Centre for Research on Health and Nursing

The experiences of nurses who blew the whistle during the COVID-19 pandemic have exposed gaps and revealed an urgent need to revisit our understanding of whistleblowing. AIM: The aim was to develop a better understanding of whistleblowing during a pandemic by using the experiences and lessons learned of Quebec nurses who blew the whistle during the first wave of COVID-19 as a case study. More specifically, to explore why and how nurses blew the whistle, what types of wrongdoing triggered their decision to do so and how context shaped the whistleblowing process as well as its consequences (including perceived consequences). DESIGN: The study followed a single-case study design with three embedded units of analysis. METHODS: We used content analysis to analyse 83 news stories and 597 forms posted on a whistleblowing online platform. We also conducted 15 semi-structured interviews with nurses and analysed this data using a thematic analysis approach. Finally, we triangulated the findings. RESULTS: We identified five themes across the case study. (1) During the first wave of COVID-19, Quebec nurses experienced a shifting sense of loyalty and relationship to workplace culture. (2) They witnessed exceedingly high numbers of intersecting wrongdoings amplified by mismanagement and long-standing issues. (3) They reported a lack of trust and transparency; thus, a need for external whistleblowing. (4) They used whistleblowing to reclaim their rights (notably, the right to speak) and build collective solidarity. (5) Finally, they saw whistleblowing as an act of moral courage in the face of a system in crisis. Together, these themes elucidate why and how nurse whistleblowing is different in pandemic times. CONCLUSION: Our findings offer a more nuanced understanding of nurse whistleblowing and address important gaps in knowledge. They also highlight the need to rethink external whistleblowing, develop whistleblowing tools and advocate for whistleblowing protection. IMPACT: In many ways, the COVID-19 pandemic has challenged our foundational understanding of whistleblowing and, as a result, it has limited the usefulness of existing literature on the topic for reasons that will be brought to light in this paper. We believe that studying the uniqueness of whistleblowing during a pandemic can address this gap by describing why and how health care workers blow the whistle during a pandemic and situating this experience within a broader social, political, organizational context.

Aim: To investigate how patients admitted to single-room accommodation experience mealtime situations. Methods: The study employed an ethnographical phenomenological design using the go-along method. From April to September 2022, 40 hours of meal-related observations and informal conversations with ten patients were completed in a Danish cardiac medicine ward and a vascular surgery ward. Data were analysed using a Ricoeur-inspired method. Results: Admission to a single-room is not unequivocally excellent or wrong with respect to the patients’ experiences of the meal or their perceived appetite. Nevertheless, meals were often referred to as the highlights of the day. Patients were positive about their own influence on their food choices, but they needed to experience professionals talking to them about healthy nutrition. Privacy was greatly emphasised, and most patients chose to eat alone because of their condition. Therefore, eating in the common dining room was seldom chosen. The results are presented in two themes: 1) Beyond the tray: Understanding the significance of meals for patients in single-rooms, and 2) Alone – but not lonely. Conclusions: Single-rooms allow for privacy during illness and recovery and make it possible to have private conversations about adequate nutrition. Clear professional responsibility needs to be assigned for the meal in single-room accommodation. Relevance to clinical practice: Knowledge of patients’ perspectives may guide nurses’ approaches to communicating with patients about the importance of the meal.