Most of us expect healthcare and academic institutions to uphold the highest ethical standards and to meet their moral obligations to patients, staff, students, and the community at large. Unfortunately, our expectations are at odds with reality.

Not only do nurses suffer abuse and harassment in the workplace, but according to recent research, the rate of such misconduct is increasing. Plus, most nurses work in institutions that don’t have safe, secure avenues for reporting serious misconduct without fear of reprisal. And, as you probably know, our profession has a long history of underreporting through existing avenues.

Consequences of acting ethically
When nurses report wrongdoing through the proper administrative channels, they may pay a heavy price. Whistleblowers may be harassed, demoted, or forced to leave the organization. They also may suffer personal and professional isolation.

The nursing staff may become divided, and professional reputations may be damaged. Healthcare delivery and patient outcomes may also suffer.

Still, a nurse who witnesses such misconduct has an ethical, and often a legal, obligation, to take action to prevent future episodes.

How to protect yourself

These recommendations are intended to protect nurse whistleblowers from reprisal:

• Seek legal advice.
• Educate yourself on federal and state whistleblower protection laws. These laws prevent employers from taking retaliatory actions against nurses, such as suspension, demotion, harassment, and discharge, for reporting wrongdoing in the workplace.
• Contact your state nurses association for answers and clarifications.
• Create a paper trail. Document episodes of abuse, including dates, times, and outcomes. Make copies of all documentation and keep them in a secure location.
• When reporting wrongdoing, stick to the facts and follow your organization’s chain of command.
• Reach out for help. As appropriate, contact professional nursing organizations, your state attorney general, the Department of Defense Inspector General, Congress, and other organizations and agencies.
• Send all documentation to outside agencies by certified mail so you can verify receipt of the materials.
• Be professional when dealing with your organization’s administration and outside agencies.

Taking political action
As a profession, nursing must ensure that members of Congress are aware of the severity of the problem of workplace abuse and that they support legislation to address this issue. In particular, we need to improve and support legislation offering whistleblower protections, such as the Paul Revere Freedom to Warn Act, which was introduced in the House of Representatives in 2006. Its purpose is to provide greater protection for federal employees and members of the uniformed services