
I wrote this original blog in 2018, and it is interesting to now reflect on what I could have done differently to advocate for unity and integrity in this moment. When do you go to the staff member directly to learn more about the situation? When do you take it to management? Important questions to carefully consider when integrity is tested.
As child life specialists, we all must face the daily challenge to commit to integrity no matter the consequences. It is difficult and no one is perfect, but committing to integrity is essential. The change starts with us. What do we do when no one is watching?
Here are 5 ways I want to seek integrity:
- Although choosing integrity may feel isolating and uncomfortable at first (and maybe always), I will not keep from courageously speaking up.
- I will focus on what is in my circle of control and what is my responsibility. I can only control what I say and how I respond. I cannot control the response of those I may have to confront.
- Similarly to #2, I must also be the change I want to see. I must be committed to maintaining strong moral principles in my own life.
- It can be easy to turn a blind eye when I see something unethical happening, but I must stare down those moments with courage and with honesty.
- I will manage people up. I will keep watch of my own speech and speak well of others even when they aren’t around. I will seek unity with my team and seek integrity in the way that I relate to others.
Question to Ponder: What keeps you from choosing integrity?
*Details of anecdote slightly changed to protect privacy of patient and staff.