ABSTRACT
Background
Despite evidence showing the importance of open communication in improving patient
safety, communication failure remains one of the main causes of patient adverse events.
Aim
This study explored nurses’ perceptions and experiences with speaking up for patient
safety in Korean hospitals.
Methods
Fifteen nurses were recruited from four tertiary hospitals in two cities in South
Korea to participate in an online semistructured interview. Data were categorised
by inductive content analysis techniques.
Findings
Although most nurses perceived that speaking up is important and half of them claimed
that they were assertive in general, only one-third reported that they would speak
up for patient safety without hesitation in their workplace. Speaking up was challenging
for nurses, particularly with senior nurses and physicians, at least partly due to
the social characteristics embedded in Korean culture, such as respect for the hierarchy
and value of groups’ ideas more than that of individuals. When speaking up, nurses
used a variety of strategies such as using polite language with embedded signals of
subordination. We found that nurses used not only problem-focused voice, but also
suggestion-focused voice. The nurses’ speaking-up behaviours resulted in positive
or negative consequences, impacting their future communication behaviours.
Discussion
Investing in individual skill building and organisational supports to ensure a safe
environment for speaking up is crucial for overcoming the barriers from the longstanding
cultural influences in Korean hospitals and for empowering nurses to speak up for
patient safety.
Conclusion
There are gaps between nurses’ perceptions of the importance of speaking up and their
ease with speaking up in practice.
Keywords
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Article info
Publication history
Published online: February 28, 2023
Accepted:
December 13,
2022
Received in revised form:
December 5,
2022
Received:
August 22,
2022
Identification
Copyright
© 2022 Australian College of Nursing Ltd. Published by Elsevier Ltd.
