Speaking up as an extension of socio-cultural dynamics in hospital settings: a study of staff experiences of speaking up across seven hospitals

Abstract

PurposeThe study aimed to understand the significance of how employee personhood and the act of speaking up is shaped by factors such as employees' professional status, length of employment within their hospital sites, age, gender and their ongoing exposure to unprofessional behaviours.Design/methodology/approachResponses to a survey by 4,851 staff across seven sites within a hospital network in Australia were analysed to interrogate whether speaking up by hospital employees is influenced by employees' symbolic capital and situated subjecthood (SS). The authors utilised a Bourdieusian lens to interrogate the relationship between the symbolic capital afforded to employees as a function of their professional, personal and psycho-social resources and their self-reported capacity to speak up.FindingsThe findings indicate that employee speaking up behaviours appear to be influenced profoundly by whether they feel empowered or disempowered by ongoing and pre-existing personal and interpersonal factors such as their functional roles, work-based peer and supervisory support and ongoing exposure to discriminatory behaviours.Originality/valueThe findings from this interdisciplinary study provide empirical insights around why culture change interventions within healthcare organisations may be successful in certain contexts for certain staff groups and fail within others.

Coworker abuse in healthcare: voices of mistreated workers

“…Linnéusson et al. , 2022), helping hospitals reframe entrenched socio-cultural dynamics (Pavithra et al. , 2022) so that different units work together better.…”

“…, 2022) so that different units work together better. Mindfulness also helps individual workers reflect on and respond to harmful work behaviors in their unit, and if utilized as part of a more holistic cultural change intervention (Pavithra et al. , 2022), is likely to improve worker (and patient) well-being.…”

“…For example, mindfulness may help facilitate the development of a new shared understanding about coworker relations within and across units in healthcare contexts from a systems perspective (e.g. Linn eusson et al, 2022), helping hospitals reframe entrenched sociocultural dynamics (Pavithra et al, 2022) so that different units work together better. Mindfulness also helps individual workers reflect on and respond to harmful work behaviors in their unit, and if utilized as part of a more holistic cultural change intervention (Pavithra et al, 2022), is likely to improve worker (and patient) well-being.…”

“…Linn eusson et al, 2022), helping hospitals reframe entrenched sociocultural dynamics (Pavithra et al, 2022) so that different units work together better. Mindfulness also helps individual workers reflect on and respond to harmful work behaviors in their unit, and if utilized as part of a more holistic cultural change intervention (Pavithra et al, 2022), is likely to improve worker (and patient) well-being. Thus, by incorporating mindfulness into future theoretical healthcare models, it is our hope that researchers and practitioners can openly examine ingrained processes and thereby facilitate the necessary dialog to ultimately bolster practitioners' interactions along with the well-being of nurses.…”

Hospital staff reports of coworker positive and unprofessional behaviours across eight hospitals: who reports what about whom?

“…Serious unprofessional behaviours, for example, assault are managed via formal, traditional disciplinary processes. A mixed-methods study was conducted to evaluate the effectiveness of the Ethos programme to reduce unprofessional behaviours 19 36–40. A survey conducted prior to the introduction of Ethos revealed baseline information on the prevalence, type and impact of unprofessional behaviours among staff at SVHA hospitals 41 42.…”