How Nurses Can Advocate for Patients
- Nurse advocacy is crucial to safeguarding patient outcomes, protecting against social injustice, and mediating obstacles to quality patient care.
- Although the concept of nurse advocacy is still poorly conceptualized, the actions are often easily recognized and may be one of the most important responsibilities of an RN.
- Patient advocacy is crucial to patient care to help them navigate the healthcare system, including billing, medical care, insurance, and assisting with legal issues.
Patients within a clinical facility or hospital often find the situation bewildering. It can make them feel nervous and anxious, which is often driven by a lack of knowledge about how things work. When patients are overwhelmed, they're unable to advocate for themselves and must rely on nurses to be their voice and keep them informed about treatment and procedures.
In a study, 25 registered nurses described patient advocacy as educating patients, being the patient's voice, and providing quality care. Yet the scope of patient advocacy is much greater. Explore what it means to be a patient advocate and how nurses can advocate for their patients.
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What It Means To Be an Advocate for Patients
Patient advocacy is so crucial to patient care that many hospitals have these positions to help patients through the healthcare system. Patient advocates communicate with providers and help ensure patients have the information they need to make independent decisions about their care.
Enabling patients to make independent decisions values and safeguards their rights, protects them from incompetency, and safeguards their health and wellness. Although the concept of patient advocacy is still poorly conceptualized, the actions are often easily recognized.
Some believe patient advocacy is one of the most important responsibilities of an RN. Nurses are the patient's first point of contact with the healthcare system and often the last one as well.
Nurse advocacy includes helping patients navigate the healthcare system through medical care, billing, and insurance. It also involves assisting patients with legal concerns and issues. Patients have come to rely on nurses to support their autonomy, keep them safe, and educate them about their condition and the healthcare system.
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How to Advocate for Patients
Nurse advocacy centers on respecting patients' dignity, treating all patients equally, protecting their rights, and preventing undue suffering. While specific steps nurses help advocate for patients with medical trauma, mental health conditions, and during labor and delivery, all nurses can advocate for patients using several simple strategies.
Communicate with the Healthcare Team
Ensuring proper patient care requires more than making the right diagnosis and performing procedures. Communication is a crucial component to ensuring good patient outcomes and high patient satisfaction. Yet, collaboration and communication do not occur without effort.
Patients must communicate symptoms, concerns, and goals with their healthcare team. Unfortunately, many people are overwhelmed or intimidated by healthcare providers. Nurses play a vital role in ensuring their patient's information is communicated, which significantly influences patient outcomes.
Educate Patients and their Families
Patient outcomes and the risk of rehospitalization also depend on a patient's compliance with recommendations. Nurses are in a unique position to advocate for their patients through education and support.
While a physician may strongly recommend a patient stop smoking, nurses can advocate for patients by providing them with outpatient programs to help them accomplish that goal. According to the Centers for Disease Control and Prevention, 6 out of 10 adults in the U.S. have at least one chronic disease.
Lifestyle changes can significantly impact chronic diseases, such as nutrition, physical activity, and excessive alcohol use. Nurses can educate patients and families, which may have a meaningful impact on patients' motivation to change their habits.
Protect Patient Rights
According to the National Institutes of Health, patients have rights while volunteering in clinical research. These rights are often incorporated into a healthcare facility's “Patient Bill of Rights,” and include the right to be safe and receive respectful care, complete information about their diagnosis, treatment, and prognosis, and enough information to give informed consent.
Ensure Patient Safety
Ensuring a patient's safety is a basic right of every patient within a healthcare facility. Nurses are on the front line of providing patient care while communicating with the healthcare team. One way that nurses ensure patient safety is to confirm the five rights of medication administration (the right patient, the right drug, the right time, the right dose, and the right route) before giving any medication to a patient.
The FDA receives nearly 100,000 reports each year of medication errors, some of which occur in hospitals. These are among the most common medical errors and are estimated to harm at least 1.5 million people each year and result in 7,000-9,000 deaths.
Nurses can advocate for patient safety by lobbying their hospitals for safe nurse-to-patient staffing ratios, appropriate in-house education, and safe working conditions. Advocacy to ensure patient safety also extends to nurses remaining vigilant during their shift, consistently monitoring patient conditions, and increasing patient engagement in treatment.
Advocate for Resources/Better Working Conditions
Nurses have a responsibility to advocate for better working conditions and adequate resources to care for their patients. Rising stress levels in patients, families, and medical staff have consequences.
One survey of healthcare workers published in The Lancet reported 82% of respondents said they had received threats and physical aggression, 21% reported severe wounding of a healthcare worker or patients, and 27% reported the staff was threatened by weapons.
Nurses have a responsibility to themselves and their patients to help create a safe environment. While they cannot do it on their own, together with administration and management, nurses can lead the way in developing processes that protect those concerned.
Address Barriers to Care
The COVID-19 pandemic highlighted many of the barriers to care that exist for low-income families and vulnerable populations. Nurses can advocate within their institution and local community to reduce or eliminate barriers to healthcare in the patient populations they serve.
The particular strategies may be specific to the population. Providing equitable healthcare may begin with educating other healthcare providers or legislators about the inequities in the system and suggesting processes that can contribute to a solution.
Support Patient Autonomy
Patients must make autonomous and independent decisions about their healthcare if providers expect them to follow through with recommendations after discharge. However, in some cases, patients may feel railroaded into the decisions within the hospital system.
Once they return home, they may revert to their old habits, which increases the risk of rehospitalization. Nurses can help support patient autonomy by protecting patients' right to make their own decisions and encouraging them to request all the necessary information.
For some patients, that may mean deciding to forgo chemotherapy after a diagnosis of cancer, and for others it might mean deciding to enroll in a community cardiac rehabilitation program to regain their strength and function after a heart attack. Ultimately, patients must make those decisions because they are the ones expected to follow through on those choices.
Nurses are frontline workers — a role where patient advocacy is required to fulfill their job responsibilities. Nurses must continue to provide quality care, compassion, and advocacy for patient safety and outcomes.
About Chronic Diseases. (2023). CDC
Medication Errors. (2019). AMCP
Mishra, V et al. Health Inequalities During COVID-19 and Their Effects on Morbidity and Mortality. (2021). NIH
Nsiah, C et al. Registered Nurses' description of patient advocacy in the clinical setting. (2019). National Library of Medicine
Patient Bill of Rights. (2021). NIH
Tariq, R et al. Medication Dispensing Errors and Prevention. (2023). NIH
Thornton, J et al. Violence against health workers rises during COVID-19. (2022). NIH
Working to Reduce Medication Errors. (2019). FDA
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