Exit only: harms from silencing employee voice

Abstract

The nationwide shortage of PPE for health care workers has been well documented. Reporting on this issue has been complicated by hospitals' imposition of gag orders on physicians and health care workers. There are harms that result from imposing these gag orders that go beyond the obvious harms to public and employee health and safety. Using Hirschman's ‘Exit, Voice, and Loyalty’ (1970) as a framework demonstrates that these orders represent a dangerous concentration of power in employer hands — health care workers are reduced to functionaries. Hirschman's argument, in part, is that organisations should seek to balance the availability of exit, voice, and loyalty for employees. Restricting employee options in morally untenable situations to exit only leads to direct and indirect harms. These gag orders are a pernicious practice, and bring with them long-term negative implications for employee morale, employee effectiveness, and public service.

How Did the Pandemic Affect Communication in Clinical Settings? A Qualitative Study with Critical and Emergency Care Nurses

“…Another limitation of this study is that it focused on communication at the level of professionals and patients/families. This research could perhaps have benefited from a perspective that connects to the managerial/organizational level, leaving aside half of the factors that influence the work of the participants and those who have already been investigated in numerous works [ 63 , 64 ].…”