Insights into insight: analysis of case files of nurse and midwife registrant performance complaints
Date
2019
Authors
Chiarella, M.
Vernon, R.
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Journal article
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Collegian, 2019; 26(3):341-347
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Abstract
Background: Losing or keeping registration following a complaint about clinical performance is often based on ability to demonstrate insight. Clear descriptions about the behaviours that manifest as insight are missing from the regulatory literature. Methods: To identify and describe the elements of insight present or absent in case files where the registrant is the subject of a complaint about nursing/midwifery performance, 712 complaint files from a regulatory authority were analysed for content. Key descriptive elements of 148 files were then thematically analysed. Findings: Key elements of insight included: ownership of/taking responsibility for the incident; reflection on/analysis of the incident; reflection on/analysis of their mental and/or physical state; analysis of the context in which the incident occurred; recognition of own failures/mistakes; expressions of remorse or regret; improvement through education; describing what they would do differently next time; and seeking out counselling/mentorship. Key elements that raised concern included where the registrant: did not understand the issue; took no personal responsibility; made excuses for why the error/incident had occurred; made no attempt to change; and was non-compliant with improvement strategies. The critical differences between the positive attributes of insight and those behaviours demonstrating lack of insight are ownership of the event and action on reflection.
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Copyright 2018 Published by Elsevier Ltd on behalf of Australian College of Nursing