Teaching and Learning in Mental Health Nursing Report (Assessment)
Speech on Whistleblowing
In modern healthcare settings, the quality of care has to be regularly checked. Nurses use their knowledge, exchange information, and share experiences. Despite the intentions to do their best, there are still moments when concerns occur. Therefore, it is important to assess nursing and apply available methods and resources. There are many ways to gather information about a healthcare facility. What tools and resources do you know as per their effectiveness in quality assessment?
Plan of Work
Have you ever heard about such a policy as whistleblowing? Nowadays, it is frequently promoted by the representatives of the National Health Service (NHS) in England. However, not much attention is paid to its characteristics and an overall impact on the quality of care. This lecture is devoted to whistleblowing and the role of nurses in it. I offer you to fill in the table and give brief definitions to several terms (Handout 1). In the end, you will be able to compare your background knowledge with the one you will receive soon.
Wrongdoing in health and nursing care is frequently reported in many countries. The task of NHS England is to make sure that everything possible is offered to improve the quality of work, support the staff and patients, and create the best conditions and services. Each organization is free to develop and support different definitions of whistleblowing. Still, the main idea remains the same: whistleblowing is an activity within an NHS organization to raise concerns about an employee, a service, or a facility (“External Whistleblowing Policy” 5). According to the External Whistleblowing Policy, a patient or a carer (a nurse or any other medical workers) cannot perform the function of a whistleblower (5). There are specific complaints policies in NHS England to meet the demand of an employee or a client, and the whistleblowing policy is not on the list. Regarding the definition and working conditions, a whistleblower may be a regular or temporary employee, a student, or a volunteer who never applies to a personal grievance, employment conditions, or financial issues in their report to an external organization.
You may wonder what issues can be raised by whistleblowers in their applications. NHS England answers to this question as well, and you can use the next handout with a list of concerns appropriate for whistleblowing (Handout 2). I call them “Golden Ten” (similar to the Ten Commandments from the Old Testament”). As you can see, they include concerns about the quality of services offered to patients, as well as different administrative, organizational, and employment issues that may discredit a facility or particular people.
Nurses in Healthcare Settings
In the intentions to promote effective teaching and learning in mental health nursing, it is necessary to identify and comprehend what roles nurses should perform in their practice. Whistleblowing occurs when something goes wrong in care, and nurses are responsible for control and prevention of mistakes and provision of high-quality services (“External Whistleblowing Policy” 8). Nurses usually introduce the first group of people with who a patient interacts. It is their duty to identify patients’ needs and offer differential nursing diagnoses to create an efficient background for doctors to continue working with patients. Communication between a nurse and a patient is integral in care, and the way of how nurses develop their relationships with patients determined the future of care and treatment.
In addition to nurse-patient connection, the quality of care depends on how well nurses are able to cooperate with other healthcare employees and complete their administrative duties. Diagnostic tests, medical equipment, signs’ monitoring, and drug administration are the tasks that cannot be ignored. Finally, if a nurse fails to share some information about a patient or introduce wrong details, the outcomes of care may be negative. Therefore, every nurse should have a plan on how to work with patients and colleagues and never miss a step. There is a box with nurse’s duties in a healthcare setting. Your task is to place tasks in accordance with their importance as per your personal opinion (Handout 4). After the work is done. In fact, the order of these tasks is not as crucial, as your understanding of all these activities. There are different situations when some qualities have to be underlined, and some should be neglected.
Nurses and Whistleblowing
Whistleblowing is the intention to expose some information to the public and underline the case of wrongdoing in an organization. Regarding the responsibilities of nurses and their ethical and moral obligations, much information should remain private in care. Therefore, when discussing the role of nurses in whistleblowing, certain dilemmas and concerns are discovered. According to NHS England, whistleblowing is ethical until its moral purpose (positive outcome, safety, or order) is considered. In other words, acting in the public interest is the main excuse for whistleblowing in nursing. However, it is not enough to say that something wrong happens to an organization or a person. It is expected to gather enough past, present, and possible future evidence to prove a crime or other type of misconduct. True information has to be disclosed, and false facts or guesses being blown may be defined as illegal activities. Finally, a whistleblower cannot raise a concern where he or she commits him/herself a crime. Nurses are the major sources of information in a hospital or any other healthcare setting. Therefore, their participation in whistleblowing is still under numerous discussions.
In general, whistleblowing is the concept that significantly contributes to safety in mental health nursing. However, this topic is not as frequently discussed as, for example, fall prevention policies or fire safety. It is necessary to continue researching this field and communicate with people about possible reasons for being a whistleblower, as well as the pros and cons of whistleblowing in nursing practice. I would like to offer you several tasks (Handouts 3, 4, and 5) to strengthen your understanding of whistleblowing, identify some new aspects for consideration, and check your current knowledge.
There are several types of additional handouts that can be offered to learners during a speech. There are several tools with the help of which people may participate in the discussion but not just be passive listeners. Several handouts may be taken to memorize the material and rely on them with time. Finally, there are some quizzes and tests to help people understand how they should use new material and develop their knowledge.
In this table, there are several simple questions about whistleblowing and the roles of whistleblowers. Learners should read the questions and offer their answer in the necessary box. At the end of the lecture, they will read their answers and underline if they agree or disagree with the positions chosen. This activity is a good opportunity to check the level of students’ background knowledge at the moment of lecturing.
(before a lecture)
|Agree/Disagree (after a lecture)|
|1. What is whistleblowing?|
|2. Can a nurse be a whistleblower?|
|3. Can a patient be a whistleblower?|
|4. Is whistleblowing ethical and legal?|
Learners’ responses may vary slightly based on their approaches to argumentation. Here are the sample answers that can be considered as correct:
- It is the act that involves the disclosure of wrongdoing or inappropriate behaviors related to internal processes in organizations. If whistleblowing takes place, information can be disclosed to media sources, government agencies, or the general public.
- Nurses can report information on their colleagues’ or managers’ misconduct, thus acting as whistleblowers.
- The process usually refers to temporary or permanent employees who have access to internal information, so patients cannot be whistleblowers (External Whistleblowing Policy 5).
- It is usually a legal practice, but its ethical status is often a matter of dispute.
This list has to be printed and given to each learner personally to memorize potential concerns for whistleblowing. It is also recommended for students to introduce several appropriate examples for each point. This activity is not only a good contribution to learning new material but also a possibility to enhance critical thinking, compare the opinions of students, and strengthen their understanding of the chosen topic.
- Unsafe patient care
- Malpractice that harms patients and their families
- Lack of protection for patients
- Poor medication administration
- Poorly trained staff
- Working conditions that lack safety and quality
- Cases of bullying in a facility
- Absence of obligatory policies
- Inability for staff to ask for professional help
- Human resource shortage that harms patients/staff/organization
There is a list of statements that should be given to every student in the classroom to be identified as true (T) or false (F):
- Whistleblowing is always legal and ethically correct
- Everyone is eager to welcome whistleblowers in their facility (F: since
- Whistleblowing means to report concerns to a national/state agency
- Private groups can provide whistleblowers with legal protection
- Whistleblowing is a possibility to reveal unsafe situations in a hospital
- A whistleblower is protected by the act only when the whistle is blown
- Low or unstable salary is a concern for whistleblowing
- Inability to meet patients’ needs is a concern for whistleblowing
- Malfunction of medical equipment is a concern for whistleblowing
- Any situation that causes concerns may be chosen for whistleblowing
Here are the correct answers for a lecturer:
1 – F, 2 – F, 3 – T, 4 – F, 5 – T, 6 – T, 7 – F, 8 – T, 9 – T, 10 – F.
- F: there can be ethical/legal concerns if the revealed information causes social destabilization or threatens people’s security.
- F: no, although their right to free speech is protected, whistleblowers face significant risks related to further career development and workplace relationships.
- F: no, legal protection must come from official bodies (External Whistleblowing Policy 5).
- F: no, “whistleblowing does not apply to personal grievances, including employment issues, which should be dealt with through internal organisational policies” (External Whistleblowing Policy 6).
- F: no, there is a limited number of situations that can be chosen for whistleblowing (External Whistleblowing Policy 6).
In this table, there is a description of the two situations happened at the same hospital. The task of students is to read them, compare the conditions, and underline the main aspects for consideration. At the end of each case, there are the questions to be answered. The main intention is not just to gather right or wrong answers but to promote critical thinking, decision-making, and the development of analytical skills in students who have listened to the speech about whistleblowing.
- A nurse was hired under the temporary terms of a contract with a defined salary. During the first three months, her salary was delayed because of various administrative or external financial reasons. Still, the necessary sum was paid with time. The nurse was not satisfied with her working conditions, a number of duties, and salary delays, and she made a decision to whistleblowing. Was she correct in her intentions to achieve legal success and public understanding through whistleblowing in this case?
- A nurse was a temporary worker in a hospital during the last three months. She identified and completed all her duties, communicated with patients and their families, and follow treatment plans offered by a doctor. Once, she noticed that the doctor drinking alcohol before meeting patients. The same situation happened several times after, and several more nurses were aware of the fact but were afraid to report. The nurse became a whistleblower, believing that such a condition could be a threat to patients. Could she succeed in her desire to change the situation in a hospital by means of whistleblowing?
- She is correct given that there are feasible arguments proving the absence of safe working conditions for the hospital staff (External Whistleblowing Policy 6). Otherwise, whistleblowing is not the correct strategy to be used.
- Yes, she can succeed in this case since her concern is based on the presence of threats to patient safety (External Whistleblowing Policy 6). However, to achieve success, she will need to encourage other witnesses of the doctor’s misconduct to report this information.
Below, there is a brief table with the major aspects of the discussion about whistleblowing to be handed to every student in the classroom:
|Types of whistleblowing may be||
|Whistleblowers are usually||
|Whistleblowing concerns may include||
“External Whistleblowing Policy,” NHS England, 2018, Web.
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Speech on Whistleblowing In modern healthcare settings, the quality of care has to be regularly checked. Nurses use their knowledge, exchange information, and share experiences. Despite the intentions to do […]