Abstract

Objective: The purpose of this study was to understand speaking up behavior among RNs.

Background: Speaking up is the use of one's voice to share information or alert those in authority of one's concerns about patients, and is primarily influenced by organizational culture, personal culture, and workforce generation. Failure to speak up can lead to moral distress; speaking up can lead to moral courage.

Methods: A cross-sectional electronic survey was distributed to several thousand RNs resulting in 303 surveys providing usable data.

Results: We found that organizational culture was a strong predictor of speaking-up behaviors, and that speaking up partially mediated the relationship between organizational culture and moral distress, but not between organizational culture and moral courage. Workforce generation or personal culture did not explain nurses using their voice (U=3217, z=1.54, p=.124, r=.12).

Conclusions: The strong role of organizational culture supports the efforts toward healthy work environments. Because not speaking up is related to moral distress, efforts must be escalated to ensure nurses are empowered to use their voices.

Description

This dissertation has also been disseminated through the ProQuest Dissertations and Theses database. Dissertation/thesis number: 13806579; ProQuest document ID: 2201874759. The author still retains copyright.

Author Details

Jennifer Boice Rainer, PhD, MBA, RN, CPHQ, CPHRM, NEA-BC

Sigma Membership

Non-member

Type

Dissertation

Format Type

Text-based Document

Study Design/Type

Cross-Sectional

Research Approach

Quantitative Research

Keywords:

Patient Safety, Patient Advocacy, Organizational Culture, Medical Errors, Verbalizing Concerns

Advisor

Joanne K. Schneider

Second Advisor

Rebecca Lorenz

Degree

PhD

Degree Grantor

Saint Louis University

Degree Year

2019

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

All permission requests should be directed accordingly and not to the Sigma Repository.

All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

None: Degree-based Submission

Acquisition

Proxy-submission

Date of Issue

2021-10-07

Full Text of Presentation

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