title: Understanding whistleblowing: qualitative insights from nurse whistleblowers.
abstract: OBJECTIVE
  This paper is a report of a study conducted to explore the reasons behind the decision to blow the whistle and provide insights into nurses' experiences of being whistleblowers.
  
  
  BACKGROUND
  Whistleblowing is a stigmatized and hidden activity that carries considerable ramifications to all concerned. In the health sector, when episodes of poor practice or service provision are identified, it is frequently nurses who are the whistleblowers. Despite this, there is remarkably limited literature that explores nurses' experiences of whistleblowing.
  
  
  METHODS
  Qualitative narrative inquiry design. Data were collected in 2008 from 11 nurse whistleblowers using in-depth semi-structured interviews.
  
  
  RESULTS
  Participants were drawn from a range of general and specialty clinical areas and experienced whistleblowing as highly stressful. The findings were clustered into three main themes, namely: (i) Reasons for whistleblowing: I just couldn't advocate, (ii) Feeling silenced: Nobody speaks out, and (iii) Climate of fear: You are just not safe.
  
  
  CONCLUSIONS
  The whistleblowing nurses believed they were acting in accordance with a duty of care. There is a need for greater clarity about the role nurses have as patient advocates. Furthermore, there is need to develop clear guidelines that create opportunities for nurses to voice concerns and to ensure that healthcare systems respond in a timely and appropriate manner, and a need to foster a safe environment in which to raise issues of concern.
authors.affiliation: School of Nursing and Midwifery, College of Health & Science, University of Western Sydney, Penrith South DC, New South Wales, Australia. debra.jackson@uws.edu.au
authors.forename: Debra
authors.initials: D
authors.lastname: Jackson
authors.forename: Kath
authors.initials: K
authors.lastname: Peters
authors.forename: Sharon
authors.initials: S
authors.lastname: Andrew
authors.forename: Michel
authors.initials: M
authors.lastname: Edenborough
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Halcomb
authors.forename: Lauretta
authors.initials: L
authors.lastname: Luck
authors.forename: Yenna
authors.initials: Y
authors.lastname: Salamonson
authors.forename: Lesley
authors.initials: L
authors.lastname: Wilkes
mesh_terms: D001291:Attitude of Health Personnel; D004993:Ethics, Nursing; D005239:Fear; D005260:Female; D006801:Humans; D007400:Interprofessional Relations; D008318:Malpractice; D024802:Nurse's Role / Q000523:psychology; D015404:Nursing Methodology Research; D009740:Nursing Staff / Q000523:psychology*; D015279:Organizational Culture; D010344:Patient Advocacy; D036301:Qualitative Research; D035642:Whistleblowing / Q000941:ethics / Q000523:psychology*