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.