School of Nursing and Midwifery, College of Health & Science, University of Western Sydney, Penrith South DC, New South Wales, Australia.
J Adv Nurs. 2010 Oct;66(10):2194-201. doi: 10.1111/j.1365-2648.2010.05365.x. Epub 2010 Jul 2.
This paper is a report of a study conducted to explore the reasons behind the decision to blow the whistle and provide insights into nurses' experiences of being whistleblowers.
Whistleblowing is a stigmatized and hidden activity that carries considerable ramifications to all concerned. In the health sector, when episodes of poor practice or service provision are identified, it is frequently nurses who are the whistleblowers. Despite this, there is remarkably limited literature that explores nurses' experiences of whistleblowing.
Qualitative narrative inquiry design. Data were collected in 2008 from 11 nurse whistleblowers using in-depth semi-structured interviews.
Participants were drawn from a range of general and specialty clinical areas and experienced whistleblowing as highly stressful. The findings were clustered into three main themes, namely: (i) Reasons for whistleblowing: I just couldn't advocate, (ii) Feeling silenced: Nobody speaks out, and (iii) Climate of fear: You are just not safe.
The whistleblowing nurses believed they were acting in accordance with a duty of care. There is a need for greater clarity about the role nurses have as patient advocates. Furthermore, there is need to develop clear guidelines that create opportunities for nurses to voice concerns and to ensure that healthcare systems respond in a timely and appropriate manner, and a need to foster a safe environment in which to raise issues of concern.
本文是一项研究报告,旨在探讨 whistleblower 做出 whistleblowing 决定的原因,并深入了解护士 whistleblower 的经历。
Whistleblowing 是一种带有污名和隐蔽性的活动,对所有相关人员都有重大影响。在医疗保健领域,当发现不良实践或服务提供情况时,通常是护士 whistleblower。尽管如此,却鲜有文献探讨护士 whistleblower 的经历。
采用定性叙事探究设计。2008 年,通过深入的半结构化访谈,从 11 名护士 whistleblower 中收集数据。
参与者来自广泛的一般和专科临床领域,经历 whistleblowing 被认为是高度紧张的。研究结果聚类为三个主题:(i) whistleblowing 的原因:我不能只做倡导者,(ii)感到被压制:没有人站出来,和(iii)恐惧气氛:你不安全。
这些 whistleblower 护士认为他们是在履行护理职责。有必要更明确地界定护士作为患者代言人的角色。此外,需要制定明确的准则,为护士提供表达关注的机会,并确保医疗保健系统及时和适当地做出回应,以及营造一个安全的环境,让人们能够提出关注的问题。