Ahern Kathryn, McDonald Sally
University of Queensland, Department of Social and Behavioural Sciences, Queensland, Australia.
J Adv Nurs. 2002 May;38(3):303-9. doi: 10.1046/j.1365-2648.2002.02180.x.
Nursing codes of ethics bind nurses to the role of patient advocate and compel them to take action when the rights or safety of a patient are jeopardized. Reporting misconduct is known as whistleblowing and studies indicate that there are personal and professional risks involved in blowing the whistle.
The aim of this study was to explore the beliefs of nurses who wrestled with this ethical dilemma.
A descriptive survey design was used to examine the beliefs of nurses in Western Australia who reported misconduct (whistleblowers) and of those who did not report misconduct (nonwhistleblowers).
The instrument listed statements from current ethical codes, statements from traditional views on nursing and statements of beliefs related to the participant's whistleblowing experience. Respondents were asked to rate each item on a five-point Likert format which ranged from strongly agree to strongly disagree. Data were analysed using a Pearson's correlation matrix and one-way ANOVA. To further explore the data, a factor analysis was run with varimax rotation.
Results indicated that whistleblowers supported the beliefs inherent in patient advocacy, while nonwhistleblowers retained a belief in the traditional role of nursing. Participants who reported misconduct (whistleblowers) supported the belief that nurses were primarily responsible to the patient and should protect a patient from incompetent or unethical people. Participants who did not report misconduct (nonwhistleblowers) supported the belief that nurses are obligated to follow a physician's order at all times and that nurses are equally responsible to the patient, the physician and the employer.
These findings indicate that nurses may respond to ethical dilemmas based on different belief systems.
护理伦理准则使护士承担起患者权益维护者的角色，并迫使他们在患者权利或安全受到威胁时采取行动。举报不当行为被称为揭发检举，研究表明揭发检举存在个人和职业风险。
本研究的目的是探讨那些在这种伦理困境中挣扎的护士的信念。
采用描述性调查设计，以检查西澳大利亚州举报不当行为的护士（揭发者）和未举报不当行为的护士（非揭发者）的信念。
该工具列出了当前伦理准则中的陈述、关于护理的传统观点的陈述以及与参与者揭发检举经历相关的信念陈述。要求受访者以从强烈同意到强烈不同意的五点李克特量表形式对每个项目进行评分。使用皮尔逊相关矩阵和单因素方差分析对数据进行分析。为了进一步探索数据，进行了具有方差最大化旋转的因子分析。
结果表明，揭发者支持患者权益维护中固有的信念，而非揭发者则保留了对护理传统角色的信念。举报不当行为的参与者（揭发者）支持这样的信念，即护士主要对患者负责，应保护患者免受不称职或不道德的人的伤害。未举报不当行为的参与者（非揭发者）支持这样的信念，即护士有义务始终遵循医生的医嘱，并且护士对患者、医生和雇主负有同等责任。
这些发现表明，护士可能基于不同的信念体系对伦理困境做出反应。
