The purpose of this multi-method study was to analyse whistleblowing for wrongdoing in health care as perceived by health care professionals. Based on the analysis, a conceptual model of reasoning for whistleblowing in health care was developed, as an overall goal of this study. In addition, based on the results, suggestions for stakeholders and researchers are presented to prevent and decrease wrongdoing and support individual whistleblowing in health care. The study was divided into descriptive (Phase I) and explorative (Phase II) phases.

In Phase I, data were collected by a cross-sectional survey, among health care professionals recruited via email from the national Finnish trade union. Whistleblowing in Health Care (WIHC) instrument was used, producing statistical data (n=278, sub-data I) and written narratives (n=226, sub-data II). In Phase II, data were collected via email among nurses from the national membership register of the Finnish Nurses’ Association. Nurses Moral Courage Scale© (Numminen et al. 2019), the video vignette of the care situation and an open question about that situation, were used, producing written narratives (n=244, sub-data III), and written narratives (n=706) of which the narratives and statistical data (n=454), were included in sub-data IV. The analysis consisted of grounded theory approach and descriptive correlational analysis.

First, according to literature, the concepts of the phenomenon of whistleblowing for wrongdoing were defined and described and then organised into a whistleblowing process. In Phase I, the manifestation of wrongdoing and the whistleblowing process in health care were described. In Phase II, a theoretical construct of reasoning for whistleblowing was created composing dimensions and patterns of reasoning and the core category. In addition, the whistle-blower as the actor, based on their background variables and moral courage, was identified.

The conceptual model of reasoning for whistleblowing was developed using integrative approach of exploring the phenomenon through multiple sources and theorising. The results of the study can be implemented both in the nursing and health care practices, management and education, for preventing and decreasing wrongdoing. The results also produce new theoretical understanding on the phenomenon of whistleblowing for wrongdoing.