Silencing Selected Advocates and Innovators

The U.S. health care system of the 21st century is in desperate need of reform. Patients are being harmed in the hundreds of thousands attributable to medical errors, identified as the third leading cause of death in hospitals. The need for health care reform is further validated by the trillions of dollars that are infused into the U.S. health care system, where quality of care benchmarks are among the worst in the world. The historical evolution of the U.S. health care system was predicated on nurses who served as advocates and innovators of safe workplace and patient care practices. The Code of Ethics and Nurse Practice Act(s) for registered nurses and the requirements of registered nurse licensure in the 21st century, partnered with an ethical barometer in the delivery of quality patient care, command that registered nurses maintain their historical role as advocates and innovators to promote and maintain safe workplace and patient care practices. Registered nurses in the 21st century are being stifled in the fulfillment of what is commanded of them professionally. It is the quagmire of fulfilling their advocate, innovator role and being penalized with unjust discipline shortly thereafter that is stifling. This “coincidence” is silencing registered nurses across the United States. The aim of this study was to employ a hermeneutic phenomenological research design utilizing Max van Manen’s phenomenology of practice to explore the lived experience of unjust discipline among registered nurses. Audio-recorded interviews were conducted with the participants of the study. Vivid descriptions of the participants’ lived experiences of unjust discipline were communicated. Transcripts were generated from the audio recordings. An interpretive analysis utilizing the hermeneutic circle disclosed nine essential themes among the participants’ experiences of unjust discipline. Respondent feedback augmented validity in the interpretive processes during data collection and thematic analysis. In the context of the study, it was evident that unjust discipline is a disruptive workplace behavior that potentiated physical workplace violence. Further, authentic social support may have precluded many of the elements of unjust discipline experienced by the participants during the lived experience of unjust discipline.