Patient advocacy is one of the most important part of a nurse’s role. Given that nurses have the most direct interaction with patients, they are ideally placed to be instrumental in initiating change on the patient’s behalf.

Nurses are required to adhere to the International Council of Nurses ‘Code of Ethics for Nurses’ to uphold patients’ rights and act within their best interests. Advocacy can take many forms ranging from direct patient care, patient safety to organisational issues such as staffing shortages, conflict and many other workplace concerns. These issues can directly and indirectly impact patient care.

Nurses can be faced with practical and ethical dilemmas that can challenge their decision-making. On rare occasions, nurses may witness illegal or unethical practice. It will take courage to expose this wrongdoing by reporting to the appropriate authority. This action is known as ‘Whistleblowing’ and is considered a last resort when other avenues have been exhausted.

While nurses have a moral obligation to report wrongdoing, whistleblowing can be a daunting prospect as nurses contemplate the consequences of taking such an action. Nevertheless, it is imperative that the responsibility of patient advocacy is well understood and taken seriously, to protect patients well-being.

This module contains a number of resources looking at the nature of whistleblowing, associated dilemmas, potential repercussions and strategies to support nurses.


Whistleblowing: what leads a nurse to make the call?
A number of human factors influence the way managers within organisations address patient safety concerns. One is wilful blindness.

Monash University
Q & A Whistleblowing Session June 2015 (1:45:00min, SD 612Mb, HD 1Gb)

Whistleblower nurse testifies at Patel hearing
The nurse who first raised complaints about former Bundaberg based doctor Jayant Patel has given evidence at his committal hearing in Brisbane.

Meet the NHS whistle-blowers who exposed the truth
As Sir Robert Francis prepares to publish the first independent review of the treatment of whistle-blowers in the NHS, we look at some of those whose disturbing experiences led to the review:

Firtko, A., & Jackson, D. (2005). Do the ends justify the means? Nursing and the dilemma of whistleblowing. Australian Journal of Advanced Nursing, 23(1), 51-56.

Hill, T. (2010). Whistleblowing: the patient or the paycheck? Kansas Nurse, 85(2), 4-8.

Watson, C. L., & O’Connor, T. (2017). Legislating for advocacy: The case of whistleblowing. Nursing Ethics, 24(3), 305-312. doi:10.1177/0969733015600911

Whistleblowing students require full support and protection. (2014). Nursing Standard, 28(27), 8-8. doi:10.7748/ns2014.