"Stop the Noise!" From Voice to Silence

Newton, Lorelei; Storch, Janet; Schick‐Makaroff, Kara; Pauly, Bernadette

doi:10.12927/cjnl.2012.22828

Cited by 15 publications

(22 citation statements)

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“…In summary, nurses’ negative beliefs about ageing are documented in hospital settings (Higgins et al ., ; Neville, ; Kjorven et al ., ), and the systems within healthcare institutions frequently do not support appropriate care of hospitalised older adults (Peek et al ., ; Sellman, ; Rodney & Varcoe, ). Evidence also supports the claim that nursing practice with this population is fraught with challenges (Plavish et al ., ; Newton et al ., ; Rodney et al ., ) although how nurses enact their practice in the context of these challenges is not well understood. Thus, the aim of this study was to explain how nurses’ manage practice with hospitalised older adults from the perspective of nurses.…”

Section: Introductionmentioning

confidence: 96%

Orchestrating care: nursing practice with hospitalised older adults

Dahlke

Phinney

Hall

et al. 2014

Int J Older People Nursing

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Section: Introductionmentioning

confidence: 96%

Orchestrating care: nursing practice with hospitalised older adults

Dahlke

Phinney

Hall

et al. 2014

Int J Older People Nursing

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“…For example, the US Sarbanes-Oxley Act {Sarbanes-Oxley Act [2002] (Pub.L. 116 Stat. 745, enacted July 30, 2002)} states that it is an offence to 'knowingly and with intent' take actions harmful to another person.…”

Section: Using the Criminal Law To Protect Whistleblowersmentioning

confidence: 99%

“…However, Hutchinson and Jackson 98 noted that the entrenched behavioural patterns within health-care organisations are often at odds with the officially espoused organisational approach, and Jones and Kelly 17 reported that formal procedural approaches were 'neutralised' by organisational cultures that opposed 'voice'. Interestingly, Newton et al, 116 in a study involving 374 acute care nurses, found that nurses often took independent action to address poor care rather than pursue official channels of compliant. McCann et al 111 observed a similar phenomenon, whereby, in response to more challenging performance targets amid a reduction in resources, both front-line and mid-management employees resorted to 'a form of "street-level bureaucracy" -a situation in which traditional professional norms are reasserted informally in ways that often transgress prescribed performance systems'.…”

Section: Professional Standards Including Ethical Codes Of Practice mentioning

confidence: 99%

“…For example, rather than blow the whistle, nurses may address problems by 'contacting other healthcare team members, making referrals and coordinating care with other departments such as home care and hospice, as well as initiating contact with groups such as professional regulatory bodies or unions'. Newton 116 suggests that nurses are 'silenced' by organisations, but are not always 'silent'; that is, if they are not listened to by the relevant authorities, or are told to be quiet, they may elect to address the poor care directly and unofficially, rather than risk suffering the negative responses to whistleblowing from organisation or peers that so many nurses seem to anticipate.…”

Section: Responses From Peersmentioning

confidence: 99%

“…McDonald and Ahern 113 Mansbach et al 114 Monrouxe et al 82 Moore and McAuliffe 115 Moore and McAuliffe 115 Newton et al 116 Ohnishi et al…”

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confidence: 99%

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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

Mannion

Blenkinsopp

Powell

et al. 2018

Health Serv Deliv Res

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Background There is compelling evidence to suggest that some (or even many) NHS staff feel unable to speak up, and that even when they do, their organisation may respond inappropriately. Objectives The specific project objectives were (1) to explore the academic and grey literature on whistleblowing and related concepts, identifying the key theoretical frameworks that can inform an understanding of whistleblowing; (2) to synthesise the empirical evidence about the processes that facilitate or impede employees raising concerns; (3) to examine the legal framework(s) underpinning whistleblowing; (4) to distil the lessons for whistleblowing policies from the findings of Inquiries into failings of NHS care; (5) to ascertain the views of stakeholders about the development of whistleblowing policies; and (6) to develop practical guidance for future policy-making in this area. Methods The study comprised four distinct but interlocking strands: (1) a series of narrative literature reviews, (2) an analysis of the legal issues related to whistleblowing, (3) a review of formal Inquiries related to previous failings of NHS care and (4) interviews with key informants. Results Policy prescriptions often conceive the issue of raising concerns as a simple choice between deciding to ‘blow the whistle’ and remaining silent. Yet research suggests that health-care professionals may raise concerns internally within the organisation in more informal ways before utilising whistleblowing processes. Potential areas for development here include the oversight of whistleblowing from an independent agency; early-stage protection for whistleblowers; an examination of the role of incentives in encouraging whistleblowing; and improvements to criminal law to protect whistleblowers. Perhaps surprisingly, there is little discussion of, or recommendations concerning, whistleblowing across the previous NHS Inquiry reports. Limitations Although every effort was made to capture all relevant papers and documents in the various reviews using comprehensive search strategies, some may have been missed as indexing in this area is challenging. We interviewed only a small number of people in the key informant interviews, and our findings may have been different if we had included a larger sample or informants with different roles and responsibilities. Conclusions Current policy prescriptions that seek to develop better whistleblowing policies and nurture open reporting cultures are in need of more evidence. Although we set out a wide range of issues, it is beyond our remit to convert these concerns into specific recommendations: that is a process that needs to be led from elsewhere, and in partnership with the service. There is also still much to learn regarding this important area of health policy, and we have highlighted a number of important gaps in knowledge that are in need of more sustained research. Future work A key area for future research is to explore whistleblowing as an unfolding, situated and interactional process and not just a one-off act by an identifiable whistleblower. In particular, we need more evidence and insights into the tendency for senior managers not to hear, accept or act on concerns about care raised by employees. Funding The National Institute for Health Research Health Services and Delivery Research programme.

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Nurses’ Responses to Initial Moral Distress in Long-Term Care

2013

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While researchers have examined the types of ethical issues that arise in long-term care, few studies have explored long-term care nurses' experiences of moral distress and fewer still have examined responses to initial moral distress. Using an interpretive description approach, 15 nurses working in long-term care settings within one city in Canada were interviewed about their responses to experiences of initial moral distress, resources or supports they identified as helpful or potentially helpful in dealing with these situations, and factors that hindered nurses in their responses. Using a thematic analysis process, three major themes were identified from the nurses' experiences: (i) the context of the situation matters; (ii) the value of coming together as a team; and (iii) looking for outside direction. The work of responding to initial moral distress was more fruitful if opportunities existed to discuss conflicts with other team members and if managers supported nurses in moving their concerns forward through meetings or conversations with the team, physician, or family. Access to objective others and opportunities for education about ethics were also identified as important for dealing with value conflicts.

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"Stop the Noise!" From Voice to Silence

Cited by 15 publications

References 0 publications

Orchestrating care: nursing practice with hospitalised older adults

Orchestrating care: nursing practice with hospitalised older adults

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

Nurses’ Responses to Initial Moral Distress in Long-Term Care

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