Whistleblowing: An integrative literature review of data-based studies involving nurses

Abstract

Nursing plays a key role in maintaining practice standards and in reporting care that is unacceptable although the repercussions to nurses who raise concerns are insupportable. Overall, whistleblowing and how it influences the individual, their family, work colleagues, nursing practice and policy overall, requires further national and international research attention.

Whistleblowing Need not Occur if Internal Voices Are Heard: From Deaf Effect to Hearer Courage Comment on "Cultures of Silence and Cultures of Voice: The Role of Whistleblowing in Healthcare Organisations"

“…Personal and professional retaliation against whistleblowers has been wellrecognised and involves damaging processes that attempt to deal with the disclosure by discrediting the whistleblower rather than dealing with the information disclosed. [24][25][26][27][28][29][30][31] Mannion and Davies 1 like others have posed the argument that whistleblowing need not occur if those responsible in an organisations respond positively to concerns raised and begin a process of learning from mistakes as well as implementing effective policies to prevent future harm. However, to achieve this there needs to be a recognition that a culture of silence will remain in health services if the following dual processes continue to occur when staff raise concerns internally.…”

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

“…81,113,133 The formal process of investigating a concern is often traumatic for complainants and for subjects of complaints, as well as for bystanders. 88,101,102,112,113,115,119,144 Jackson et al 145 explored this issue, interviewing both whistleblowers and targets of whistleblowing. They found that 'whistle-blowing had a profound and overwhelmingly negative effect on working relationships', 145 with collegial and interprofessional relationships damaged, and those involved suffered bullying and exclusion.…”

“…88,101,102,112,113,115,119,144 Jackson et al 145 explored this issue, interviewing both whistleblowers and targets of whistleblowing. They found that 'whistle-blowing had a profound and overwhelmingly negative effect on working relationships', 145 with collegial and interprofessional relationships damaged, and those involved suffered bullying and exclusion. Bystanders were not immune to the impact of poorly managed whistleblowing, and could also suffer from a decline in peer relationships.…”

Clinical governance breakdown: Australian cases of wilful blindness and whistleblowing

“…11 Since then, a range of studies examining the complexities associated with nurses who report patient safety concerns internally and, when no action is taken, blow the whistle, have appeared. 12,[13][14][15][16][17][18] The research indicates that nurses hold strong views that internal reporting will not be listened to, leading to the perception that little or nothing would be done about the issue of concern. 12,[13][14][15][16][17]19 A number of human factors influence the manner in which organisations address patient safety concerns.…”

“…20 While the wilful blindness process and the human factors involved have not been directly examined by research, there is evidence in the literature of healthcare managers who apparently distance themselves from those staff raising concerns about patient safety. 18,19 In total, 2000 managers and clinicians from the UK National Health Service (NHS) were surveyed regarding quality of leadership, transparency and whistleblowing. Clear disparities emerged between medical staff, nursing staff and those identified as executive directors in the perception of the 'culture of voice'.…”