A report suggests that United States’ army officers may engage in dishonest reporting regarding their compliance procedures. Similarly, nurses with espoused high ethical standards sometimes fail to live up to them and may do so while deceiving themselves about such practices. Reasons for lapses are complex. However, multitudinous managerial demands arising within ‘technical and instrumental rationality’ may impact on honest decision‐making. This paper suggests that compliance processes, which operates within the social structural context of the technical and instrumental rationality manifest (...) as ‘managerialism’, contributes to professional ‘dishonesty’ about lapses in care, sometimes through ‘thoughtlessness’. The need to manage risk, measure, account, and control in order to deliver efficiency, effectiveness, and economy (technical rationality) thus has both unintended and dysfunctional consequences. Meeting compliance requirements may be mediated by factors such as the ‘affect heuristic’ and ‘reflexive deliberations’ as part of the ‘structured agency’ of nurses. It is the complexity of ‘structured agency’ which may explain why some nurses fail to respond to such things as sentinel events, a failure to recognize ‘personal troubles’ as ‘public issues’, a failure which to outsiders who expect rational and professional responses may seem inconceivable. There is a need to understand these processes so that nurses can critique the context in which they work and to move beyond either/or explanations of structure or agency for care failures, and professional dishonesty. (shrink)

Using 2015 International Social Survey Program (ISSP) data on 38,179 individuals from 36 countries in 9 relatively homogeneous global regions, we analyze the gender differences and the gender gap in perceived workplace harassment (PWH) with particular attention to gender equality's and gender egalitarianism's roles in molding these differences. We find that despite large regional differences, women in most countries are more likely than men to perceive workplace harassment, although this likelihood is higher in countries that score favorably on our gender (...) equality measures. Hence, political empowerment and better economic opportunities alter women's perceptions of workplace harassment, increasing the probability of their experiencing it. Our results also underscore the important roles of values and gender egalitarian practices. Whereas enhanced gender egalitarianism values increase women's perceptions of workplace harassment, concrete practices tend to reduce them. Especially for management, this result highlights the importance of actually implementing gender equality policies at a corporate level, because a discrepancy between corporate values and practices on this issue will only accentuate the perception of harassment. (shrink)

Bullying remains a pervasive problem in healthcare, and evidence suggests systems in place are not utilised due to perceptions of ineffectiveness and inequity. This study examines bystander responses to bullying and factors that influence decisions to intervene. We explore relationships between bystanders’ perceptions of psychological safety across three levels (organisation, supervisor and colleague) and reactions to witnessing bullying. We suggest psychological safety would be positively associated with the decision to intervene. Findings indicate the most pervasive reaction to witnessing incidents of (...) bullying is to discuss with colleagues, a low‐involvement reaction. We find perceptions of supervisory and organisational safety/support are positively related to high‐involvement decisions such as formal reporting of the incidents, highlighting the importance of support from those in power. However, perceptions of collegial support may lead to low‐involvement responses, which risk reinforcing and underpinning dysfunctional organisational dynamics by providing informal social and emotional responses that may substitute more formal organisational responses to this persistent problem. This study highlights the importance of support from individuals in power if bystanders are to feel comfortable making high‐involvement interventions. (shrink)

The specific arrangements of power/knowledge that characterize nurse interactions with the electronic health record form a panopticon. As health care moves into the 21st century, sophisticated technologies like the electronic health record shape the terrain of professional possibilities. The longer it is in use, the more it is possible to excavate the inherent disciplinary function of electronic health record. A panopticon is a generalizable, replicable apparatus of power that cultivates discipline when similar behaviours are desired from a group of people. (...) This paper traces the arrangements of power/knowledge that characterize nurse interactions with the electronic health record rooted in a trauma critical care setting. Examining the apparatuses of power/knowledge enforced through panopticism in nursing makes the invisible visible. This in turn enables nurses to address the intended and unintended consequences of the electronic health record. If nurses are to effectively shape the direction of their own futures and the future of health care, nurses will need to unpack the invisible techniques of power such as the electronic health record as a panopticon. In the process of building a visible identity, contextualizing nursing knowledge to better care for patients on the one hand and understand the relationships of power that limit us on the other, nurses are neither apolitical nor powerless. Considering the dialectic of power/knowledge in the healthcare setting helps to illuminate spaces to recharacterize nursing, reveal the contributions and knowledge of nurses, and consolidate the professional power of nurses to affect meaningful change and self‐governance in the healthcare setting. (shrink)