1. List the reasons given for not reporting illegal, unethical or unsafe conduct.  Which reasons are listed most frequently? 2. What is your employer’s and/or board of nursing’s position on reporting illegal, unethical or unsafe conduct?   3. What influences your decision regarding reporting illegal, unethical or unsafe conduct?  4. What advice would you give to a new nurse seeking this information?  5. Cite the information source you referred to for this information (may include board of nursing website, employer policy or other resource)

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1. Reasons given for not reporting illegal, unethical, or unsafe conduct include fear of retaliation, lack of trust in the reporting system, fear of jeopardizing personal or professional relationships, belief that reporting would not lead to any action or change, fear of litigation or legal action, lack of knowledge or awareness of what should be reported, and fear of being seen as a “snitch” or troublemaker. The fear of retaliation, which can include losing your job, getting demoted or being shunned by colleagues, is often cited as the main reason why employees do not report illegal, unethical or unsafe behavior.
2. The American Nurses Association states that nurses are required to report illegal, unethical or unsafe behavior they see. The majority of nursing employers adhere to a “zero-tolerance” policy when it comes to illegal, unethical and unsafe conduct. These policies and procedures are in place for employees to learn how to report these types of conduct. In the event that such conduct is not reported, there may be disciplinary measures or even termination. There could also be legal consequences.
3. Several factors may influence a nurse’s decision regarding reporting illegal, unethical, or unsafe conduct, including fear of retaliation, personal values and beliefs, potential consequences of reporting, trust in the reporting system, and level of knowledge or awareness about what should be reported. Reporting may have an impact on a nurse’s personal and professional relationships as well as on the safety or care of patients.
4. For new nurses seeking information about reporting illegal, unethical, or unsafe conduct, it is important to consult the policies and procedures of their employer and the guidelines provided by their state’s board of nursing. To better understand professional obligations, they should seek advice from nursing peers, mentors or professional organisations, like the ANA.
5. Websites of the ANA or state nursing boards are excellent resources for nurses who want to learn more about how they can report illegal, unethical and unsafe conduct. In addition, most nursing employers provide policies and procedures that instruct employees how to report illegal, unethical, or unsafe conduct. They can be located in employee manuals, as well as through the human resources department. These resources are available to nurses, but they should also seek support and guidance from other professionals and their peers when required.

References:

American Nurses Association (2015). Code of ethics with interpretations for nurses. Silver Spring: American Nurses Association.

Buchanan, J. A., & Carson, A. M. (2018). Reporting unethical, illegal, or unsafe conduct: A study of registered nurses’ decisions. Western Journal of Nursing Research, 40(2), 147-166. doi: 10.1177/0193945917717931.