Royal College of Physicians of Ireland, Dublin, Ireland.
School of Nursing, Psychotherapy and Community Health, DCU, Dublin, Ireland.
J Health Organ Manag. 2021 May 7;ahead-of-print(ahead-of-print):178-94. doi: 10.1108/JHOM-08-2020-0353.
Workplace silence impedes productivity, job satisfaction and retention, key issues for the hospital workforce worldwide. It can have a negative effect on patient outcomes and safety and human resources in healthcare organisations. This study aims to examine factors that influence workplace silence among hospital doctors in Ireland.
DESIGN/METHODOLOGY/APPROACH: A national, cross-sectional, online survey of hospital doctors in Ireland was conducted in October-November 2019; 1,070 hospital doctors responded. This paper focuses on responses to the question "If you had concerns about your working conditions, would you raise them?". In total, 227 hospital doctor respondents (25%) stated that they would not raise concerns about their working conditions. Qualitative thematic analysis was carried out on free-text responses to explore why these doctors choose to opt for silence regarding their working conditions.
Reputational risk, lack of energy and time, a perceived inability to effect change and cultural norms all discourage doctors from raising concerns about working conditions. Apathy arose as change to working conditions was perceived as highly unlikely. In turn, this had scope to lead to neglect and exit. Voice was seen as risky for some respondents, who feared that complaining could damage their career prospects and workplace relationships.
ORIGINALITY/VALUE: This study highlights the systemic, cultural and practical issues that pressure hospital doctors in Ireland to opt for silence around working conditions. It adds to the literature on workplace silence and voice within the medical profession and provides a framework for comparative analysis of doctors' silence and voice in other settings.
工作场所的沉默会阻碍生产力、工作满意度和员工保留率，这是全球医院劳动力的关键问题。它可能对患者的结果和安全以及医疗机构的人力资源产生负面影响。本研究旨在调查影响爱尔兰医院医生工作场所沉默的因素。
设计/方法/方法：2019 年 10 月至 11 月，对爱尔兰医院医生进行了全国性的、横断面的、在线调查；共有 1070 名医院医生做出回应。本文主要关注对“如果您对工作条件有顾虑，您会提出吗？”这一问题的回答。共有 227 名（25%）医院医生表示他们不会对工作条件提出担忧。对关于他们工作条件的自由文本回答进行了定性主题分析，以探讨为什么这些医生选择对工作条件保持沉默。
声誉风险、缺乏精力和时间、认为无法改变以及文化规范都阻止医生对工作条件提出担忧。对工作条件的改变持漠不关心的态度，因为认为改变工作条件的可能性很小。反过来，这可能导致忽视和离职。对一些受访者来说，声音被视为有风险的，他们担心抱怨会损害他们的职业前景和工作场所关系。
原创性/价值：本研究强调了迫使爱尔兰医院医生对工作条件保持沉默的系统性、文化性和实际问题。它增加了关于医疗行业工作场所沉默和声音的文献，并为在其他环境中分析医生沉默和声音提供了框架。
