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Kearns AJ. The principle of double effect and external whistleblowing in nursing. Nurs Outlook 2022; 70:807-819. [PMID: 36400577 DOI: 10.1016/j.outlook.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 09/12/2022] [Accepted: 09/14/2022] [Indexed: 11/17/2022]
Abstract
Nurses are generally expected to raise concerns when a harm or wrongdoing is committed against patients. Should their concerns not be adequately addressed, then nurses may take the decision to engage in external whistleblowing. Given that it could have a negative effect on the health care organization or service, nurses may question whether they should engage in external whistleblowing. Consequently, is there an ethical criterion to discern whether the negative effect on the health care organization or service is ethically permissible? This paper argues for the suitability of the Principle of Double Effect as an ethical criterion. The position of this paper is that external whistleblowing by a nurse when understood as an advocacy act with two effects (i.e. the effect of defending a patient and the further negative effect on the health care organization or service) can be ethically permissible through meeting the conditions of the Principle of Double Effect.
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Affiliation(s)
- Alan J Kearns
- School of Theology, Philosophy, and Music, Dublin City University, Dublin, Ireland.
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Wang D, Zhan C. Why Not Blow the Whistle on Health Care Insurance Fraud? Evidence from Jiangsu Province, China. Risk Manag Healthc Policy 2022; 15:1897-1915. [PMID: 36268183 PMCID: PMC9577100 DOI: 10.2147/rmhp.s379300] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 10/01/2022] [Indexed: 11/06/2022] Open
Abstract
Purpose To identify the factors that influence whistleblowing behavior as it relates to health care insurance fraud in Jiangsu Province, China. Methods To construct a factor model and formulate research hypotheses using the Motivation–Opportunity–Ability framework. We designed a questionnaire containing 24 items and distributed it on-site to 2081 respondents in Jiangsu Province, China. Afterward, we applied structural equation modeling to validate the research hypotheses. Results Policy awareness negatively contributes to whistleblowing behavior, risk perception does not reduce the incentive to blow the whistle, and an inability to recognize fraud is another critical barrier to converting whistleblowing intentions into behavior. Conclusion Practices that are likely to promote citizen whistleblowing on insurance fraud may focus on the constraints identified by the comprehensive Motivation–Opportunity–Ability framework.
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Affiliation(s)
- Dandan Wang
- School of Management, Jiangsu University, Zhenjiang, People’s Republic of China
| | - Changchun Zhan
- School of Management, Jiangsu University, Zhenjiang, People’s Republic of China,Correspondence: Changchun Zhan, Tel +86-15952808385, Email
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Wiisak J, Suhonen R, Leino‐Kilpi H. Reasoning for whistleblowing in health care. Scand J Caring Sci 2022; 37:316-327. [PMID: 35872611 DOI: 10.1111/scs.13109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 06/15/2022] [Accepted: 07/10/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Whistleblowing is recognised as part of solving wrongdoing. It requires individual reasoning as it is a potentially complicated process with a risk of possible negative consequences for oneself. Knowledge on how individuals reason for whistleblowing in healthcare context is lacking. AIM This study aimed to create a theoretical construct to describe individual reasoning for whistleblowing. METHODS The methodology was grounded theory, with 244 nurses as informants. The data consisted of nurses' written narratives in response to a wrongdoing situation presented in a video vignette. To ensure the heterogeneity of the population and variation in nurses' professional expertise, experiences and geographical locations in health care to capture the multidimensionality of the responses, nurses were invited to participate, and data were collected electronically from the membership register of the Finnish Nurses' Association on a national level. Constant comparison was used to analyse the open data. RESULTS The core category of the theoretical construct, 'The formation of morally courageous intervening', was discovered, reflecting individual's values and beliefs. It forms mentally as an integration of cognition and emotion for recognising one's own strengths and limits to act to do the right thing despite the risk of negative consequences for oneself. The core category consists of three dimensions of reasoning: (1) Reasoning Actors, (2) Reasoning Justifications and (3) Reasoning Activities, their categories and three patterns of reasoning connecting the dimensions and their categories with each other: (I) Individual Reasoning, (II) Collaborative Reasoning and (III) Collective Reasoning. DISCUSSION AND CONCLUSION The theoretical construct indicate that reasoning is a multidimensional phenomenon. In future, a theoretical construct could be further developed. In health care, managers could use the theoretical construct to support employees in their whistleblowing.
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Affiliation(s)
- Johanna Wiisak
- Department of Nursing Science University of Turku Turku Finland
| | - Riitta Suhonen
- Department of Nursing Science University of Turku Turku Finland
- The Welfare Services Division of Turku City Turku University Hospital Turku Finland
| | - Helena Leino‐Kilpi
- Department of Nursing Science University of Turku Turku Finland
- Turku University Hospital Turku Finland
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Speaking-up for patient safety: A scoping narrative review of international literature and lessons for radiography in Ghana and other resource-constrained settings. Radiography (Lond) 2022; 28:919-925. [PMID: 35820354 DOI: 10.1016/j.radi.2022.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 06/08/2022] [Accepted: 06/24/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Employees 'speaking-up', or raising concerns about unsafe practices, has gained traction across healthcare, however, the topic has not been widely discussed within radiography generally or within resource-constrained healthcare settings. A systematic scoping narrative review identified the experiences of radiographers in speaking-up about safety concerns, which was extended to healthcare professionals more broadly. The scope of the review was further extended to cover speaking-up in non-healthcare resource-constrained settings in Africa. KEY FINDINGS Sixty-three studies were included in the review. The majority originated from westernised and/or higher resource health systems, with a dearth of literature from Africa and other resource-constrained settings. Several studies identified barriers and enablers confronting healthcare workers wishing to speak-up. While 'speaking-up' as a concept has gained international interest, most studies are, however, focussed on nursing and medical practice contexts, overlooking other healthcare professions, including radiography. The findings are synthesised into a series of key lessons for healthcare and radiography practitioners in Ghana and other resource-constrained settings. CONCLUSION The topic has been largely overlooked by policy makers, both within healthcare generally and specifically within radiography in Ghana. This is particularly concerning given the many complexities and risks inherent to radiography. A radiography and a healthcare workforce lacking in voice is poorly positioned to improve workers' safety and patient safety. More generally, promoting speaking up could enhance Ghana's ambitions to deliver a high-quality health care system and Universal Health Coverage (UHC) in the future. IMPLICATIONS FOR PRACTICE National and regional policy makers need to implement speaking-up processes and procedures reflecting the lessons of the literature review, such as ensuring no detriment as result of speaking-up and making staff feel that their concerns are not futile. Speaking-up processes should be implemented by individual organisations, alongside staff training and monitoring.
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Abstract
Background Moral courage means courage to act according to individual’s own ethical
values and principles despite the risk of negative consequences for them.
Research about the moral courage of whistle-blowers in health care is
scarce, although whistleblowing involves a significant risk for the
whistle-blower. Objective To analyse the moral courage of potential whistle-blowers and its association
with their background variables in health care. Research design Was a descriptive-correlational study using a questionnaire, containing
Nurses Moral Courage Scale©, a video vignette of the wrongdoing
situation with an open question about the vignette, and several background
variables. Data were analysed statistically and inductive content analysis
was used for the narratives. Participants and research context Nurses as healthcare professionals (including registered nurses, public
health nurses, midwives, and nurse paramedics) were recruited from the
membership register of the Nurses’ Association via email in 2019. A total of
454 nurses responded. The research context was simulated using a
vignette. Ethical considerations Good scientific inquiry guidelines were followed. Permission to use the
Nurses’ Moral Courage Scale© was obtained from the copyright
holder. The ethical approval and permission to conduct the study were
obtained from the participating university and the Nurses’ Association. Findings The mean value of potential whistle-blowers’ moral courage on a Visual
Analogue Scale (0–10) was 8.55 and the mean score was 4.34 on a 5-point
Likert scale. Potential whistle-blowers’ moral courage was associated with
their socio-demographics, education, work, personality and social
responsibility related background variables. Discussion and conclusion In health care, potential whistle-blowers seem to be quite morally courageous
actors. The results offer opportunities for developing interventions,
practices and education to support and encourage healthcare professionals in
their whistleblowing. Research is needed for developing a theoretical
construction to eventually increase whistleblowing and decrease and prevent
wrongdoing.
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Affiliation(s)
- Johanna Wiisak
- 8058University of Turku, Department of Nursing Science, Turku, Finland
| | - Riitta Suhonen
- University of Turku, Department of Nursing Science and Director of Nursing, 60652Turku University Hospital, and City of Turku, Welfare Services Division, Finland
| | - Helena Leino-Kilpi
- University of Turku, Department of Nursing Science and Director of Nursing, 60652Turku University Hospital, Finland
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Blenkinsopp J, Snowden N, Mannion R, Powell M, Davies H, Millar R, McHale J. Whistleblowing over patient safety and care quality: a review of the literature. J Health Organ Manag 2020; 33:737-756. [PMID: 31625824 DOI: 10.1108/jhom-12-2018-0363] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The purpose of this paper is to review existing research on whistleblowing in healthcare in order to develop an evidence base for policy and research. DESIGN/METHODOLOGY/APPROACH A narrative review, based on systematic literature protocols developed within the management field. FINDINGS The authors identify valuable insights on the factors that influence healthcare whistleblowing, and how organizations respond, but also substantial gaps in the coverage of the literature, which is overly focused on nursing, has been largely carried out in the UK and Australia, and concentrates on the earlier stages of the whistleblowing process. RESEARCH LIMITATIONS/IMPLICATIONS The review identifies gaps in the literature on whistleblowing in healthcare, but also draws attention to an unhelpful lack of connection with the much larger mainstream literature on whistleblowing. PRACTICAL IMPLICATIONS Despite the limitations to the existing literature important implications for practice can be identified, including enhancing employees' sense of security and providing ethics training. ORIGINALITY/VALUE This paper provides a platform for future research on whistleblowing in healthcare, at a time when policymakers are increasingly aware of its role in ensuring patient safety and care quality.
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Affiliation(s)
- John Blenkinsopp
- Department of Leadership and HRM, Northumbria University , Newcastle upon Tyne, UK
| | - Nick Snowden
- Hull University Business School, University of Hull , Hull, UK
| | - Russell Mannion
- Health Services Management Centre, University of Birmingham , Birmingham, UK
| | - Martin Powell
- Health Services Management Centre, University of Birmingham , Birmingham, UK
| | - Huw Davies
- University of Saint Andrews , Saint Andrews, UK
| | - Ross Millar
- Health Services Management Centre, University of Birmingham , Birmingham, UK
| | - Jean McHale
- Birmingham Law School, University of Birmingham , Birmingham, UK
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Gagnon M, Perron A. Whistleblowing: A concept analysis. Nurs Health Sci 2019; 22:381-389. [DOI: 10.1111/nhs.12667] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 10/22/2019] [Accepted: 10/23/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Marilou Gagnon
- School of NursingUniversity of Victoria Victoria British Columbia Canada
| | - Amélie Perron
- School of NursingUniversity of Ottawa Ottawa Ontario Canada
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Pohjanoksa J, Stolt M, Suhonen R, Leino‐Kilpi H. Wrongdoing and whistleblowing in health care. J Adv Nurs 2019; 75:1504-1517. [DOI: 10.1111/jan.13979] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 11/14/2018] [Accepted: 12/10/2018] [Indexed: 11/30/2022]
Affiliation(s)
| | - Minna Stolt
- Department of Nursing Science University of Turku Turku Finland
| | - Riitta Suhonen
- Department of Nursing Science University of Turku Turku Finland
- Welfare Division Turku University Hospital and City of Turku Turku Finland
| | - Helena Leino‐Kilpi
- Department of Nursing Science University of Turku Turku Finland
- Turku University Hospital Turku Finland
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Mannion R, Blenkinsopp J, Powell M, McHale J, Millar R, Snowden N, Davies H. Understanding the knowledge gaps in whistleblowing and speaking up in health care: narrative reviews of the research literature and formal inquiries, a legal analysis and stakeholder interviews. HEALTH SERVICES AND DELIVERY RESEARCH 2018. [DOI: 10.3310/hsdr06300] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background
There is compelling evidence to suggest that some (or even many) NHS staff feel unable to speak up, and that even when they do, their organisation may respond inappropriately.
Objectives
The specific project objectives were (1) to explore the academic and grey literature on whistleblowing and related concepts, identifying the key theoretical frameworks that can inform an understanding of whistleblowing; (2) to synthesise the empirical evidence about the processes that facilitate or impede employees raising concerns; (3) to examine the legal framework(s) underpinning whistleblowing; (4) to distil the lessons for whistleblowing policies from the findings of Inquiries into failings of NHS care; (5) to ascertain the views of stakeholders about the development of whistleblowing policies; and (6) to develop practical guidance for future policy-making in this area.
Methods
The study comprised four distinct but interlocking strands: (1) a series of narrative literature reviews, (2) an analysis of the legal issues related to whistleblowing, (3) a review of formal Inquiries related to previous failings of NHS care and (4) interviews with key informants.
Results
Policy prescriptions often conceive the issue of raising concerns as a simple choice between deciding to ‘blow the whistle’ and remaining silent. Yet research suggests that health-care professionals may raise concerns internally within the organisation in more informal ways before utilising whistleblowing processes. Potential areas for development here include the oversight of whistleblowing from an independent agency; early-stage protection for whistleblowers; an examination of the role of incentives in encouraging whistleblowing; and improvements to criminal law to protect whistleblowers. Perhaps surprisingly, there is little discussion of, or recommendations concerning, whistleblowing across the previous NHS Inquiry reports.
Limitations
Although every effort was made to capture all relevant papers and documents in the various reviews using comprehensive search strategies, some may have been missed as indexing in this area is challenging. We interviewed only a small number of people in the key informant interviews, and our findings may have been different if we had included a larger sample or informants with different roles and responsibilities.
Conclusions
Current policy prescriptions that seek to develop better whistleblowing policies and nurture open reporting cultures are in need of more evidence. Although we set out a wide range of issues, it is beyond our remit to convert these concerns into specific recommendations: that is a process that needs to be led from elsewhere, and in partnership with the service. There is also still much to learn regarding this important area of health policy, and we have highlighted a number of important gaps in knowledge that are in need of more sustained research.
Future work
A key area for future research is to explore whistleblowing as an unfolding, situated and interactional process and not just a one-off act by an identifiable whistleblower. In particular, we need more evidence and insights into the tendency for senior managers not to hear, accept or act on concerns about care raised by employees.
Funding
The National Institute for Health Research Health Services and Delivery Research programme.
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Affiliation(s)
- Russell Mannion
- Health Services Management Centre, University of Birmingham, Birmingham, UK
| | - John Blenkinsopp
- Newcastle Business School, Northumbria University, Newcastle upon Tyne, UK
| | - Martin Powell
- Health Services Management Centre, University of Birmingham, Birmingham, UK
| | - Jean McHale
- Birmingham Law School, University of Birmingham, Birmingham, UK
| | - Ross Millar
- Health Services Management Centre, University of Birmingham, Birmingham, UK
| | | | - Huw Davies
- School of Management, University of St Andrews, St Andrews, UK
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Pohjanoksa J, Stolt M, Suhonen R, Löyttyniemi E, Leino-Kilpi H. Whistle-blowing process in healthcare: From suspicion to action. Nurs Ethics 2017; 26:526-540. [DOI: 10.1177/0969733017705005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Whistle-blowing is an ethical activity that tries to end wrongdoing. Wrongdoing in healthcare varies from inappropriate behaviour to illegal action. Whistle-blowing can have negative consequences for the whistle-blower, often in the form of bullying or retribution. Despite the wrongdoing and negative tone of whistle-blowing, there is limited literature exploring them in healthcare. Objective: The aim was to describe possible wrongdoing in Finnish healthcare and to examine whistle-blowing processes described on the basis of the existing literature in healthcare as perceived by healthcare professionals. Research design: The study was a cross-sectional descriptive survey. The data were collected using the electronic questionnaire Whistle-blowing in Health Care and analysed statistically. Participants and research context: A total of 397 Finnish healthcare professionals participated, 278 of whom had either suspected or observed wrongdoing in healthcare, which established the data for this article. Ethical considerations: Ethical approval was obtained from the Ethics Committee of the University (20/2015). Permission to conduct the study was received according to the organisation’s policies. Findings: Wrongdoing occurs in healthcare, as 96% of the participants had suspected and 94% had observed wrongdoing. Regarding the frequency, wrongdoing was suspected (57%) and observed (52%) more than once a month. Organisation-related wrongdoing was the most common type of wrongdoing (suspected 70%, observed 66%). In total, two whistle-blowing processes were confirmed in healthcare: (1) from suspicion to consequences occurred to 27%, and (2) from observation to consequences occurred to 37% of the participants. Discussion and conclusion: Wrongdoing occurs in healthcare quite frequently. Whistle-blowing processes were described based on the existing literature, but two separate processes were confirmed by the empirical data. More research is needed on wrongdoing and whistle-blowing on it in healthcare.
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Affiliation(s)
| | - Minna Stolt
- University of Turku, Finland; Turku University Hospital, Finland
| | - Riitta Suhonen
- University of Turku, Finland; Turku University Hospital, Finland; City of Turku, Welfare Division Administration, Finland
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Abstract
Purpose
In line with the current literature, the purpose of this paper is to contribute to a better understanding of whistleblowing procedures and their influence on overall organisational quality. To this end, institutional, organisational, and cultural barriers to whistleblowing implementation have been investigated.
Design/methodology/approach
A qualitative analysis based on three explorative case studies investigates and compares different whistleblowing practices implemented in health care organisations, operating within the Italian National Health Service (INHS).
Findings
INHS organisations have implemented whistleblowing procedures in different ways, despite the fact that the procedures are laid down by law. These differences are mainly due to cultural, administrative, organisational, and process barriers, which have a deep impact on whistleblowing integration in managerial practices and their influence on the overall quality of health processes and services.
Research limitations/implications
This research paper was limited by the analysis of three Italian public health care organisations, which did not allow the generalisability of findings. Therefore, the study offers interesting insights on the way effective whistleblowing systems should be implemented in order to support managers to improve organisation’s management and service quality.
Originality/value
The paper represents one of the first attempts to structurally analyse the practice of whistleblowing in an Italian healthcare system. Therefore the study has mainly focussed not only on the analysis of whistleblowing practices, but also on their impacts on the improvement of organisational processes’ quality and, subsequently, on social well-being.
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Ion R, Smith K, Moir J, Nimmo S. Accounting for actions and omissions: a discourse analysis of student nurse accounts of responding to instances of poor care. J Adv Nurs 2016; 72:1054-64. [DOI: 10.1111/jan.12893] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2015] [Indexed: 11/28/2022]
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Ion R, Smith K, Nimmo S, Rice AM, McMillan L. Factors influencing student nurse decisions to report poor practice witnessed while on placement. NURSE EDUCATION TODAY 2015; 35:900-905. [PMID: 25765226 DOI: 10.1016/j.nedt.2015.02.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Revised: 02/10/2015] [Accepted: 02/13/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND While it is commonly accepted that nursing care is generally of a good standard, it would be naïve to think that this is always the case. Over recent years, concern about aspects of the quality of some nursing care has grown. In tandem with this, there is recognition that nurses do not always report poor practice. As future registrants, student nurses have a role to play in changing this culture. We know, however, relatively little about the factors that influence student decisions on whether or not to report. In the absence of a more nuanced understanding of this issue, we run the risk of assuming students will speak out simply because we say they should. OBJECTIVES To explore influences on student decisions about whether or not to report poor clinical practice, which is a result of deliberate action and which is witnessed while on placement. METHODS Qualitative interviews were conducted with thirteen pre-registration nursing students from the UK. Participants included both adult and mental health nurses with an age range from 20 to 47. Data were analysed to identify key themes. Category integrity and fit with data were confirmed by a team member following initial analysis. RESULTS Four themes. The first of these, 'I had no choice' described the personal and ethical drivers which influenced students to report. 'Consequences for self' and 'Living with ambiguity' provide an account of why some students struggle to report, while 'Being prepared' summarised arguments both for and against reporting concerns. CONCLUSION While there is a drive to promote openness in health care settings and an expectation that staff will raise concerns the reality is that the decision to do this can be very difficult. This is the case for some student nurses. Our results suggest ways in which educationalists might intervene to support students who witness poor practice to report.
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Affiliation(s)
- R Ion
- Abertay University, United Kingdom.
| | - K Smith
- Abertay University, United Kingdom
| | - S Nimmo
- Abertay University, United Kingdom
| | - A M Rice
- Glasgow University, United Kingdom
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Jafree SR, Zakar R, Fischer F, Zakar MZ. Ethical violations in the clinical setting: the hidden curriculum learning experience of Pakistani nurses. BMC Med Ethics 2015; 16:16. [PMID: 25888967 PMCID: PMC4369076 DOI: 10.1186/s12910-015-0011-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 03/03/2015] [Indexed: 11/10/2022] Open
Abstract
Background The importance of the hidden curriculum is recognised as a practical training ground for the absorption of medical ethics by healthcare professionals. Pakistan’s healthcare sector is hampered by the exclusion of ethics from medical and nursing education curricula and the absence of monitoring of ethical violations in the clinical setting. Nurses have significant knowledge of the hidden curriculum taught during clinical practice, due to long working hours in the clinic and front-line interaction with patients and other practitioners. Methods The means of inquiry for this study was qualitative, with 20 interviews and four focus group discussions used to identify nurses’ clinical experiences of ethical violations. Content analysis was used to discover sub-categories of ethical violations, as perceived by nurses, within four pre-defined categories of nursing codes of ethics: 1) professional guidelines and integrity, 2) patient informed consent, 3) patient rights, and 4) co-worker coordination for competency, learning and patient safety. Results Ten sub-categories of ethical violations were found: nursing students being used as adjunct staff, nurses having to face frequent violence in the hospital setting, patient reluctance to receive treatment from nurses, the near-absence of consent taken from patients for most non-surgical medical procedures, the absence of patient consent taking for receiving treatment from student nurses, the practice of patient discrimination on the basis of a patient’s socio-demographic status, nurses withdrawing treatment out of fear for their safety, a non-learning culture and, finally, blame-shifting and non-reportage of errors. Conclusion Immediate and urgent attention is required to reduce ethical violations in the healthcare sector in Pakistan through collaborative efforts by the government, the healthcare sector, and ethics regulatory bodies. Also, changes in socio-cultural values in hospital organisation, public awareness of how to conveniently report ethical violations by practitioners and public perceptions of nurse identity are needed.
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Affiliation(s)
- Sara Rizvi Jafree
- Institute of Social and Cultural Studies, University of the Punjab, P.O. Box 54590, Lahore, Pakistan. .,Forman Christian College, Sociology Department, University of the Punjab, 21 FCC Maratib Ali Road, 54000, Gulberg, Lahore, Pakistan.
| | - Rubeena Zakar
- Institute of Social and Cultural Studies, University of the Punjab, P.O. Box 54590, Lahore, Pakistan.
| | - Florian Fischer
- School of Public Health, Department of Public Health Medicine, Bielefeld University, P.O. Box 100 131, 33501, Bielefeld, Germany.
| | - Muhammad Zakria Zakar
- Institute of Social and Cultural Studies, University of the Punjab, P.O. Box 54590, Lahore, Pakistan.
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Kelly D, Jones A. When care is needed: the role of whistleblowing in promoting best standards from an individual and organizational perspective. QUALITY IN AGEING AND OLDER ADULTS 2013. [DOI: 10.1108/qaoa-05-2013-0010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Peters K, Luck L, Hutchinson M, Wilkes L, Andrew S, Jackson D. The emotional sequelae of whistleblowing: findings from a qualitative study. J Clin Nurs 2011; 20:2907-14. [DOI: 10.1111/j.1365-2702.2011.03718.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Jackson D, Peters K, Andrew S, Edenborough M, Halcomb E, Luck L, Salamonson Y, Wilkes L. Understanding whistleblowing: qualitative insights from nurse whistleblowers. J Adv Nurs 2010; 66:2194-201. [DOI: 10.1111/j.1365-2648.2010.05365.x] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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