Speaking up as an extension of socio-cultural dynamics in hospital settings: a study of staff experiences of speaking up across seven hospitals

Antoinette Pavithra*, Russell Mannion, Neroli Sunderland, Johanna Westbrook

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)
30 Downloads (Pure)


Purpose - The study aimed to understand the significance of how employee personhood and the act of speaking up is shaped by factors such as employees' professional status, length of employment within their hospital sites, age, gender and their ongoing exposure to unprofessional behaviours.

Design/methodology/approach - Responses to a survey by 4,851 staff across seven sites within a hospital network in Australia were analysed to interrogate whether speaking up by hospital employees is influenced by employees' symbolic capital and situated subjecthood (SS). The authors utilised a Bourdieusian lens to interrogate the relationship between the symbolic capital afforded to employees as a function of their professional, personal and psycho-social resources and their self-reported capacity to speak up.

Findings - The findings indicate that employee speaking up behaviours appear to be influenced profoundly by whether they feel empowered or disempowered by ongoing and pre-existing personal and interpersonal factors such as their functional roles, work-based peer and supervisory support and ongoing exposure to discriminatory behaviours.

Originality/value - The findings from this interdisciplinary study provide empirical insights around why culture change interventions within healthcare organisations may be successful in certain contexts for certain staff groups and fail within others.
Original languageEnglish
Pages (from-to)245-271
Number of pages27
JournalJournal of Health, Organisation and Management
Issue number9
Early online date16 Nov 2022
Publication statusPublished - 2022

Bibliographical note

Copyright the Author(s). Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.


  • Speaking up
  • unprofessional behaviour
  • Culture change
  • Organisational change
  • Hospital employees
  • Bourdieu
  • Staff wellbeing
  • interprofessional relations
  • reporting
  • whistleblowing
  • socio-cultural factors
  • organisational behaviour
  • Culture change intervention
  • Unprofessional behaviour


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