Nurses: An integral Part of Advocacy

Vulnerability is the core condition that requires patient advocacy. Vulnerability caused by illnesses as well as risks natural in the healthcare industry, demand advocacy action for patients and their respective families. So who provides this advocacy and how?

           

For many decades the expression ‘advocacy’ has described patient-nurse relationships. Thus advocacy has become an obligation, a key nursing role. Many models for advocacy in nursing are derived from philosophical writings of Curtin LL, The nurse as advocate: a philosophical foundation for nursing, and Gadow S., Existential advocacy: philosophical foundation of nursing. Both authors base advocacy models on “patients’ right to self-determination” and “nurses’ role in assisting patients to exercise this right.” Soon after, more practical models stated that patients must be allowed to make informed decisions and that the role of the advocate was to provide patients with necessary information and support their choices.  However advocacy also consists of the relationship that exists between patients, nurses, and other healthcare professionals present in the environment.

           

Although many models have been constructed regarding the role of a patient advocate, they all vary in their own interpretation of advocacy in the nursing practice. This unclear definition and lack of consensus concerning the true meaning of advocacy, what it involves, demands research; research that will help achieve a well-rounded definition of advocacy while simultaneously considering the perspectives of individual societies on advocacy.

In 2008 a study was conducted in a university hospital in Tehran, Iran in order to gain more information on advocacy in an Iranian society. According to Ahmadi et al, authors of The Meaning of Patient Advocacy for Iranian Nurses, approximately 24 nurses working in various wards in the hospital such as neonatal intensive care, oncology, ophthalmology, and more were recruited for interviewing. The interviews encompassed a broad question, ‘could you describe one of your working shifts?’, and continued as nurses were also asked to describe their experience with patient advocacy. Each interview lasted for about 40-75 minutes. The results of the experiment showed five primary categories Iranian nurses considered part of their role as advocates. These categories were:

• Informing and educating

• Valuing and respecting

• Supporting physically, emotionally and financially

• Protecting and representing

• Promoting continuity of care

Additionally, data analysis indicated that nurses believe their patients lack appropriate knowledge about their medical condition, its diagnosis, services available to them and their families etc.

Granted that numerous studies such as the one described above have been conducted in order to reach an agreement on the definition of advocacy, further research is needed to better understand the nature, risks, and types of advocacy. This understanding is crucial for nurses as patient advocacy continues to become an integral part of their practice.