The Process of Whistleblowing in a Japanese Psychiatric Hospital

Abstract

This study aims to unveil the process of whistleblowing. Two nursing staff members who worked in a psychiatric hospital convicted of large-scale wrongdoing were interviewed. Data were analyzed using a modified grounded theory approach. Analysis of the interviews demonstrated that they did not decide to whistleblow when they were suspicious or had an awareness of wrongdoing. They continued to work, driven by appreciation, affection, and a sense of duty. Their decision to whistleblow was ultimately motivated by firm conviction. Shortly after whistleblowing, wavering emotions were observed, consisting of a guilty conscience, fear of retribution, and pride, which subsequently transformed to stable emotions containing a sense of relief and regret for delayed action. It is necessary for nurses to recognize that their professional responsibility is primarily to patients, not to organizations. Nurses should also have professional judgment about appropriate allegiance and actions.

Understanding whistleblowing: qualitative insights from nurse whistleblowers

“…A limited number of studies have used qualitative methodology (Orbe & King 2000, Kingston et al. 2004, Attree 2007, Ohnishi et al. 2008) and very few papers published in the last 10 years have used face‐to‐face data collection methods (Kingston et al.…”

“…2008) and very few papers published in the last 10 years have used face‐to‐face data collection methods (Kingston et al. 2004, Attree 2007, Ohnishi et al. 2008).…”

“…The professional effects include loss of reputation, reprisals, and loss of job security (McDonald & Ahern 2000, Kingston et al. 2004, Attree 2007, Ohnishi et al. 2008).…”

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

“…In a health-care context, Ohnishi et al 117 note the significant impact of national culture in their research with psychiatric nurses in Japan, and Cheng et al 128 compared British and Chinese students (from various disciplines) and noted that 'individuals from collectivist cultures are less likely to be whistleblowers, and less accepting of whistleblowing behaviour, than individuals from individualistic cultures'.…”

“…Ohnishi et al 117 note the large personal challenge of blowing the whistle: 'The social significance of belonging to a group, the psychological pain of disloyalty, obedience to the chain of command, fear of being exposed as the whistleblower, and fear of accusation and retribution all hinder whistleblowing'. Indeed, the authors draw attention to the complexity of social, ethical and personal forces at work in these situations.…”