School of Nursing, University of Victoria, Victoria, British Columbia, Canada.
School of Nursing, University of Ottawa, Ottawa, Ontario, Canada.
J Adv Nurs. 2022 Dec;78(12):4135-4149. doi: 10.1111/jan.15365. Epub 2022 Jul 19.
The experiences of nurses who blew the whistle during the COVID-19 pandemic have exposed gaps and revealed an urgent need to revisit our understanding of whistleblowing.
The aim was to develop a better understanding of whistleblowing during a pandemic by using the experiences and lessons learned of Quebec nurses who blew the whistle during the first wave of COVID-19 as a case study. More specifically, to explore why and how nurses blew the whistle, what types of wrongdoing triggered their decision to do so and how context shaped the whistleblowing process as well as its consequences (including perceived consequences).
The study followed a single-case study design with three embedded units of analysis.
We used content analysis to analyse 83 news stories and 597 forms posted on a whistleblowing online platform. We also conducted 15 semi-structured interviews with nurses and analysed this data using a thematic analysis approach. Finally, we triangulated the findings.
We identified five themes across the case study. (1) During the first wave of COVID-19, Quebec nurses experienced a shifting sense of loyalty and relationship to workplace culture. (2) They witnessed exceedingly high numbers of intersecting wrongdoings amplified by mismanagement and long-standing issues. (3) They reported a lack of trust and transparency; thus, a need for external whistleblowing. (4) They used whistleblowing to reclaim their rights (notably, the right to speak) and build collective solidarity. (5) Finally, they saw whistleblowing as an act of moral courage in the face of a system in crisis. Together, these themes elucidate why and how nurse whistleblowing is different in pandemic times.
Our findings offer a more nuanced understanding of nurse whistleblowing and address important gaps in knowledge. They also highlight the need to rethink external whistleblowing, develop whistleblowing tools and advocate for whistleblowing protection.
In many ways, the COVID-19 pandemic has challenged our foundational understanding of whistleblowing and, as a result, it has limited the usefulness of existing literature on the topic for reasons that will be brought to light in this paper. We believe that studying the uniqueness of whistleblowing during a pandemic can address this gap by describing why and how health care workers blow the whistle during a pandemic and situating this experience within a broader social, political, organizational context.
以魁北克护士在 COVID-19 大流行第一波期间的 whistleblowing 经历为案例研究，深入了解大流行期间 whistleblowing 的情况。具体来说，探究为什么以及如何护士 whistleblowing，是什么类型的不当行为触发了他们这样做的决定，以及情境如何塑造 whistleblowing 过程及其后果（包括感知后果）。
我们使用内容分析法分析了 83 篇新闻报道和 whistleblowing 在线平台上发布的 597 份表格。我们还对 15 名护士进行了半结构化访谈，并使用主题分析方法对这些数据进行了分析。最后，我们对研究结果进行了三角验证。
我们在案例研究中确定了五个主题。（1）在 COVID-19 大流行的第一波期间，魁北克护士经历了对工作场所文化忠诚感和关系的转变。（2）他们目睹了异常高数量的交织不当行为，这些行为因管理不善和长期存在的问题而加剧。（3）他们报告缺乏信任和透明度；因此，需要外部 whistleblowing。（4）他们利用 whistleblowing 来维护自己的权利（特别是言论自由的权利）并建立集体团结。（5）最后，他们认为 whistleblowing 是面对危机中的系统的一种道德勇气的行为。总的来说，这些主题阐明了为什么以及为什么在大流行时期护士 whistleblowing 是不同的。
在许多方面，COVID-19 大流行挑战了我们对 whistleblowing 的基本理解，因此，由于将在本文中揭示的原因，它限制了现有关于该主题文献的实用性。我们相信，通过描述为什么以及如何在大流行期间医护人员 whistleblowing，并将这种经历置于更广泛的社会、政治和组织背景下，研究大流行期间 whistleblowing 的独特性可以解决这一差距。
