“I feel ashamed I had to take a course to be able to slow down and have an intentional conversation with someone who felt so marginalized. Think about all of the other marginalized people and what we, as healthcare professionals, have missed!” said Jenna (not her real name) who is my client, an executive on the leadership team of a hospital group.

I asked Jenna, who is working on a nurse practitioner doctorate, if she’d tell me more about what happened. She explained, “This week, for my doctoral work, we were asked to interview a person who has experienced health disparity, social injustice and/or been marginalized. So, I reached out and was connected with a transgender gentleman.

“During the interview, I thought about the “Head, Heart & Hands” assignment you’d given us after the workshop on compassion. I was careful to lean in and listen with both my head and heart. I also thought about how I could activate the Hand part of the assignment – to take action to show solidarity with him. Because you taught us to listen actively, the 45 minutes with this incredible man will have an impact on me for the rest of my life.”

Head, heart and hands

Jenna described the experience this way.…

  • Heart: “My heart hurt for him hearing how difficult the journey to transition was for him – how he had to travel hours and across state lines for treatments that we are capable of delivering in our region. I can only imagine how he was treated by other healthcare professionals.
  • Head: “My head told me we can – have to – do better for people and their unique circumstances in our community.
  • Hands: “I used my hands to change my signature line to include my pronouns. I know that may seem small, but for me this was an important action I hadn’t taken before, acknowledging people and their identity.” She added, “My head, heart, and hands will continue to look for opportunities to educate myself and our nurses to be better here at our hospitals!”

Jenna recognized a key point in our cultural intelligence (CI) training. If people of dominant culture learn to see both sides but then “go along to get along” while allowing the people of under-represented groups to remain marginalized, that’s minimization in practice. A full 67 percent of people who take the Intercultural Development Inventory® (IDI) worldwide are right in the middle of the five stages of cultural intelligence, the stage called “Minimization.”(1) What that means is, on average, more than two-thirds of the people in any organization minimize their own experience and that of others, perpetuating the marginalization of under-represented group members. And because minimizing our own and other’s experience is so normalized worldwide, we’re typically unaware that we’re doing this.

With minimization in play, leaders can be ignorant of the needs and assets of minority communities, which reinforces and perpetuates the status quo in their organization. The status quo is what keeps people of both dominant and non-dominant groups from being their genuine selves at work, stifling collaboration and innovation. It’s also what keeps and an organization from growing their company’s cultural relevance and appealing to a broader market.

But Jenna was able to upend the status quo and fully exercise her cultural intelligence, using her head, heart and hands not only to appreciate this man’s experience but also take initial steps toward meaningful action for herself and the hospital group.

Here’s a question though: If cultural intelligence requires our head, heart and hands, what exactly are we thinking, feeling and doing when we’re in a conversation like Jenna’s?

The five keys

You’ll notice five key elements of cultural intelligence are embedded in Jenna’s story. There is…

  1. Curiosity (in the head): the interest, intrigue and wonder about people, places and systems that are new and different. With her growth mindset, Jenna approached her interview assignment with curiosity. She genuinely wondered about the man and his experience within the hospital system. But curiosity alone wasn’t enough to express cultural intelligence. Though motivating for us, curiosity by itself (without any heart) can inadvertently make another person feel like an object of curiosity. The impact is tokenism and the effect is demoralizing. But Jenna didn’t only express curiosity. She slowed down and got reflective.
  2. Contemplation uses our head and heart to slow down, soften our gaze to practice presence. Contemplative presence is the embodied awareness of your mental, emotional and sensory experience. In contemplative awareness, Jenna prepared for her interview with intention. She looked the person up on LinkedIn to look for common ground, developed a series of respectful open-ended questions and decided her goal for the interview was to deeply listen and develop a shared understanding with the person. When she spoke with him, Jenna practiced presence; she was aware of her own deep sadness about how the system failed the man. But contemplation alone wasn’t enough to express cultural intelligence. Though able to make discoveries in the quiet of presence, she needed courage to pursue what she didn’t know. Because very often we don’t know what we don’t know about another person’s experience.
  3. Courage uses head and heart to understand another person, even though it may feel awkward, scary or hard. With courage, Jenna prepared for the interview. She told me, “I was sweating I was so nervous about talking with him. I didn’t know what I was going to find out.” Yet, even though she knew the conversation could both uncover cracks in the system and highlight her lack of knowledge, Jenna had the courage to go forward with it. When she slowed down and leaned into the potentially awkward and hard feelings, she discovered this conversation was a learning opportunity. She wondered what it had to teach her. Jenna heard the man’s unique story, in his particular context.
  4. Context is using our head to learn the unique circumstances, history and cultural container within which we live, work and play. When we deeply listen to a person who has been marginalized, we come to know their context. Listening to his unique story Jenna learned the impact of this man’s feelings of isolation and alienation. Jenna has seen an increase in trans adolescents who were admitted to the hospital for suicidal ideation. The man told her that, in the last four years, he knew three transgender adults who had committed suicide because they’d felt such gender dysphoria and were isolated by family and society.
  5. Compassion is using our head, heart and hands to hold our judgment a little more lightly, make room for the other’s perspective so we can empathize with them and take steps within our sphere of influence to ensure they feel valued and heard. Jenna was able to hold her judgment a little more lightly as she learned more of the man’s story. As she listened, her heart broke, and she took the initial action step of adding pronouns after her name. Then she began to wonder what action steps she could take so that she and her team could create intentional practices to ensure each patient and healthcare professional in the hospital system feels valued and heard.

So often in our western culture, we think we can think our way into just, compassionate practice. However, that’s not how diversity and inclusion work. Jenna needed all five key elements of her cultural intelligence to incorporate her head, heart and hands into her work.

As she continues to develop her cultural intelligence, Jenna’s actions will expand and embrace more and more people. With cultural intelligence, her sphere of influence will continue to grow. Next month I’ll share what leaders like Jenna can do with their cultural intelligence to affirm others’ humanity across gender identity and orientation. In the coming months, as Jenna and her leadership team learn to apply their cultural intelligence organizationally, I’ll share the effective practices they discover – practices that affirm employee and patients’ experience so no one feels sidelined or silenced. Jenna and her leadership team’s overall goal in developing their CI is continually striving to ensure everyone in their workplace community genuinely feels valued, heard and engaged. -Amy S. Narishkin, PhD

Who do you know in your network that would like to learn more about how to be a compassionate leader? Please share this link with them.


  1. Hammer, M. (2016) Intercultural Development Inventory Resource Guide. Olney, MD: IDI, LLC.
  2. Photo by Nerene Grobler on Unsplash