The Nurse as Advocate

The ethics of advanced nursing practice often requires nurses to serve as advocates for their patients to provide them with high-quality care. Considering the complexity of a current healthcare system, people who apply for medical assistance find themselves overwhelmed by the enormous amount of information they receive from clinicians. In the meantime, the lack of specific knowledge and the stress these individuals face in a clinical environment forces patients to look for support from both doctors and nurse practitioners. As stated in the research, “such vulnerability is cited as a key reason for advocacy at the macrosocial level” (“5 ways nurse practitioners,” 2017, para. 1). Nurses’ efforts to address social justice by disclosing patients’ needs serve as a means to help clients to access the health care they deserve.

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Drivers and Factors Forcing Nurses to Become Advocates for Their Patients

The necessity to understand patients’ needs better usually arrives as the main driver for nurse practitioners to try on the role of an advocate. When creating the atmosphere of trust and undisputed support, clinicians motivate clients to discuss their preferences more openly, fostering collaboration and a friendly tone of communication. Cooperation in which “knowing the patient and feeling empathy for the patient” prevails contributes to more precise decision-making and reduces the occurrence of a disruptive activity (Josse-Eklund, Jossebo, Sandin-Bojö, Wilde-Larsson, & Petzäll, 2014, p. 673).

There could also be economic drivers for some individuals to engage in patients’ advocacy, as well as the issues within a clinical setting itself. The cost of treatment is among the factors forcing people to complain about the health care system’s operation on an ongoing basis. Nurses, however, may directly advocate for their clients in specific instances delivering information to elected officials and community leaders (“5 ways nurse practitioners,” 2017). By providing expertise to public organizations, they live up to patients’ expectations and thus, improve the entire health care infrastructure.

Among the other factors, one may highlight the need for a regular change of health policy. Nurse practitioners currently form the largest group of medical experts. Some nursing associations may publish advocacy tools on their sites to influence the governmental machinery at all possible levels. The expertise delivered by an APRN carries significant weight in preparing these tools. As Arabi, Rafii, Cheraghi, and Ghiyasvandian (2014) admit, “nurses’ influence on health policy protects the quality of care by access to required recourses and opportunities” (p. 315). The given opportunities allow them to participate in legislative action alerts with the consideration of the needs of regular patients.

Barriers to Advocacy that Nurses Encounter in Their Practice

When nurse practitioners advocate for their patients, they may face certain obstacles or challenges within a working environment. Choi, Cheung, and Pang (2014) claim lack of support, code of ethics, time constraints, and limited communication to be the key barriers for medical workers to exercise advocacy. The major problem is that nurses feel no support from the government or public organizations in their activities. Many of them complain that neither head nurses nor matrons assist with the discussed matters. Hence, patients cannot receive the proper level of support too.

The code of ethics arrives as an additional challenge for medical workers to advocate for some of their clients. Provoking or aggressive behavior of particular patients might force registered nurses to intentionally ignore the needs of the former due to their demands being unethical or abusive. Moreover, members of the nursing staff may be unaware of some rules and try advocating in the field they are not authorized to or in which they do not possess enough competence.

Some nurses write in their reports that time constraints often interfere in their plans or intentions to advocate for a patient on a clinical level. The fact is medical workers are usually overwhelmed with duties, which leaves them little time to solve opportunity tasks. There are frequent occasions when people express a desire to communicate, but a nurse practitioner is obliged to stop the conversation and head towards the other room. The need to fulfill all of the duties on time forces these individuals to reject advocacy completely.

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Limited communication is another obstacle clinical experts may encounter when attempting to advocate for someone. The modern healthcare system requires clinicians to focus more on recording patients’ data rather than communicating in person (Barlem et al., 2015). However, the system does not take into account the fact that receiving accurate data involves establishing close verbal contact with a client. When a nurse discovers the needs of a patient, he/she can more precisely speak of a person’s state of health and express more effective engagement in a therapy course. It is expected that medical workers allocate more time to studying individuals’ desires to collect enough evidence to effectively advocate on all levels.

Comparing Nurses’ Drivers and Challenges to Personal Factors and Barriers

As to the factors driving nurses to engage in advocacy, I am convinced that establishing close interpersonal relationships between nurse practitioners and patients is the major constituent of providing effective treatment. In my attempts to advocate for clients on a clinical level I also rely on the principles of understanding the primary needs, reducing the excessive costs, and enhancing the existing health policy. Showing empathy for an ill person is a central point of a clinician’s professional activity (Josse-Eklund et al., 2014). However, no matter how strong my intentions to support these individuals are, I still face challenges when trying to assist them. Lack of colleagues’ support is the most crucial factor influencing my motivation and desire to acquire new knowledge. I experience the same concerns other nurses do when attempting to help my patients. Also, the absence of proper time management skills forces me to strictly limit this advocacy practice.

I strongly believe that if I continue to demonstrate maximum care for patients, I will motivate other members of the nursing staff to show higher professional integrity too. Within the next five years, my advocacy skills will improve significantly, as I will acquire extensive work experience to earn colleagues’ respect. While also remaining a part of the nursing staff, I will rely on the experience of the rest of the practitioners and will borrow the practices that only the leading clinicians use.


Advocating patients at both local and governmental levels is one of the duties registered nurses fulfill when attempting to help people with serious health issues. Through the intervention into treatment course, medical workers discover the drivers forcing them to support their clients and learn to overcome barriers interfering with the advocacy practice. The research findings show that many nurses face the same challenges when trying to resolve the given tasks within their clinical environments. Lack of support and time constraints prevent them from providing proper assistance.


Arabi, A., Rafii, F., Cheraghi, M. A., & Ghiyasvandian, S. (2014). Nurses’ policy influence: A concept analysis. Iranian Journal of Nursing and Midwifery Research, 19(3), 315-322.

Barlem, J. G. T., Lunardi, V. L., Barlem, E. L. D., Ramos, A. M., Figueira, A. B., & Fornari, N. C. (2015). Nursing beliefs and actions in exercising patient advocacy in a hospital context. Revista da Escola de Enfermagem da USP, 49(5), 811-818.

Choi, S. P. P., Cheung, K., & Pang, S. M. C. (2014). A field study of the role of nurses in advocating for safe practice in hospitals. Journal of Advanced Nursing, 70(7), 1584-1593.

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5 ways nurse practitioners can serve as advocates. (2017). Web.

Josse-Eklund, A., Jossebo, M., Sandin-Bojö, A. K., Wilde-Larsson, B., & Petzäll, K. (2014). Swedish nurses’ perceptions of influencers on patient advocacy: A phenomenographic study. Nursing Ethics, 21(6), 673-683.

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