Institutional betrayal in nursing: A concept analysis

Area of Science:

• Nursing Ethics
• Organizational Behavior
• Healthcare Management

Background:

• Ethical relationships are fundamental in healthcare, particularly between nurses and employers.
• Institutional betrayal, a facet of organizational behavior, significantly influences ethical culture and nurse well-being.
• Understanding institutional betrayal is vital for addressing ethical challenges within healthcare settings.

Purpose of the Study:

• To establish a conceptual understanding of institutional betrayal within the nursing profession.
• To define institutional betrayal and distinguish it from other forms of betrayal.
• To provide a clear definition applicable to nursing practice and research.

Main Methods:

• A concept analysis was performed using the Walker and Avant methodology.
• A comprehensive review of health literature databases was conducted without date restrictions.
• Analysis adhered to established guidelines for ethical research practices.

Main Results:

• The concept of institutional betrayal is under-explored in nursing literature.
• Examples include inadequate workplace protections, hostile management, and gaslighting.
• Instances of institutional betrayal have become more apparent, especially during the COVID-19 pandemic.

Conclusions:

• Institutional betrayal is defined as a profound violation of trust or moral standards by an institution toward a nurse.
• Negative outcomes include detrimental effects on nurses' psychological and workplace well-being.
• This concept offers valuable insights into ethical workplaces, moral distress, and moral resilience, necessitating further research.