The Nurse as an Advocate for the Patient

Nurses are highly skilled and trained professionals who take care of the sick. They educate patients, families, communities and populations on wellness and healthy living as well as health approaches to any chronic or current disease process and treatment. Moreover, nurses are entrusted with the duty of performing treatment and procedures as prescribed by physicians, physician assistants and nurse practitioners. Pattillo (2011) notes that a nurse is full of compassion for her fellow human beings; they possess good communication skills and good listening skills. They are required to report the progress of their patients to physicians, keep patient records, chart all patients’ observations, do the teaching procedures for patients and document communications with their patients. The nature and duties of nurses depict them as health care providers that are closest to patients and their families. They are therefore endowed with the task of advocating for the rights of patients within health care institutions. This paper discusses nurses as advocates for the patients, giving reasons why advocacy for patients’ rights should be incorporated into the nursing practice.

Nurses are better placed as advocates of patients because they are constantly interacting with patients, thus making it easy for patients to trust them and confide in them. Pattillo (2011)

describes a wide range of activities performed by nurses, which extend to the wider community. Nursing involves collaborative care of communities, individuals of all ages, groups and families; both sick and healthy (Pattillo, 2011). Nurses prevent illnesses, promote health, and care for the disabled, the ill and the dying people placed under their care. Moreover, they are advocates for promotion of safe environment, health education, research participation in shaping health policy as well as systems and patient management (Pattillo, 2011).

Marquis & Huston (2009) observe that nurses are the first health care professionals to recognize situations which are not in the best interest of patients and to report these situations to persons that could effect change. They identify and take action or report things such as questionable drug order to the physician or report an incompetent health care provider to a nursing supervisor; thus advocating for the rights of the patient (Marquis & Huston, 2009).

The American Nursing Associations Code requires nurses to be advocates of patients by reporting cases of patient abuse, including known or suspected cases of emotional, physical or sexual abuse because they constitute unprofessional conduct and form basis for disciplinary action against the culprits (Marquis & Huston, 2009). In the event that the nurse is not satisfied with how a reported case is handled to protect interest of the patient, the Code provides for nurses to pursue the case further within appropriate reporting channel and outside the agency (Marquis & Huston, 2009). According to Marquis & Huston (2009), the policy for board of registered nurses warns that reporting duties are responsibilities of individual nurses and supervisors or administrators are not required to impede or inhibit the process or subject the reporting nurse to any sanction for making the report. Nurses are further advised to follow guidelines developed by the board of registered nurses concerning content of patient abuse course in identifying abuse cases that require action to protect the rights of their patients (Marquis & Huston, 2009).

Nursing advocacy plays a key role in observing safety of patients during their encounters with health care system; especially when the patient is too ill to serve his own advocate or when the patient is undergoing surgery and anesthesia. Marquis & Huston (2009) highlight that during situations of surgery, the circulating nurse must serve as the patient’s advocate, speaking for the patient and protecting patient’s wishes throughout the process. The nurse is required by the nursing code to support the cause or proposal as a result of patient’s vulnerability. Nurses serve as patients advocate by advocating improved health care practices that relate to control of infections and patient care environments as well as access to care. Marquis & Huston (2009) note that each encounter that the nurse has with his patient presents an opportunity for the nurse to serve as the advocate for the patient.

Giving voice to patients in situations where patients decide to give their full trust to health care provider or when the patients are hesitant to speak their mind is an advocacy role of nurses to their patients. Goldberg (2011) reiterates that in such situations, nurses should encourage patients to voice their wishes and provide care that focuses on meeting patients’ specific wishes. In addition, nurses should ensure that the safest procedures are observed for patients during care provision. As advocates for the patients, nurses are required to limit traffic in operating suite or delay the beginning of a surgery procedure until correct instructions are provided (Goldberg, 2011). This not only eliminates carelessness but also protects the well being of patient throughout the process. Furthermore, Goldberg (2011) embraces the importance of nnurses in the preoperative arena who play a critical role by care environment monitoring, provision of safe care for the patient and promotion of best practices for prevention and control of infection. The nurse as an advocate for the patient must intervene in situations where patient’s safety is compromised like in cases where a physician does not routinely wash his hands before touching a patient or physicians who regularly violate sterile technique and ignores other practice standards. The code stipulates for nurses to recognize and address practice patterns that put patient at risk in order to protect the rights and well being of the patient.

Besides acting as advocates for patients, nurses also act as advocates for family members of the patient. Goldberg (2011) points out that positive results have been achieved through advocacy in situations where patients are very ill and at point of death; where upon request of family members to be with the patients, nurses have respected these wishes and allowed family members to be with the patient. In such situations, death conditions have been reversed with the patient’s condition improving drastically upon seeing family members. Patient’s advocacy guarantees safety and protection of patients from preventable harm as patients and their family members depend on nurses to detect and address potential safety issues (Goldberg, 2011).

Nurses as advocates for patients face numerous challenges in their daily advocacy duties. Goldberg (2011) observes that some physicians may not respond or listen to nurses in a timely manner as a result of competing priorities for nurse attention and efforts, thus placing tasks before advocacy. Additionally, hierarchical and institutional constraints frequently limit nurses from role as advocates of patients; placing patient’s safety at risk. People who espouse advocacy for patients are of the opinion that nurses should achieve higher professional autonomy for rights of patients to be fully protected in hospital settings. Goldberg (2011) regrets that while medical ethics rarely addresses the freedom of physicians to establish professional relationships with patients, nursing ethics must deal with continuous challenges to freedom of practice, especially in hospital settings.

The intertwining of professional and ethical concerns, with the principles such as rights of patient and autonomy being considered in the same context as professional freedom to practice is quite challenging and places nurses at an awkward position. However, it is clear that the primary obligation of a nurse is to the patients, but not to physicians or hierarchies in health care facilities. This has gained prominence and wide acceptance within the profession. The American Nursing Associations Code requires nurses to be always alert as client’s advocates by taking necessary action on any situations of unethical, illegal or incompetent practices originating from health care system, members of health care team or actions that violate patient’s best interest. This has overtaken sections of previous code that mandated nurses to be obedient to physicians’ orders and observe high level of confidence in physicians. In addition, putting nurses as advocates for the patients has led to shift of nurses’ perceptions of their primary allegiance from physicians and hospitals to patients. However, advocacy for patients may be a complex issue, especially when patients are unwilling to express their preferences or are afraid to say what they want because they believe it will alienate their physician. Sometimes disagreements may arise between choices and also the nurse may find other care professionals indifferent or opposed to wish of his patient. These reasons and others make advocating for patients a complex activity.

In conclusion, nurses as advocates for patients have been embraced in most health care institutions. Advocacy for patients guarantees safety and protection for patients, especially in situations where patients are too ill or during surgery. Health care professionals should therefore respect the role of nurses as advocates for patients by providing adequate support and cooperation in order to attain this goal.