Exploring confidentiality in the context of nurse whistle blowing: issues for nurse managers

AIM: The aim of this paper is to reveal the experiences and meaning of confidentiality for Australian nurses in the context of whistle blowing. BACKGROUND: Despite the ethical, legal and moral importance of confidentiality within the health-care context, little work has addressed the implications of confidentially related to whistle-blowing events. METHODS: The study used qualitative narrative inquiry. Eighteen Australian nurses, with first-hand experience of whistle blowing, consented to face-to-face semi-structured interviews. RESULTS: Four emergent themes relating to confidentiality were identified: (1) confidentiality as enforced silence; (2) confidentiality as isolating and marginalizing; (3) confidentiality as creating a rumour mill; and (4) confidentiality in the context of the public's 'right to know'. CONCLUSIONS: The interpretation and application of confidentiality influences the outcomes of whistle blowing within the context of health-care services. Conversely, confidentially can be a protective mechanism for health-care institutions. IMPLICATIONS FOR NURSING MANAGEMENT: It is beholden upon nurse manager to carefully risk manage whistle-blowing events. It is important that nurse managers are aware of the consequences of their interpretation and application of confidentiality to whistle-blowing events, and the potentially competing outcomes for individuals and the institution.