Question

1. Compare the roles and responsibilities of the nurse in advocating for safe care for individuals, for families, and for communities.

2. Describe how your experiences in advocating for individuals, families, and/or communities could help you to engage in advocacy in the political arena

Answer 1

Ans) The American Nurses Association (ANA) provides this definition of nursing practice: “The protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations.”

The ANA also addresses the importance of advocacy in its Code of Ethics, specifically in Provision 3: “The nurse promotes, advocates for, and protects the rights, health, and safety of the patient.” Clearly, advocacy is a key tenet of nursing practice.

The following forms the basis of nursing advocacy: preserving human dignity, patient equality and freedom from suffering.

Preserving human dignity:
- In many medical situations, patients and their families are anxious and confused. A calm, experienced nurse can help patients navigate an unfamiliar system and communicate with their physicians.

- In some cases, nurses also educate the patient about tests and procedures. They should be aware of how culture and ethnicity can affect the patient’s experience while also adhering to privacy laws.

- In general, nurses are in a unique position that allows them to integrate all aspects of patient care, ensuring that concerns are addressed, standards are upheld and positive outcomes remain the goal.

Patient equality:
- The healthcare system is constantly changing, both in terms of organization and technological advancement. With these changes come shifting regulations related to the delivery of care and health services. However, nurses must remain above the fray, advocating for patients “with compassion and respect for the inherent dignity, worth, and uniqueness of every individual, unrestricted by considerations of social or economic status, personal attributes, or the nature of health problems,” the ANA Code of Ethics states.

Freedom from suffering:
- Nurses enter the profession because they have a desire to help others. The core value of helping to prevent or manage suffering is a significant part of this. This can be achieved at the physical, emotional or psychological level, and is one of the most important aspects of patient care.

- Nursing professionals should be available for patients and their families as advocates for their well-being.

Nurses are advocates for their patients in several critical ways. They are communicators, liaisons, educators, interpreters and caregivers.

Helping to make informed decisions:
- One of the most basic ways that nurses can be advocates for their patients is ensuring they have the right to make decisions about their own health. Especially if a patient is alert and competent, nurses should take the patient’s decisions seriously, even if the patient declines to take certain medication or refuses a treatment. When the physician doesn’t agree, the nurse has a responsibility to provide information so the patient can make informed decisions and to offer support.

Making patients a priority:
- The ethics involved in patient advocacy can make for complex situations. For example, if a patient is dealing with a terminal illness, family members may disagree about care. Although patients may only want comfort measures, oftentimes their loved ones seek strategies that can prolong life. Regardless of the family’s wishes, in this situation the nurse has a duty to facilitate the patient’s needs. Nurses must make the patient their priority. “Advocating is about standing up for the rights of your patients and firmly defending them even if you personally may not agree. Personal feelings or preferences are put aside, since health care is about the patient and his needs, not caregivers,” said a registered nurse employed by a New York City hospital in an article from NurseZone.

Being a resource:
- Another area that often calls for advocacy is the financial aspect of healthcare. Families are sometimes more comfortable discussing the difficulties they experience due to treatment costs with nurses, rather than physicians or other healthcare professionals. The conversations nurses have with patients can mitigate these situations, helping patients access the healthcare services they need.

One example of this is prescription drug costs. Nurses are knowledgeable about a variety of resources, either within their communities or directly through healthcare organizations, that can assist patients who have difficulty paying for prescriptions and other healthcare services. Nurses can also advocate for their patients by assisting them with the research involved in cost savings. This can include comparing one drug over another or even communicating with physicians to find ways to lower costs.

Nurses have hundreds of patient experiences upon which to draw in order to impact public policy. It is our obligation to strengthen skills that enable us to influence public policy so we can better serve patients. We begin by describing advocacy and providing examples of how nurses can advocate in the community, specifically in economic matters and the educational and healthcare systems. Then we describe the process for advocating in the legislative arena. We conclude by noting that the public needs the voice of nursing in public policy and that now is the time to move forward to advocate for patients in these various arenas.