The nursing practice has human well-being as its central moral good, and all nurses are morally responsible for their decisions, actions, and omissions. The courage is an attitude and a quality of mind that enables and all nurses are morally responsible for their decisions, actions, and one to face anything recognized as danger, difficult, or painful with firmness and without fear, instead of withdrawing from it. Despite fear for self and others, courage in nursing is usually presented as ethical-moral risk taking actions with the intent to ensure safe patient care. Courage is important in relation to advocacy for both the patient and the profession.
The purpose of this study is to develop an explanatory model of courage based on an explanatory model of practice domain phenomena(Kim, H. S., 2010) and literature on courage and to test the developed model with covariance structure analysis in order to find a causal path among the variables. In the hypothetical model, courage is induced into the practice domain phenomenon. Nurse factors that explain courage included years of clinical experience, humanism and compassion by the induction method. Exogenous factors that explain courage included relationship-innovation oriented nursing organizational culture and nurse’s perception to client vulnerability by the same way. In the hypothetical model, relationship-innovation oriented nursing organizational culture and years of clinical experience caused humanism and compassion by the synthesis method. And relationship-innovation oriented nursing organizational culture, years of clinical experience, humanism and compassion caused nurse’s perception to client vulnerability with the same way.
A Total of 300 hospital nurses were recruited for the study from April to June, 2017. The data were collected with structured questionnaires and analyzed with SPSS 20.0 and AMOS 22.0.
The model showed good fit to the data with χ2/df=2.45, GFI=.94, RMSEA=.07, SRMR=.05, TLI=.90, CFI=.93, PNFI=.61 and 9 of 13 hypotheses were supported. Relationship-innovation oriented nursing organizational culture, years of clinical experience, humanism and compassion explained 45% of variance in courage.
In conclusion, relationship-innovation oriented nursing organizational culture can explain the courage mediated by humanism and compassion. Years of clinical experience is the most influential factor to explain courage. Effective strategies for nurses to act the courage in nursing practice should encourage the application of relationship-innovation oriented organizational culture and train the moral integrity including humanism and compassion.