Negotiating the tension between policy and reality: exploring nurses' communication about organizational wrongdoing

Health Commun. 2000;12(1):41-61. doi: 10.1207/S15327027HC1201_03.


This article explores the ways in which registered nurses communicate about organizational wrongdoing. Critical incidents were gathered from over 200 registered nurses. Through the phenomenological process of description, reduction, and interpretation, 5 themes emerged as central to responses of policy violations and personal ethics in the workplace: (a) perceptions of wrongdoing, (b) upholding the ideals of the profession, (c) clarity and evidence of wrongdoing, (d) consequences of reporting, and (e) workplace dynamics. The interpretative findings focus on how these themes are united by a tension that nurses face in terms of adhering to policy while attempting to manage the realities of their everyday professional lives. A discussion of these findings, including how they relate to existing and future research and practice, is offered.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Communication
  • Ethics, Institutional
  • Ethics, Nursing
  • Humans
  • Nurses / psychology*
  • Organizational Culture
  • Organizational Policy*
  • Quality of Health Care
  • Truth Disclosure*