The relationship between ethical position and whistleblowing: A cross-sectional study among nurses

Abstract

Aim and objectives: The aim of this study is to determine nurses' ethical positions, whistleblowing intention and its causes, and to analyse the correlation between them, while revealing the personal and professional characteristics causing significant difference.

Background: In today's challenging healthcare settings, ethical dilemmas are inherent to nursing practices, leading to situations whereby nurses must consider whistleblowing and reasons such as reporting medical errors or misbehaviors.

Design: The study is descriptive, cross-sectional and correlational.

Methods: The data were collected from a convenience sample consisting of 294 nurses between 1 April and 30 June 2019, in four hospitals in two cities. An introductory information form, Ethics Position Questionnaire, Whistleblowing Scale and Causes of Whistleblowing Scale were employed to collect data. The data were analysed with descriptive, correlational, comparative and internal consistency analyses (Guidelines for reporting cross-sectional studies (Data S1)).

Results: It was found that nurses encountered (31.3%) and reported (85.9%) unethical incidents. According to the subscales, they obtained higher scores from idealism (4.37 ± 0.52), supportive whistleblowing (3.75 ± 0.72), and moral and professional values (3.77 ± 0.67). The Ethics Position Questionnaire, as well as the Whistleblowing Scale (r = .302) and the Causes of Whistleblowing Scale (r = .211) had a positive weak correlation (p < .001). Nurses' age, marital status, and professional and institutional experiences all created a significant difference (p < .05).

Conclusions: The nurses mostly encountered unethical incidents associated with management. The rates of reporting the unethical incidents were high, and they were found not hesitating to report using whistleblowing, yet intended to keep the incidents within the institution. In addition, idealistic nurses were more likely to whistleblow, and their causes for whistleblowing were mostly associated with moral and professional values.

Relevance to clinical practice: It is recommended that nurses' ethical position, and whistleblowing intentions and causes should be supported and improved through the corporate culture.

Keywords: ethical position; ethical value; nurse; whistleblowing; whistleblowing cause; whistleblowing intention.