The "Good Nurse" Narrative, Speaking Up, and the Prevention of Violence in the Workplace.

Background: Assaults on nurses from patients or other nurses are endemic in healthcare settings. Still, nurses underreport or are silent about workplace aggression. Nurses' silence is embedded in social and organizational structures that discriminate against them and make speaking up unsafe.

Aim: The aim of this article is to examine professional identity attributes and how they intersect with prevailing social and organizational cultural norms to suppress nurses' voices. To determine how professional identities are gendered socially and culturally, a keyword focused cultural inquiry was conducted.

Methods: Attributes identified by keywords were extracted from 20 research reviews or data-based studies. Ten studies that reported results as linguistic data identified attributes of professional nurses; an additional 10 studies of this kind reported attributes of professional women outside the discipline. The keyword attributes were quantified then compared using word cloud analysis. The Master Narrative Framework was used to situate these identities within master narratives of gender and violence.

Results: Both identities examined were composed of terms socially and culturally attributed to women including "compassionate, respectful, a listener, kind, honest, empathetic, trustworthy, gentle, caring, and friendly." Nurses' identity attributes were reported as qualities of a good nurse while professional women attributes were presented as sources of gender discrimination.

Conclusions: Speaking up is critical to understanding workplace violence, yet nurses do not routinely report aggression or take action to prevent violence in their workplace. Understanding their silence as a response to gender discrimination provides potential avenues for enabling nurses to speak up to improve their work conditions.