Hofling (1966)
Aim: To see whether nurses would follow orders given by an authority figure (doctor) when the orders are given over the phone and would be breaking regulations. To study obedience in a real life setting
Procedure: Involved both public and private hospital wards. In Hospital 1: 21 student nurses and 12 graduate nurses were asked to complete a questionnaire asking them what they would do if confronted by the experimental situation. This was a control group to make comparisons.
In the other hospitals 22 nurses took part in the field experiment which was covert (nurses did not know they were in a study).
While alone on the night shift (7pm – 9pm) the nurses received a phone call from a unknown doctor asking them to administer a drug to a patient - astroten. The amount of drug nurses were asked to give would have been an overdose (it was a placebo) as they were asked to give 20mg, the box was labelled maximum daily dose 10mg. The drug was also not authorised for the ward the nurses were working on and nurses should not carry out orders given over the phone.
The phone called ended when the nurse complied; the nurse refused; the nurse referred them to someone else; if they became upset; if they could not find the medication or if the call lasted longer than 10 mins.
An observer on the ward stopped the study when the nurse got the medication and was approaching the patient; the nurse began to contact another professional or it had been over 10 mins since the call.
Findings: The control group: 10 of the graduate and all of the student nurses given the questionnaire said they would NOT give the drug; yet in the experimental group 21 out of 22 nurses started to give the medication, they did not give much resistance and admitted they knew they should not have carried out the orders
Conclusion: Nurses will knowingly break hospital rules in a situation where a doctor tells them to, even if it could endanger a patients life. This study supports that research that suggests people obey authority figures – doctors are more senior so nurses would have been expected to do as they told them
Evaluation
Generalisability: Hofling’s study took place in the USA so may not apply to other cultures; also as it took place in the 1960’s the findings may not be relevant to modern doctor nurse relationships
Reliability: It followed a standardised procedure as the same instructions and script were used when asking nurses to give astroten, so it can be replicated. A control group was also used which allowed comparisons to be made.
Application: Changes in nurse training to make sure nurses do not blindly obey, nurses now have greater responsibility and room for autonomy
Validity: It was a field experiment in hospitals where nurses were working at the time on their normal shift, so it has high ecological validity. Nurses were unaware of an experiment so there were no demand characteristics as they were going about their everyday job, acting as they would normally.
Ethics: It was conducted covertly, so no informed consent was given by the nurses. Some were left distressed by the study so lacked protection from harm. However nurses were given a full debrief, results are confidential, and the study would not have worked if nurses had been aware of the study and the drug being a placebo.
Aim: To see whether nurses would follow orders given by an authority figure (doctor) when the orders are given over the phone and would be breaking regulations. To study obedience in a real life setting
Procedure: Involved both public and private hospital wards. In Hospital 1: 21 student nurses and 12 graduate nurses were asked to complete a questionnaire asking them what they would do if confronted by the experimental situation. This was a control group to make comparisons.
In the other hospitals 22 nurses took part in the field experiment which was covert (nurses did not know they were in a study).
While alone on the night shift (7pm – 9pm) the nurses received a phone call from a unknown doctor asking them to administer a drug to a patient - astroten. The amount of drug nurses were asked to give would have been an overdose (it was a placebo) as they were asked to give 20mg, the box was labelled maximum daily dose 10mg. The drug was also not authorised for the ward the nurses were working on and nurses should not carry out orders given over the phone.
The phone called ended when the nurse complied; the nurse refused; the nurse referred them to someone else; if they became upset; if they could not find the medication or if the call lasted longer than 10 mins.
An observer on the ward stopped the study when the nurse got the medication and was approaching the patient; the nurse began to contact another professional or it had been over 10 mins since the call.
Findings: The control group: 10 of the graduate and all of the student nurses given the questionnaire said they would NOT give the drug; yet in the experimental group 21 out of 22 nurses started to give the medication, they did not give much resistance and admitted they knew they should not have carried out the orders
Conclusion: Nurses will knowingly break hospital rules in a situation where a doctor tells them to, even if it could endanger a patients life. This study supports that research that suggests people obey authority figures – doctors are more senior so nurses would have been expected to do as they told them
Evaluation
Generalisability: Hofling’s study took place in the USA so may not apply to other cultures; also as it took place in the 1960’s the findings may not be relevant to modern doctor nurse relationships
Reliability: It followed a standardised procedure as the same instructions and script were used when asking nurses to give astroten, so it can be replicated. A control group was also used which allowed comparisons to be made.
Application: Changes in nurse training to make sure nurses do not blindly obey, nurses now have greater responsibility and room for autonomy
Validity: It was a field experiment in hospitals where nurses were working at the time on their normal shift, so it has high ecological validity. Nurses were unaware of an experiment so there were no demand characteristics as they were going about their everyday job, acting as they would normally.
Ethics: It was conducted covertly, so no informed consent was given by the nurses. Some were left distressed by the study so lacked protection from harm. However nurses were given a full debrief, results are confidential, and the study would not have worked if nurses had been aware of the study and the drug being a placebo.