Blowing the whistle: Research findings of a qualitative study in the field of nursing

Poor quality, errors, mistakes and unethical behaviours can be observed also in health care settings and in homes for the elderly. The results can be severe damages for patients and residents and economical losses for institutions, communities and health insurances. Reporting such incidents or failed processes as well as insufficient structures to institutions or individual persons of influence is one possibility to seek improvement and secure the wellbeing of patients and residents. Such reporting is known as whistleblowing. Nurses work on the sharp end and they are many in numbers. They are important members of the health workforce to augment security and wellbeing by reporting. However, whistleblowing is a difficult concept for nurses.

The presentation exemplifies results of a qualitative study in Northern Germany. Purpose of the study had been the exploration of handling errors and qualitative problems as preparation for outlining a prevalence study focusing on nursing errors*. Eighteen nurses had been questioned with semi-structured interviews. Of these nurses, eight had been working in hospital settings and ten in nursing homes. One of the persons had been employed as assistant nurse, the others had been registered nurses. A convenient sampling had been done. The interviews of 35-75 Minutes had been recorded, transcribed and analysed.

Results: Most of the respondents (16) would not consider whistleblowing as a serious choice even in case of observing severe misconduct and endangered patients or residents. Reasons are fears to experience personal disadvantages, and feelings of loyality towards colleagues and organisations. Two person felt professional obligation to act as advocate for patients/inhabitants.

The results are supplemented by a systematic review of international studies (N=9) concerning whistleblowing in health care settings.

Conclusions for health care planners and quality control are drawn.

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* Funded by the Ministry of Education and Research, Federal Republic Germany

Learning Objectives: Participants know the concept of whistleblowing in health care settings and legal background (USA/UK/Germany) Recognizes whistleblowing as an ethical and personal demanding issue for health care professionals Recognizes demand of action in health care settings. Learns about mistakes and errors in health care settings and possible strategies to answer this

Sub-Theme: Improving performance and productivity of the health team

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