The Importance of Nurse Advocacy
By Debra Wood, RN, contributor
What does a patient advocate nurse look like?
Nurses advocating for patients, a tenet of professional practice, can be exhibited in different ways.
“In the nurse-to-patient relationship, there is a fundamental trust that occurs,” said Audrey Wirth, MSN, RN-BC, CVRN-BC, a nursing instructor at Aurora University in Aurora, Illinois. “Nurses must serve as advocates for both their patients and for better health care in general.”
Wirth suggested nurses collaboratively plan to provide safe, high-quality, patient-centered health care, adding that patients may not know what questions to ask. Therefore, nurses can facilitate informed decision-making.
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Why nurses are the best patient advocates
Nurses spend the most time with patients, and they also experience the health care system’s limitations firsthand. This puts them in the best position to speak up about their patients’ needs and safety concerns.
“Nurses must be vocal and know the avenues, both internal and external to their facility, that are available to facilitate and promote changes for the benefit of both patients and the health care system,” Wirth said.
Cindy Cain, DNP©, MSN, CNS, RN, CCRN, clinical practice specialist with the American Association of Critical-Care Nurses (AACN), added that a nurse advocating for a patient means ensuring the patient is aware of his or her rights; feels supported in making decisions about his or her care; and receives basic rights like privacy.
“Nurses hold the unique distinction of being the most trusted profession in the nation,” Cain said. “That trust comes with the responsibility to ensure patients a voice in the delivery of their care.”
Developing the nurse-patient relationship
During the time they spend with patients, nurses develop a closeness and unique insight into the patients’ and families’ wishes and treatment goals. Cain said this intimate knowledge can become especially important if the patient’s condition deteriorates to the point that he or she cannot voice his or her own choices.
“Take the time to get to know them and develop the nurse-patient relationship,” Cain advised. “That is the sacred knowledge that will best guide you in the role of patient advocate.”
Sandra Barnaby, RN, CDE, MPH, clinical manager at the Care Management Organization at Montefiore Health System, works with outpatients and often will take her elderly patients to lunch to learn more about them and their health needs, while helping them make healthy choices.
“We advocate for the patients for their health care needs, their psychosocial needs and physiological needs,” Barnaby said. That may include calling a physician’s office to secure a primary care appointment. Or it may entail identifying barriers and securing needed services, such as adequate housing.
“Nurses as advocates in care management is primary,” said Barnaby, adding that for nurses to advocate for patients successfully, they must understand the patient’s culture.
Some nurses work as special patient advocate nurses. Lisa Bushman, RN, started Patient Advocacy Nurse Denver, in July 2017, to help people navigate complex medical situations.
Taking nurse patient advocacy to the next level
Karen Tomajan, MS, RN, NEA-BC, recently retired from John Muir Health in Walnut Creek, California, makes a case for nurses advocating for themselves and the profession, and how that, in turn, can help patients, since nursing care influences patient outcomes.
Nurse patient advocacy includes speaking up while serving on committees or councils to solve problems and ensure patients receive the best care possible.
“Advocating for one another would open the doors to more effective working relationships,” Tomajan said.
Tomajan suggested working with fellow nurses to approach leadership and improve the environment for their patients. Advocacy skills, she reported, include problem solving, communicating, influencing and collaborating. Nurses can also work through shared governance councils.
“You have to advocate for nurses, because it is so difficult,” she said. “If we don’t, we are not going to produce quality outcomes.”
RELATED: Nursing Advocacy: Standing Up for Patients and the Profession
Nurses advocating for health care issues
“One way a nurse can become a better advocate is to continually gain more knowledge of current health and patient care issues,” Cain advised. “It is important to consider becoming active in one or more professional nursing organizations and participating in the local and national discussion regarding the future of health care.”
Nurses advocating for patients can become involved with their professional organizations, volunteer to serve on a board or in other ways influence policy makers.
“As nurses, patient advocacy also means being engaged in the discussion of healthcare’s future and using our voice to guide the decisions that will impact the future of patient care,” Cain said.
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