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

Abstract

This 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.

Whistle‐blowing and workplace culture in older peoples' care: qualitative insights from the healthcare and social care workforce

“…Whistle‐blowers have been characterised in the literature as courageous employees who act to maintain standards against the might of faceless organisations (Jackson and Raftos ), sometimes at great personal cost (Iliffe ). An alternative view, and one that is sometimes promulgated by targeted organisations (Firtko and Jackson ), is that whistle‐blowers are also malcontents, who will stop at nothing to pursue their own agenda, regardless of the destructive and negative consequences of their actions for colleagues and organisations.…”

Promoting integrity in the workplace: A priority for all academic health professionals

“…Indeed, staff can feel that they are unable to speak up or raise issues of concern, and this has implications for the quality of service that can be provided (Jackson & Raftos, 1997). Faculty may be required to make tough decisions, and the consequences of 'being aware of "what should be done" and not having the power or the resources to act on this awareness may lead to a "troubled conscience"' (Lützén et al, 2006, pp.…”

Monetising your mum: The industrification of aged care

“…The aged care industry and their powerful backers and lobbyists have been remarkably successful in using the positive connotations of qualified nursing for their own ends, while fervently avoiding any of its standards, practices, ratios, salaries or responsibilities (Jackson & Raftos, 1997). Aged care staffing is now a byword for the exploitation of many of society's most vulnerable people, such as new migrants (Fine & Mitchell, 2007; van Hooren, 2012), or new mothers (Palmer & Eveline, 2012) who have few other options, and who are desperate for any employment.…”

“…Residential aged care staff might be referred to as ‘nurses’ in day‐to‐day language (De Bellis, 2010), leading residents and their families to believe they are getting what they imagine they are paying for—expert nursing care. This myth of available expertise is carefully reinforced through the deliberate misappropriation of nursing iconography (Jackson & Raftos, 1997). Google ‘aged care staff stock photos’, exactly as the industry does, and be prepared to adorn your corporate brochures or company website from the copious pages of young, smiling, overwhelmingly white, young women who will appear wearing the proverbial white or blue uniforms or scrubs, donning items such as corporate badges, and strategically placed stethoscopes, and with an arm caringly draped across the shoulders of a smiling older person.…”

“…Residential aged care staff might be referred to as 'nurses' in day-to-day language (De Bellis, 2010), leading residents and their families to believe they are getting what they imagine they are paying for-expert nursing care. This myth of available expertise is carefully reinforced through the deliberate misappropriation of nursing iconography (Jackson & Raftos, 1997).…”