Whistleblowing: Reporting Malpractices in the Health Institutions

Problem Statement

Whistleblowing in the nursing profession is a method that has brought to fruition many changes with regards to the health sector. Whenever one raises concerns, normally it is not for their own personal benefit. Rather, it is for public good. That notwithstanding, many employers and/or victims in the whistleblowing process end up lashing at employees for reporting cases to the health bodies that deal with them. An extreme scenario is where employees have even lost their jobs for the sake of whistleblowing (Game 2014). Whistleblowing exposes malpractices exhibited in a health facility or a medical practitioner. Its aim is to protect the interests of the patients that receive services from the health facilities. Nevertheless, whistleblowing should be done in a manner that does not harm the reputation of either a medical professional or a health organization without cause. The process must be based of truths derived from a factual basis.   Therefore, whistleblowing of malpractices needs to be done with utmost care to ensure that the issues raised are valid and can be proven.

Section 1: Introduction: The Moral Purpose for Whistleblowing

Whistleblowing presents nurses with both an ethical and practical dilemma. On one hand, they feel that being silent about wrongdoing at the workplace may endanger patients’ health and the public’s health by extension. On the other hand, they fear the consequaences of whistleblowing such as losing one’s job, demotion, or a hostile work environment. Hence, an individual becomes confused as to what action they should take. They are also not sure whether it is really necessary to report any incidences of concern if they will get penalized afterwards.           Workers have a moral responsibility both to their patients and to the public to ensure that the treatments received improve their health conditions. This responsibility is driven by two views of their moral purpose: consequentialist and deontological views. Whistleblowing is not always an easy task for nurses because of the conflict of their duty to their employer versus their duty to the patients whom they serve. An employer may argue that nurses’ first duty is to them by virtue of their employment contracts. However, the health organizations also have a duty of care to their patients. As a result, the nurses’ duty to their patients to deliver on their promise on better healthcare often overrides the duty to the employer. Hence, whistleblowing is a moral obligation of the nurses. Whistleblowing can be done by an employee including student midwife or student nurse, and trainees.

Section 2: Significance of Reporting Malpractices

The importance of whistleblowing may be underrated in most cases. However, it is required in order to disclose the malpractices and poor standards of health care. Whistleblowing enables an individual to report illegitimate, illegal, and immoral nursing practices seen at the work place. Disclosure of these malpractices is significant for two reasons. The first significance is unto the patient concerned. Reporting malpractice enables the nurses to protect the health of their patients. Sometimes the malpractices cited may be harmful or even fatal to the patients. The second significance is long-term whereby the public is able to receive professional, skilled, and better services in the future. Malpractices may lead to the impairment of a health organization’s goodwill with the community. Whenever these concerns are tackled, the confidence of the public in the organization is raised. Besides, the leadership of a facility has the chance to improve the quality of service delivery when they handle the raised concerns objectively (Johnstone 2013).

Section 3: Literature Review

Whistleblowing must be done within the confines of the outlined procedures. According to Nursing and Midwifery Council (2017), there are five steps that must be followed in order to report an incident for it to qualify as whistleblowing. First, the person raising the concern should not be guilty of the malpractice they are reporting. Secondly, the information must be true. Furthermore, the whistle blower will be called upon to ascertain that the wrongdoing was done in the past, is being committed or is likely to be committed for it to be considered a valid concern. Thirdly, the matter must fall within the remit of the nursing council. Fourthly, a whistleblower must be an employee of the organization they are working for. The term “employee” in this regard includes agency workers, trainees, volunteers, employees, and student nurses/student midwives. Fifthly, the individuals must be sure that they are acting in the interest of the public and not for selfish gains. Once the nursing council or any other related bodies hear a case of wrongdoing, they have the liberty to investigate the matter and take appropriate action (Hickman et al. 2014).

Examples of Malpractice Cases

Examples of whistleblowing incidences include (1) a doctor who makes patients believe that he is treating their illness when in fact the doctor is advancing wrong medication aimed at aiding them in carrying out a research. The fact that the patients are in the dark about his intentions make the practice a wrongful conduct. (2) A case where the hospital discriminates their patients based on color, race, age, gender, or religion. (3) An instance when the doctor advances a kind of medication or treatment which is not necessary in order to gain financially. For instance, not all child births need to be by Ceaserian (CS) Section. But doctors today insist on CS because of the financial gain.

Factor that Influence the Reporting of Incidences by Health Workers

Most nurses and other health workers shy away from reporting malpractices due to reasons such as: (1) fear of repercussions such as loss of employment, (2) being blamed for raising concerns, and (3) retribution. These three factors are considered the disincentives to whistleblowing. In order to develop an objctive culture of whistle blowing, the nursing body needs to do away with them. Whistleblowing is not about harming one’s career; rather it is an important system of organizational reporting. It leads to the continuous review and improvement of professional and organizational guidelines (Blenkinsopp & Snowden 2015).

Section 4: Application to Nursing (e.g., Implications or Consequences for Nursing Leaders)

Whistleblowing impacts the leadership of an organization in several ways. First of all it makes them more accountable for their deeds and the operations of their institution. Whenever leaders are aware that they will be held responsible for any malpractices, they work very hard to ensure that no such incidences occur. They do so by encouraging professionalism and insisting on best nursing practice. Secondly, individual employees become aware of their responsibility in curbing malpractices at the work place. The consequances of abusing such knowledge is without excuse. Another implication of whistleblowing is the continued drive to offer one’s best professional skills that results in better health care overally. The knowledge that one is bound to face disciplinary action in case of any illegal practices minimizes on laxity and complacency seen at work (Cleary & Doyle 2015). Ethical practices appeal to the conscience of people. The ethical value systems in the organizations enhance good nursing practice.

Besides the positive implications, sometimes the consequences of whistle blowing are not very interesting. Negative effects of whistleblowing may include loss of one’s job, negative publicity especially when the matter is leaked to the media, closure of a health facility, and being sued in court. In any case, a malpractice is proven as true; the personnel involved lose their jobs in most cases. In cases of extreme misconduct, the institution may even be shut down for the safety of the public. Most issues of malpractice often end in court. The courts have the prerogative of ordering compensation for the affected persons.

Section 5: Conclusion

In conclusion, it is both the professional and ethical duty of a nurse to report any malpractices that they witness at the workplace. However, their duty is normally met with a lot of resistance and victimization by the persons and organizations which they report. This should not be the case since over time it has been proven that whistleblowing does more good than harm. Therefore, whistleblowing needs to be done in a safe environment such as in the confines of bodies such as the Nursing Councils (Ortega et. al. 2013). The practice of whistleblowing is guided by several steps. For instance, the person who blows the whistle must not be guilty of the illegal activity that they have cited. Furthermore, they must be employees of the organization (although out of fear they may extend the obligation to a third party). It is the duty of the nursing council and any other related bodies to perform investigations into the matters raised and give a verdict. Sometimes the matter raised may involve criminal activity. Such a scenario must be presented to a court of law for its hearing and court verdict.

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