In uncharted waters: Confronting the culture of silence in a residential care institution

Abstract

In unchartered waters: Confronting the culture of silence in a residential care institutionThis paper describes a study grounded in feminism, which explored the experiences of three registered nurses who were employed in a residential care institution in which they believed the standard of care to be unacceptably poor. Ultimately, the nurses became 'whistle blowers'. Data surrounding these events were gathered through serial encounters and analysed using feminist interpretive methods. Three distinct phases were revealed: (i) trepidation and optimizm; (ii) barriers and obstacles; and (iii) disillusionment and defeat. It was in this final phase that the whistle blowing occurred. For these women, whistle blowing was an intervention of last resort; a stressful and negative event that carried personal and professional cost. Issues pertaining to professional autonomy and patient advocacy are raised, together with concerns surrounding the appropriation by business people of the language and images of nursing, and the power of these people to negatively impact upon nursing practice.

Who would want to be a nurse? Violence in the workplace - a factor in recruitment and retention

“…(1997) suggest that most bullying is carried out by line managers to their subordinate staff. Given the size of the problem there is scant research on the topic, but there is evidence to show that workplace bullying and marginalization can jeopardize patient care as well as have a devastating effect on nurses themselves (Jackson and Raftos 1997).…”

Conflict of roles: A conflict of ideas? The unsettled relations between care team staff and independent mental health advocates

“…In a UK context, the need for independent advocacy is illustrated by concerns over care and compassion (Randall & McKeown ) and treatment under the Mental Health Act. Notable nurse whistleblowing cases demonstrate that practitioners can set aside their interests and advocate for patient rights and welfare (Ahern & McDonald ; Jackson & Raftos ). This does not obviate a need for independent advocacy, especially considering the liberty‐limiting constraints of much standard psychiatric care, circumscribed by legislation and biotechnologies bound up with governance and control (Ingleby ; Rose ), with compulsion rates steadily increasing across Europe (van der Post et al .…”

Bridging the gap between learning and practice: from where we were to where we are now

“…Reports suggest that organisational factors, such as treatment of the whistleblower and reactions to attempts to raise concerns, deter even experienced staff (Bjørkelo et al, 2008;Jackson et al, 1997). Therefore, training is unlikely to do more than inform staff about what they should do, rather than assist them to overcome such workplace barriers.…”