Regarding Fletcher, Sorrell and Silva's article, "Whistleblowing as a Failure of Organizational Ethics," I have two comments. First, I appreciate the reality-based focus on the fear many nurses and health care providers have in dealing with this issue.
Indeed, the choice between morality and providing for the family is a dilemma that no one should have to struggle with. Having guaranteed legal recourse and protection that would override individual Health Care Organizations' (HCOs) capricious policies would go a long way in emboldening health care workers to act on their moral principles.
Secondly, as the authors have shown, JCAHO sadly has not codified such requirements in their accrediting process. While I appreciate the authors' emphasis on individual HCOs and their need to individually establish clear procedures, reality dictates that a universal policy is needed that could override the inconsistencies of individual HCOs. This leads me to a practical question: how can I, as a nurse, have a part in influencing JCAHO to change this aspect of their accrediting requirements? What are the more useful methods of getting their attention?
James Bergstrom, BSN, RN
Graduate Student: The University of Texas at Austin School of Nursing