Advocacy in nursing

Arts and Science of Nursing concepts Nursing Advocacy The heart of nursing is advocacy. It is a vital function inwhich the nurse must be competent. There are many strategies that the nurse can use as she walks the tight rope of trying to safeguard the well being and interests of her patients. She does this by ensuring that they are aware of their rights and can make informed decision. This paper will critically discuss advocacy in nursing and how it is applied in practice.
Advocacy is described as many things. In nursing, it is the essence of the relationship. It has been defined as participating with the client in such a way as to help determine the meaning of health, illness, suffering and dying (Vaartio, Kilpi, Salantera, et. al., 2006). It is a method of providing information and supporting clients in their decisions. Pleading a patients case when necessary and protecting the client from worry when possible is important (Kennedy, 2006). In simple terms, it means actively supporting a cause and trying to get others to support it. It is speaking up and effecting change. It can be drawing attention to an important issue or directing those that need to make a decision in the right direction (Hussein, 2005).
Advocacy has been an essential component of Registered Nurses professional role since 1976. It is much more important now than it was then, with the public demanding more control over their own healthcare (Bu & Jezewski, 2006). Patients in today’s system with all of its equipment and techniques can be fairly powerless if no one is there to advocate. The American Nurses Association Code of Ethics for Nurses with Interpretive Statements requires that nurses advocate for, and protect the health, well-being, safety, values, and rights of patient in the healthcare system (ANA. org). The International Council of Nurses Code of Ethics for Nurses also mandates an advocacy role for nurses (Kennedy, 2005).
In the twentieth century, nursing advocacy has had to take on a large dose of ethics. With advent of medical technology and science, end of life issues have become much greater. The care of the dying patient has shifted from family and the community to health professionals. Advocacy according to Thacker, (2008), is the common thread of quality between end of life nursing care, encompassing pain, symptom management, ethical decision making, cultural sensitivity, and caring for patients through their death and dying experiences. Nursing spends more time with patients when they face death than any other member of the healthcare team and therefore, must advocate for their treatment and stopping treatment when appropriate (McDonald, 2006). There are sometimes legal aspects here as the decisions about legal guardians and advanced directives come up more often than they once did.
Patient advocacy has received international focus of late. It is being studied by many under many circumstances. It has been broadly recognized for its importance over the last two decades to the Nursing associations and Advanced Practice Nurses taking up the banner and trying to move forward with its importance (Bu & Jezewski, 2006). Nursing itself has in the past painted it with a broad brush of importance but now has realized that it is actually deserving of a mid range theory which is being studied (Bu et. al., 2006). As we as nurses become more and more aware of our responsibilities to our patients in a time of advanced medicine, we also realize that advocacy must be a greater piece of that care.
In conclusion, advocacy must be based on more than a patients requests or expectations. It must be based on a professional responsibility for ethical conduct. Patients are highly vulnerable in the healthcare system today due their illness and the possible loss of their human rights. When patients are not able to act as their own advocates, nurses must act in their place. This may be forgotten in the busy of the wards today but somehow we must find that time again. Patients often say that advocacy is when a nurse through her professional commitment to help, goes beyond good care. Advocacy, however, is much, much more than that.

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