After reading the article, "Whistleblowing As a Failure of Organizational Ethics," I find I strongly agree that whistleblowing is a failure of organizational ethics. I think there is a need for health care organizations (HCOs) to establish a supportive organizational environment, effective communication channels, and a belief system that values ethical actions to ensure quality of patient care.
I came to the U.S. from Hong Kong where most of the hospitals are owned by a semi-governmental agent. I do not know if there are mission statements to guide practice in these hospitals. Unfortunately in Hong Kong, and also here in the U.S., many unethical and unsafe practices are occurring everyday. Most of the time, nurses either fail to recognize the important consequences of these practices or simply ignore them. I believe this occurs because we don't have adequate support, communication, and value systems.
Support, communication, and value systems can be enhanced by mission and philosophy statements. All HCOs should have a clear mission statement and philosophy that are implemented on a daily basis. To implement these statements it is necessary to communicate these statements to all employees and patients on a regular basis. Too often these statements are just words on a piece of paper.
All health cares systems also need effective support and communicating networks and value systems. As a profession predominantly occupied by women, nursing does not receive enough support from men who are occupy administrative positions. Most of the time, managers misinterpret the importance of employee's responses related to ethical issues and consider that these responses threaten their managerial power. They want to cover up the unethical situations as much as possible. Also, the present system makes it difficult for bottom-to-top communication to succeed. Additionally, as mentioned in the article, I agree that a personal belief system that values taking time to listen to concerns of others can play an important role in handling ethical issues that are by nature time-consuming.
In my personal opinion, in order for nursing to assume accountability as a profession, effective support and communication networks and belief systems must be present. At this time, I agree that whistleblowing is a moral action of last resort to provide quality patient care. The need to utilize such action can be prevented through a supportive organizational environment and effective communication channels.
Master's Candidate in Nursing
School of Nursing
University of Texas, Austin