Whistle-blowing process in healthcare: From suspicion to action

Nurs Ethics. 2019 Mar;26(2):526-540. doi: 10.1177/0969733017705005. Epub 2017 May 11.

Abstract

Background:: Whistle-blowing is an ethical activity that tries to end wrongdoing. Wrongdoing in healthcare varies from inappropriate behaviour to illegal action. Whistle-blowing can have negative consequences for the whistle-blower, often in the form of bullying or retribution. Despite the wrongdoing and negative tone of whistle-blowing, there is limited literature exploring them in healthcare.

Objective:: The aim was to describe possible wrongdoing in Finnish healthcare and to examine whistle-blowing processes described on the basis of the existing literature in healthcare as perceived by healthcare professionals.

Research design:: The study was a cross-sectional descriptive survey. The data were collected using the electronic questionnaire Whistle-blowing in Health Care and analysed statistically.

Participants and research context:: A total of 397 Finnish healthcare professionals participated, 278 of whom had either suspected or observed wrongdoing in healthcare, which established the data for this article.

Ethical considerations:: Ethical approval was obtained from the Ethics Committee of the University (20/2015). Permission to conduct the study was received according to the organisation's policies.

Findings:: Wrongdoing occurs in healthcare, as 96% of the participants had suspected and 94% had observed wrongdoing. Regarding the frequency, wrongdoing was suspected (57%) and observed (52%) more than once a month. Organisation-related wrongdoing was the most common type of wrongdoing (suspected 70%, observed 66%). In total, two whistle-blowing processes were confirmed in healthcare: (1) from suspicion to consequences occurred to 27%, and (2) from observation to consequences occurred to 37% of the participants.

Discussion and conclusion:: Wrongdoing occurs in healthcare quite frequently. Whistle-blowing processes were described based on the existing literature, but two separate processes were confirmed by the empirical data. More research is needed on wrongdoing and whistle-blowing on it in healthcare.

Keywords: Healthcare; process; questionnaire survey; whistle-blowing; wrongdoing.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Chi-Square Distribution
  • Cross-Sectional Studies
  • Delivery of Health Care / ethics
  • Delivery of Health Care / methods*
  • Delivery of Health Care / standards
  • Female
  • Finland
  • Humans
  • Male
  • Middle Aged
  • Process Assessment, Health Care / ethics
  • Process Assessment, Health Care / standards
  • Surveys and Questionnaires
  • Whistleblowing / ethics*