Abstract
Background: Cultivating internal whistleblowing among nurses is of paramount importance to nurse leaders. Yet, the literature on how nurse leaders can foster this phenomenon among nurses is limited. Additionally, the underlying mechanisms linking leadership behaviors to internal whistleblowing intentions remain underexplored.
Aim: This study aimed to examine how ethical leadership is linked to internal whistleblowing intentions among nurses through the mediating effect of psychological safety.
Research design: A multicenter cross-sectional research design was used for this study.
Participants and research context: This study involved 201 nurses working in three tertiary governmental hospitals across three cities in Egypt. Data were collected between October and December 2023, using an introductory information form, the Ethical Leadership Scale, the Psychological Safety Scale, and the Internal Whistleblowing Intentions Scale. Structural equation modeling was used to evaluate study hypotheses.
Ethical consideration: Research Ethics Committee of Faculty of Nursing, Port Said University, Egypt approved the study (reference number: NUR (6/8/2023)(28)), and each participant signed the informed consent form before participation in the study.
Results: Ethical leadership was positively linked to nurses’ psychological safety and internal whistleblowing intentions. Psychological safety mediated the link between ethical leadership and nurses’ internal whistleblowing intentions.
Conclusion: Our study suggests that nurse leaders can foster nurses’ intentions to blow the whistle internally by adopting ethical leadership behaviors and enhancing psychological safety among nurses.
Implications:The study enriches the current body of nursing literature in several ways. First, to date, research on whistleblowing among nurses is highly limited.10 The present findings extend the literature on the determinants of nurses’ whistleblowing intentions. Second, the study highlights novel outcomes of ethical leadership in the nursing literature.
Notes
References:
1. Malak MZ, Salouk J, Al-Shawawreh R, et al. Perceptions of patient safety culture among emergency room nurses in Jordanian accredited hospitals. J Nurs Manag 2022; 30: 3131–3138.
2. World Health Organization. Patient safety. https://www.who.int/news-room/fact-sheets/detail/patient-safety (2023).
3. Wiisak J, Suhonen R and Leino-Kilpi H. Reasoning for whistleblowing in health care. Scand J Caring Sci 2023; 37: 316–327.
4. Firtko A and Jackson D. Do the ends justify the means? Nursing and the dilemma of whistleblowing. Aust J Adv Nurs : A Quarterly Publication of the Royal Australian Nursing Federation 2005; 23: 51–56.
5. Gagnon M and Perron A. Whistleblowing: a concept analysis. Nurs Health Sci 2020; 22: 381–389.
6. Mannion R, Blenkinsopp J, Powell M, et al. Understanding the knowledge gaps in whistleblowing and speaking up in health care: narrative reviews of the research literature and formal inquiries, a legal analysis and stakeholder interviews. Health Serv Deliv Res 2018; 6: 1–190. DOI: 10.3310/hsdr06300.
7. Anugerah R, Abdillah MR and Anita R. Authentic leadership and internal whistleblowing intention: the mediating role of psychological safety. J Financ Crime 2019; 26: 556–567.
8. Pohjanoksa J, Stolt M, Suhonen R, et al. Wrongdoing and whistleblowing in health care. J Adv Nurs 2019; 75: 1504–1517.
Sigma Membership
Alpha Beta Tau at-Large
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Cross-Sectional
Research Approach
Other
Keywords:
Ethics, Global Leadership, Workforce, Whistleblowing
Recommended Citation
Abdelaliem, Sally Mohammed Farghaly; Baghdadi, Nadiah A.; El-Gazar, Heba Emad; and Zoromba, Mohamed Ali, "Linking Ethical Leadership to Nurses’ Internal Whistleblowing Through Psychological Safety" (2025). International Nursing Research Congress (INRC). 227.
https://www.sigmarepository.org/inrc/2025/presentations_2025/227
Conference Name
36th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Seattle, Washington, USA
Conference Year
2025
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.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Linking Ethical Leadership to Nurses’ Internal Whistleblowing Through Psychological Safety
Seattle, Washington, USA
Background: Cultivating internal whistleblowing among nurses is of paramount importance to nurse leaders. Yet, the literature on how nurse leaders can foster this phenomenon among nurses is limited. Additionally, the underlying mechanisms linking leadership behaviors to internal whistleblowing intentions remain underexplored.
Aim: This study aimed to examine how ethical leadership is linked to internal whistleblowing intentions among nurses through the mediating effect of psychological safety.
Research design: A multicenter cross-sectional research design was used for this study.
Participants and research context: This study involved 201 nurses working in three tertiary governmental hospitals across three cities in Egypt. Data were collected between October and December 2023, using an introductory information form, the Ethical Leadership Scale, the Psychological Safety Scale, and the Internal Whistleblowing Intentions Scale. Structural equation modeling was used to evaluate study hypotheses.
Ethical consideration: Research Ethics Committee of Faculty of Nursing, Port Said University, Egypt approved the study (reference number: NUR (6/8/2023)(28)), and each participant signed the informed consent form before participation in the study.
Results: Ethical leadership was positively linked to nurses’ psychological safety and internal whistleblowing intentions. Psychological safety mediated the link between ethical leadership and nurses’ internal whistleblowing intentions.
Conclusion: Our study suggests that nurse leaders can foster nurses’ intentions to blow the whistle internally by adopting ethical leadership behaviors and enhancing psychological safety among nurses.
Implications:The study enriches the current body of nursing literature in several ways. First, to date, research on whistleblowing among nurses is highly limited.10 The present findings extend the literature on the determinants of nurses’ whistleblowing intentions. Second, the study highlights novel outcomes of ethical leadership in the nursing literature.
Description
Encouraging internal whistleblowing is vital for nursing integrity and patient safety, yet guidance on how leaders foster this behavior is scarce. This study explored how ethical leadership affects nurses' whistleblowing intentions via psychological safety. Results from 201 nurses in Egyptian hospitals show that ethical leadership enhances both psychological safety and whistleblowing intentions, suggesting that supportive, safe environments are essential for open reporting in healthcare.