Florence, a neophyte social worker, was employed by a long-term care unit for people with severe disabilities. After approximately one month, she observed what to her appeared to be incidents of resident abuse. She first attempted to discuss the situation with a staff member and was told, "You're new here. This is how we have to treat them or they won't listen to us." After discussing the situation with other people in the organization, including the medical staff, she learned of suspicious injuries some residents had incurred over the preceding eight months. Those that were reported to the local protective services agency resulted in inconclusive or negative findings. As a result, employees accepted periodic incidents of abuse as inevitable.
Florence brought up her concerns at a routine meeting. Her immediate supervisor and unit coordinator discussed the magnitude of the problem, yet at the end of the meeting, Florence sadly concluded that neither would pursue the matter. After agonizing about the issue for several days and reading and rereading the NASW Code of Ethics, she finally decided to chronicle what she had witnessed and to express her apprehensions publicly at a quarterly caretaker meeting. At the meeting, after voicing her suspicions, she implored those present "to take it upon yourselves to become advocates for not only your loved ones, but also those who have no one to advocate for them."
Strong disapproval of Florence's actions was expressed over the next few days. Other employees immediately distanced themselves from her. Shortly after the caretakers' meeting, Florence's immediate supervisor and unit coordinator met with her and attempted to explain why her actions had been inappropriate. Angry and hurt, she refused to retract her claims or to consider the possibility that speaking up at the caretakers' meeting had been unwise. Her credibility within the agency seriously undermined, Florence was asked to leave the organization.
As a value and a skill, advocacy has been an inherent component of social work since the mid- 1800s--the era of Dorothea Dix (Fisher & Karger, 1997). Advocates commonly are viewed as practitioners who defend have-nots against an uncaring bureaucracy in accordance with professional values and using professional skills. The NASW Code of Ethics (2000) explicitly promotes advocacy as an ethical stance against inhumane conditions.
When a social work employee goes beyond advocacy inside the organization to advocacy outside the organization, she or he engages in what is known as "external whistle-blowing" and may be subject to repercussions. Whistle-blowing as a phenomenon has been studied and discussed extensively in business and public administration disciplines. Media portrayals show real-life dramas in which lone individuals place millions of dollars at stake and the whistle-blower's career, reputation, health, family, and life are in jeopardy. Business, public, and health administration articles offer guidance to organizations on how to prevent and respond to whistle-blowing.
Whistle-blowing has received increasing attention in the social work field as well, particularly since the 1999 revision of the NASW Code of Ethics (2000). Most discussions of whistle-blowing in social work have occurred in the context of ethical decision making (Loewenberg, Dolgoff, & Harrington, 2000; Reamer, 1998). For example, the 19th edition of the Encyclopedia of Social Work (Edwards, 1995) has a subsection on whistle-blowing under the major category of "Ethics and Values" (Reamer, 1995).
Our literature review, however, revealed a dearth of articles exploring whistle-blowing in the context of social work advocacy. Using the case composite as an illustration, this article seeks to fill that gap by offering pragmatic guidance to practitioners on how to mitigate against negative consequences if they decide to publicly reveal ethical violations within their organizations. …