Advocacy in Nursing Practice
#1 Reply to Kayla Cristina Incera
Advocacy in Nursing Practice
Nursing advocacy takes many forms and is meant to protect and promote the rights, health, and overall well-being of patients. When carried out well, nursing advocacy is an added value—sometimes an ingredient that can improve patient outcomes. Whether at the bedside or in health policy, nursing advocacy is an expression of the ethical principles that govern our work and an acknowledgment of the right every person has to health and health care. Even more, it is a call to action for nurses as patient advocates to be five stars, not three stars, and to push for not just any old health care but for very good health care—some have called it the pursuit of health justice
Advocating for Patient-Centered Care
The practice of nursing must be focused on patient-centered care to be effective. Such care leaves nothing to chance, making it much more likely that the patient’s needs and wants will be correctly understood and accurately acted upon (Okoro et al., 2023). Advocating for patient-centered care takes many forms, but one form it often takes is that of advocating for ensuring that patients have all necessary information allowing them to make fully informed, autonomous decisions. Key among these forms of information giving is the giving of detailed information about the risks and benefits of any potential or planned treatment options.
One more instance is the act of creating customized care plans that take into account individual patients’ likes, dislikes, and cultural backgrounds. For example, I had a patient who followed the Muslim faith and also had diabetes. This patient, like many others, considered our health system woefully unaware of their spiritual and cultural needs (Hickmann et al., 2022). They recognized that the Western healthcare system was not fashioned for people with such needs. While working with them to manage their disease, it became clear to me the kind of cultural competency healthcare professionals need to practice if we are to assure the patients we are here to serve.
Promoting Health Equity
Nursing practice pays significant attention to another important area: achieving health equity. This may be the most critical and potentially controversial part of the “care” function of nursing, as it often involves the “payment” part of healthcare. Advocacy is central to this effort, even as the term “advocacy” is controversial in itself. From a human rights perspective, advocacy doesn’t just make suggestions or recommendations on behalf of patients; it is also a declaration that people have the right to access quality care, regardless of their socioeconomic position, gender, or other social determinants.
I also worked with the hospital’s financial aid office, looking into additional ways the patient could get the help they needed to pay for their treatment if they were eligible. On another point, the language barrier is tough to break in health care. Many patients, not just at Northwestern, do not speak English as their first language, restricting their access to me as their doctor in any meaningful way. Since this is the U.S., we’ve been able to get by with my very basic Spanish, but if we can help people understand the medical jargon using words they know, then maybe the patient will be more likely to ask questions and stay engaged in their healthcare plan.
Conclusion
Nurses must promote health fairness and patient-centered care. These lobbying initiatives boost patient outcomes and nurse-patient trust. Nurses enable patients to make healthcare decisions by assuring informed consent and creating tailored care plans. Patients have equal access to care by addressing financial and language barriers. Nursing advocacy needs proactive collaboration, resource use, and education. These advocacy initiatives promote nurse ethics and a more equal healthcare system.
#2 Reply to Adrian Soto
What examples of advocacy do you see in your own nursing practice?
As a nurse in general, advocacy is embedded in our daily function as nurses, as it is one of if not the focus when providing patient care. It is our nature to advocate, hence a probable factor as to why nurses became nurses. It is a crucial aspect of our role in ensuring the well-being and rights of our patients. Here are two examples from my nursing practice where advocacy plays a significant role.
As a nurse case manager, my role focuses on advocating for patients via means of ensuring that they receive the right level of care at the right time. This role involves reviewing and interpreting medical records, consulting with healthcare providers physicians, APRN’s and PA’s, and obtaining an overall picture to assess patients’ needs so that treatment plans are tailored to individual circumstances. Advocacy in this realm includes ensuring that patients receive timely interventions, have access to necessary medications and treatments, and are involved in decision-making regarding their care.
Utilization review nurses also assess patient safety and quality of care by monitoring healthcare practices and outcomes. This is also a form of advocacy. This may involve identifying opportunities for improvement in clinical processes, adherence to evidence-based guidelines, and patient outcomes. Sometimes a patient might be admitted under an observation level of care, and upon my review, the patient might warrant inpatient hence more days and therefore extended treatment and monitoring. By advocating for best practices and quality improvement initiatives, utilization review nurses contribute to the delivery of safe, effective, and patient-centered care. Inappropriate care in the role can cost the patient money and treatment outcomes.
Another aspect of my role as a nurse case manager involves loading patients with the knowledge necessary to navigate their healthcare journey effectively while hospitalized and after discharge. This often involves simplifying complex medical information and providing patients with the tools to make informed decisions about their care. This role also includes complex scenarios as each patient presents different challenges, such as ethical, financial, cultural, educational, and hence there are overlapping functions. For example, in the past, I have cared for patients who had orthopedic procedures, required outside care post discharge, and lacked understanding about their management. Throughout their stay, I would already work on establishing services such as home health care, or coordinating transfers to skilled nursing facilities and I would tailor education to the path for their specific care. Patients felt empowered and at ease with the information that I would provide. This allowed the patient to become more involved in their care secondary to an enhanced understanding of their current medical problem. As a result, I not only addressed immediate health concerns but also empowered the patient to take an active role in managing their condition beyond the hospital setting.
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