[Whistleblowing: a difficult concept for nurses].

Preventig errors and implementing risk management systems in health and nursing care requires knowledge about nurses' perceptions of errors, such as their handling and their reporting of errors. Whistleblowing is a way of reporting serious deficits by leaving predetermined pathways and addressing persons, institutions or media outside the organisation. In eighteen semi-structured interviews nurses were asked if they could imagine acting as a whistleblower, or if they even had ever blown the whistle before. The scope of their appraisal ranged from strictly disapproving such behaviour (what was done by most of the interviewees) to approving only hesitantly because of personal risks. Central themes were allegiance to the organisation, to the team and to colleagues, responsibility for the patients, and the consideration of personal risks. This corresponds to the results of other studies on whistleblowing, as described in the discussion. Nurses have to be encouraged to accept professional responsibilities as well as organisational ways of error reporting have to be found and to be discussed, e. g. in terms of best practice examples. Whistleblowing should be regarded as an act by which patient advocacy is expressed.