Patient advocacy and whistle-blowing in nursing: help for the helpers.

This article examines the phenomenon of whistle-blowing and its antecedent dynamics, including invidious organizational tactics that are employed to silence patient advocates. Moral distress and moral outrage are identified and described as manifestations of the stress that nurses experience when acts of patient advocacy are subverted. Recommendations are offered to empower and protect present and future practitioners who may be faced with having to take on the role of whistle-blower. Research initiatives are also suggested.