An Article Written By Robert Hanks ( 2012b ) From The University Of Texas At Health Science School Of

It’s the nurse's duty to advocate for her patient and to make sure that the patient understands and ask questions if necessary.

Not all patients are capable of independently identifying and articulate their care needs, so the nurse also adapts the role as an advocate. Clarity and continuity in a trusting environment enables good communication. Progressive identification of needs takes place as nurse and patient communicate with one another in the interpersonal relationship (Peplau 1988, p. 84). Being considerate to the needs and vulnerability of patients is a moral attribute, as nurses are accountable for the care they deliver.

In Nursing, there will always be instances where the patient's nurse needs to advocate for their patient. There are numerous reasons why a nurse would advocate for their patient ranging from getting the doctor to change the patient’s orders, helping the patient’s treatment team understand what it is the patient is requiring for the day, to expressing the patient’s last wishes before death. In every situation, the nurse should do what is in the patient’s best interest. Tomajan (2012), “Advocacy skills are the ability to successfully support a cause or interest on one’s own behalf or that of another. Advocacy requires a set of skills that include problem solving, communication, influence, and collaboration”(p. 2). With those skills, the

Poor communication puts patients in danger because it can lead to medical errors and adverse events. For example, a medication error can occur if a physician’s orders are not updated in time or if the outgoing nurse does not provide the correct time in which a dose was administered last. Thus it is crucial to communicate any recent treatment that has been implemented. In this way, nurses and physicians can facilitate the prevention of errors. Another consequence of ineffective communication is that it can decrease morale and increase work-related stress among members of the healthcare team. If nurses and physicians are not understanding each other’s actions, conflict ensues. It can cause toxic interpersonal relationships. This, in turn, will affect the level of patient care because it is difficult to focus amidst emotional strain and

“Errors in communication give rise to substantial clinical morbidity and mortality (Riesenberg, Leitzsch, & Cunningham, 2010).” As a result, the Joint Commission has identified effective communication as one of its National Patient Safety Goals (Dunsford, 2009).

A nurse is given an opportunity to help patients, either if its by helping them through a very serious sickness or just helping a patient get to the bathroom on time, or a time when happiness is overfilling the room and a child is being born. Registered nurses provide a wide variety of patient care services (Mitchell, p.12). A Nurse must always know where to begin and where to stop, as any other career in the health field there is always something that cannot be done by everyone but only the certified person, a nurse must always remain inside her scope of practice to prevent any misunderstandings. A nurse must also follow a code of ethics , the code of ethics of the American Association of Medical Assistants states that a nurse should at all times render service with full respect and dignity of humanity, respect confidential information obtained by a patients file, uphold the honor and high principles the profession and accept its discipline, and last but not least always want to improve her services to better serve the health and well being of the community. (Mitchell, p.65).

The concept of patient advocacy was the focus of the article entitled, “Developing a mid –range theory of patient advocacy through concept analysis” by Xiaoyan Bu and Mary Ann Jezewski published in the Journal of Advanced Nursing 2007. In an attempt to clarify the definition as well as the refine the concept of patient advocacy, the authors synthesized advocacy in nursing literature and sought with this information to establish a theoretical basis for future studies on patient

The healthcare industry has intensely advanced throughout the world, in turn changing the principles that incorporate the practice and culture of nursing practice. Altering the model of care to a patient-centered mode signifies an organizational culture shift and requires the participation of executives at the senior level (Cliff, 2012). To practice this care to provide the best care possible, it goes beyond the nurse to all healthcare professionals and senior leadership. The days of patients and nurses following a physician’s order without favor to care has now loaned themselves to more of an interdisciplinary approach to practice. Though, it is encouraged that the patient makes decisions for themselves, after receiving the proper education and information on their condition. Part of the patient-centered care is to be the patients’ advocate, by letting them know you are there for them when they are unable to speak and advocate for themselves and what is in their best interest. That goes in hand with educating them on “self-management of care, health literacy, patient, and family education through nurse-patient communication and interaction (Finkelman & Kenner, 2016, p. 271).”

Everyday nurses encounter situations in the workplace and frequently find themselves in the role for advocate for both patients and staff. Advocacy is a process used to facilitate growth in others and provide others with the information that empowers them to make their own decisions. While advocating nurses main focus remains on supporting decision making rather than making decision for others (Grand Canyon University, 2011).

A weakness in communication between interdisciplinary team members can impact patient safety and health . A recent study revealed that out of all the claims analyzed , 57 percent of malpractice cases reflected miscommunication between two or more healthcare providers (Riah, 2015). In fact, the same communication failures directly linked to 1,744 deaths over the past five years (Budryk, 2016). During my clinical placement this semester I have witnessed the overwhelming number of health care team members that are involved in each patient’s care. I also take part in morning nursing rounds where all nurses are updated on every patient’s status. Transmission of permanent patient information is also relayed to all members of the health team via the patient chart .Here , interdisciplinary notes all come together to form updated health information on patients. However, although I have read interdisciplinary notes from all team members , I rarely have had the opportunity to personally communicate with members other than doctors and nurses. Personal communication allows for a team member to pass on relevant information in a timely manner without the possibility or misinterpretations. When communication is strictly done non-verbally, it is impossible to ask any questions.. This is why communication between professionals in health care is essential for patient safety and improved quality of care (Koivunen, Niemi., & Hupli,2015). There are 3 main factors that cause miscommunication

There are five principles to ethical nursing. The first principle, nonmaleficence, or do no harm, it is directly tied to a nurse's duty to protect the patient's safety. This principle dictates that we do not cause injury to our patients. A way that harm can occur to patients is through communication failures. These failures can be intentional or as a result of electronic or human error. Failing to convey accurate information, giving wrong messages, and breaking down of equipment, can cause harm to patients. Some of these communication problems may certainly occur whether a patient is at a neighborhood clinic or 500 miles away, but distance and high reliance on electronic technology make close examination of communication and ethical

The purpose of this concept analysis is to clarify, define, and refine how patient advocacy is perceived in the nursing community. Much of the literature has attempted to define patient advocacy and emphasis its role within the nursing profession. This paper will discuss multiple definitions of patient advocacy from existing literature and refine them into two critical characteristics.

Advocacy is risky, in that other peers may disagree with the decision when addressing the good of individuals or the nurse may potentially lose their position. But being able to find a balance between the foreseeable risks and benefits involved when advocating for better conditions is what leads to a more effective patient care plan (Edelman, Mandle, & Kudzma, 2014, p. 111). In the novel “A Nurse’s Story” by Tilda Shalof (2015), a positive example of advocacy is demonstrated between a patient named Sylvie and a nurse named Tracy. Sylvie is on the top of the organ transplant list for a new lung, but needs oxygen at the moment because she is struggling to breathe. The nurses are put in a situation where she either gets a sedation and intubation but gets taken off the transplant list, or gets the sedation and intubation to help her breathe at the moment. Despite the repercussions of possibly jeopardizing Sylvie’s chance for a lung transplant and going against the doctor in charge’s disapproval, she still gave her a dose of morphine to ease her breathing. Tracy in this situation is a perfect example of an advocate nurse. There were so many risks involved, but she was able to put a whole picture together and add in her instinct to come up with a plan of action. The interpersonal interaction between Tracy and her patient previously enabled her to spend more time to connect with the patient to understand what she needs and how to solve this situation. Not only did the nurse-patient relationship help the patient and her family feel as though they are being cared for, but also helped them feel more motivated to open up to the nurse to achieve better satisfaction. As said in the novel, “it was a small thing, but it was a big thing to Sylvie and her mother” (Shalof, 2015, p.

A professional nurse is one who puts the needs and importance of patient care above all others. While striving for professionalism, nurses need compassion, patience, empathy, strong moral and ethics, accountability and the commitment to always act in the best interest of their patients. Nurses are held accountable for providing quality, safe, and effective nursing care (Hood, 2014). A professional nurse has the responsibility to continually improve and implement nursing standards while maintaining integrity by involving themselves in various tasks. Regular involvement in reading professional literature and sharing of evidence- based research with other healthcare personal helps increase knowledge and skills. This nursing ability can be used to encourage the actions of others in the healthcare team resulting in improved patient care. Nurses should encourage each other to become involved in hospital committees, provide an environment to encourage the discussions of ethical dilemmas, promote professional growth of nurses to voice their concerns and share viewpoints to address issues. “A professional nurse should expect to commit to a life of continuous learning growth and development”. (Hood, 2014, pp. 29). Nurses choose this profession to help others. As professional nurses we must maintain our ethics, values, characteristics, and commitment to drive our profession forward (CCN, 2015). Nurses must be autonomous, accountable, and be able to delegate to unlicensed assistive personnel. Being autonomous as a nurse means having control over their practice (Hood, 2014). It allows a nurse to take risks while being held accountable for ones’ actions (Hood, 2014).

I have known for a long time that nurses make some of the best advocates. They are known for being the ones who spend the most time with patients, so in turn they are able to better recognize their immediate needs. Advocating for patients does not have to involve major health care decisions, but rather it can be small actions that are simply for the benefit or comfort of the patient. Throughout my clinical rotations, I can say that I have advocated in small ways. An example of an act I consider to be advocacy was simply letting the nurse know that my patient was having abdominal pain after not having a bowel movement since admission. I didn’t want to make a suggestion to the point of making it seem as though I was telling the nurse how to do her job, but at the same time, I was letting her know about the patient’s concern so that she could decide for herself if it was information worthy of reporting to the doctor or simply performing an action herself.