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Advocacy is a process of supporting people who are vulnerable in the society and are unable to express their views and opinions, pass on important information to them to the appropriate authorities and access services that they require, explore their choices and right, defend and promote their rights and responsibilities (Teasdale, 1999).
An advocate is therefore someone who provides support to those who are vulnerable or less able to speak for themselves or access services that they require. For example, a service user who is unable to attend a meeting/interview alone or speak for him/herself due to any reason, may ask someone to act as an advocate. Health professionals have a duty or care to advocate for service users that they work with and their role is to ensure that the service users' voices are heard by representing their wishes and views and making sure that they have access to services that will meet their needs (Bateman and Bateman, 2000).
However, these health professionals may be reluctant to do so if they consider that what the service user ask them to do is not to his/her best interest. For health workers to adequately advocate on behalf of their service users, they must listen to them and ensure that they understand the needs of the service user. As seen in the first scenario in the video, when a patient was to be supported to get out of bed, it was obvious that health staff did not allow him to express his wishes because they pounced on him and started to open the window without asking if he would like his window opened.
Nurses are seen as advocates of patients in their care. They are to listen to patients because they constantly interact with them, making it easy for patients to trust them and confide in them (Loue, Lloyd and O'Shea, 2003).
In scenario 1 in the video, the nurses completely ignored the patient in their care whilst telling them that he needed his glasses. He was considered as though not in existence in spite of asking for his glasses repeatedly(Grogan and Gusmano, 2007).pointed out that nurses are the first health care professionals to recognise situations that are not in the best interest of patients and report these situations to those that can effect change.
Nurses promote health and care for the disabled, the ill and the dying people placed under their care and prevent illnesses but these attributes were lacking in the health professionals that cared for the patient in scenario 1. It was clear that he got frustrated that he lost his appetite. He probably would be thinking if he was in the wrong place and with the wrong people. Nurses are advocates for the promotion of safe environment, health education, research participation in shaping health policy as well as systems and patient management (Loue, Lloyd and O'Shea, 2003).
Nurses spot and take action or report issues such as questionable drug order to the doctors or report an incompetent health care provider to a supervisor, thus advocating for the right of the patient (Gordon et al., n.d.).
According to nurses code of practice, nurses are required to advocate on behalf of patients by reporting cases of patient abuse, including known or suspected cases of physical, emotional or sexual abuse because they constitute unprofessional conduct and form basis for disciplinary action against the culprit (Lustig, 2012). Not listening to patients and providing care based on their needs as seen in the scenario is unprofessional and also an abuse. for example, a service user who asked for his/her medication from a health provider and he/she is refused, has been abused. Nurses are therefore required to report cases of abuse to protect the rights of their patients (Keefe and Jurkowski, 2013).
Nursing advocacy plays an important role in observing the safety of patients when they make contact with health care system particularly when they are too ill to be their own advocate or when undergoing surgery or anaesthesia (Lustig, 2012). Bateman and Bateman (2000) highlights that during surgery, the nurse must serve as the patient's advocate, speak for the patient to protect the patient's wishes throughout the surgery. Nurses therefore serve as patient's advocate by advocating improved health care practices that relate to control of infections as well as access to care. Bateman and Bateman (2000)notes that each encounter that the nurse has with the nurse presents an opportunity for the nurse to serve as the advocate for the patient.
Good communication between service users and staff is very important.AsApker (2013) suggests, it is important that health and care workers develop good communication skills for them to have effective communication with service users and explain their treatment needs to them. More so, health and care workers must learn professional communication skills and know how to apply them to create a better care environment (Collins, 2009). Health workersmust listen to service userswhilst expressing their views and needs, and also pass on important information to them, to the appropriate authorities and for them to access services that they require through advocacy (Luckmann and Nobles, 2000). While advocating for service users, health workers need to explore their choices, defend and promote their rights and responsibilities(Loue, Lloyd and O'Shea, 2003).
Health workers such as nurses are highly skilled and well trained professionals who take care of the sick. They educate patients, their families and the communities on wellness and healthy living.Bateman and Bateman (2000)suggests that a nurse is full of compassion for clients and human beings in general. They posses good communication and listening skills but in the video in scenario 1, this appeared not to be so as the service user was completely ignored. Nurses are also required to report the progress of their patients to the doctors and their loved ones. They are to keep patients records, chart all patient's observations, do the teaching procedures and document conversations and discussions with their patients. The nature and duties of nurses portray them as health care professionals that are closest to patients and their families. They are equipped with the task of advocating for the rights of patients within health care institutions (Grogan and Gusmano, 2007). These are what he nurses in the video should be to the service user and not the other way round.
In communicating with the service user, the nurses need to be able to use a variety of strategies to ensure that professional practice meets health and care needs of the service user and facilitates a positive working relationship with him. Undoubtedly, Lustig (2012) suggests that there are different approaches to communication and it is important that the individual health professional channels his or her use of these approaches to the individual needs of the patient.
Therefore a good working knowledge of cognitive, humanistic, behavioural, social and psychoanalytical is vital. Lustig (2012)states that humanistictheory is applicable in situations where people are involved in aspects of self actualisation, self conception, self esteem, honour and dignity. This approach reflects on the viewpoint that every human being has the potential to be good, to contribute positively, to enjoy life and to be a loving and lovable member of the society.
Thus, in health and care sector, nurses, doctors, home care managers, including social workers as Kerson and McCoyd (2010) comment, are offered adequate training in order to care adequately for service users in the most humanistic manner by practising methods of communication relevant to the individual or to the appropriate situations
Giving voices to service users in situations where they are unable or hesitate to speak their minds or when they decided to give their full trust to health practitioners such as nurses, is an advocacy role of nurses to their patients. Grogan and Gusmano (2007) note that in such circumstances, nurses should encourage patients to voice their wishes and opinions and provide care that focuses on meeting their specific wishes.
Teasdale (1999)states that patient's advocacy guarantees safety and protections of patients from preventable injury as patients and their family members depend on health workers such as nurses to detect and address potential safety issues. Providing the service user with his glasses to enhance his sight to function will guarantee his safety. Nurses also acts as advocates for family members of patients.
Listening to service user in scenario one in the video and meeting his needs such as offering him his glasses for clear vision, communicating with him by telling him what they have come into his room to do and asking him about his health and wellbeing and not discussing about their personal issues will enable the service user to have trust, confidence, feel safe and establish a good working relationship with the nurses caring for him.
- Apker, J. (2013). Communication in Health Organizations. Hoboken: Wiley.
- Bateman, N. and Bateman, N. (2000). Advocacy skills for health and social care professionals. London: J. Kingsley.
- Collins, S. (2009). Effective communication. London: Jessica Kingsley.
- Gordon, S., Feldman, D., Leonard, M. and Jackson, A. (n.d.). Collaborative caring.
- Grogan, C. and Gusmano, M. (2007). Healthy voices, unhealthy silence. Washington, D.C.: Georgetown University Press.
- Improving access to oral health care for vulnerable and underserved populations. (2011). Washington, D.C.: National Academies Press.
- Keefe, R. and Jurkowski, E. (2013). Handbook for public health social work. New York: Springer Pub.
- Kerson, T. and McCoyd, J. (2010). Social work in health settings. Abingdon, Oxon: Routledge.
- Loue, S., Lloyd, L. and O'Shea, D. (2003). Community health advocacy. New York: Kluwer Academic.
- Luckmann, J. and Nobles, S. (2000). Transcultural communication in health care. Albany, NY: Delmar.
- Lustig, S. (2012). Advocacy strategies for health and mental health professionals. New York: Springer Publishing Company.
- Teasdale, K. (1999). Advocacy in health care. Malden, Mass.: Blackwell Science.
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