Although available scholarship shows that nursing advocacy is a relatively new concept (Kibble, 2012), it is evident that the role of the nurse as an advocate in healthcare settings is not necessary new considering that nurses have historically been involved in identifying patient needs and seeking ways to have these needs met (Maryland & Gonzalez, 2012).
In the recent past, stakeholders in the health sector have been in agreement that patients require advocates for optimal treatment and care outcomes, but are still to agree on whether nursing professionals are in the superlative position to provide such services (Kibble, 2012). In this light, the present paper reviews available nursing literature to provide a well reasoned discussion on the role of the nurse in the continuum of patient advocacy.
Owing to the fact that advocacy basically entails the practice of persuading an individual or an entity to at least consider one’s point of view, it can be argued that a major nursing role in patient advocacy involves representing the patients in the policy-making process at the community and legislative arenas (Maryland & Gonzalez, 2012).
As demonstrated by these authors, nurses are better placed to not only identify prevailing patients care needs and concerns, but also to share these experiences and insights with public and elected administrators due to the high level of trust and respect accorded to them by the community.
Indeed, available evidence demonstrates that nurses all over the world continue to use their positions in society to influence healthcare policies in terms of advocating for enhanced access to immunizations and funding for education, among others (Maryland & Gonzalez, 2012).
Patient advocacy has been defined in the literature “as an iterative process of analyzing, counseling, and responding to patients’ care and self-determination preferences” (Vaartio-Rajalin & Leino-Kilpi, 2011, p. 526).
Drawing from this description, nurses are better placed to use their role to not only promote and safeguard the well-being and interests of patients, but also to ensure that patients are fully aware of their rights and have unlimited access to the information they require to be able to give informed consent (Vaartio-Rajalin & Leino-Kilpi, 2011; Wilkinson, 2012).
Here, nurses act as advocates in (1) analyzing the patient’s care preferences, (2) analyzing the patient’s self-determination preferences, (3) counseling patients about their rights and type of care, (4) counseling other care professionals with regard to the patient’s preferences, (5) responding to the patient’s care preferences, (6) responding to the patient’s self-determination preferences, and (7) identifying important information gaps and patient concerns during the informed consent process (Vaartio-Rajalin & Leino-Kilpi, 2011; Wilkinson, 2012).
Kibble (2012), citing other research studies, defines advocacy in nursing in terms of “participating with the patient in determining the meaning of health, illness, suffering and dying; providing information and supporting patients in their decisions; pleading the case of a patient; protecting the patient from unnecessary worry; disclosing negligence and misconduct; and valuing, appraising and interceding” (p. 10).
Drawing from this description, it can be synthesized that a major role of the nurse as a patient advocate entails disclosing professional negligence and misconduct, implying that nurses are better placed to act as whistle blowers in exposing events and experiences that often jeopardize the patient’s health and wellbeing.
Consequently, as acknowledged by Kibble (2012), nurses should always expose institutions and practices viewed as unethical or negligent, and also assume an active role in assisting patients to achieve the legal rights in the event that they are treated unfairly or negligently. Such assistance, according to Maryland and Gonzalez (2012), can be provided in terms of nurses appearing in court jurisdictions to give evidence against other care providers who put the lives of patients at risk due to professional negligence or misconduct.
Lastly, owing to the incompetence and unethical standards demonstrated by some physicians, it should be the task of nursing professionals to challenge the physician orders where necessary and provide alternatives that they feel are best suited to the patients. Many physicians do not spend substantial amount of time with their patients and are hence unable to understand some patient concerns and needs in the same way nurses do.
Consequently, nurses have a role to act as patient advocates by questioning the physician’s authority and orders in areas where such orders can compromise the patients’ care and treatment outcomes (Hanks, 2010; Kibble, 2012). This role demonstrates that nurses should no longer blindly obey instructions or orders given by physicians by virtue of the fact that they are active participants in the care process.
Overall, this paper has successfully demonstrated that nurses have many roles to play in advocating for the needs, concerns, and rights of patients, and that these roles stem from the nursing professionals’ knowledge, experience, and competencies to be outstanding advocates. As such, more research studies need to be undertaken to come up with theoretical applications through which these roles can be effectively internalized in the nursing profession for optimal patient health outcomes.
References
Hanks, R.G. (2010). The medico-surgical nurse perspective of advocate role. Nursing Forum, 45(2), 97-107.
Kibble, G. (2012). Patient advocacy in nursing practice: A systematic literature review (Bachelor thesis, Turku University of Applied Sciences, Finland).
Maryland, M.A., & Gonzalez, R.I. (2012). Patient advocacy in the community and legislative arena. Online Journal of Issues in Nursing, 17(1), 1-1.
Vaartio-Rajalin, H., & Leino-Kilpi, H. (2011). Nurses as patient advocates in oncology care: Activities based on literature. Clinical Journal of Oncology Nursing, 15(5), 526-532.
Wilkinson, K. (2012). Informed consent and patients with cancer: Role of the nurse as advocate. Clinical Journal of Oncology Nursing, 16(4), 348-380.