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How to Become A Nurse Advocate

NurseJournal Staff
Updated May 4, 2023
Nurse advocates liaise between patients and physicians. Explore how nurse advocates help patients gain a greater understanding of diagnoses and make the right decisions for their health.
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If you are interested in helping people navigate the complex U.S. healthcare system, then a nurse advocate career may be right for you. This guide introduces you to this nursing specialty, lists the steps to becoming a nurse advocate, and describes the educational and certification processes.

What Is a Nurse Advocate?

A registered nursing (RN) specialty, nurse advocacy involves educating patients about their treatment choices, advocating for patients’ rights, and communicating with medical billing offices and insurance companies. Nurse advocates work in hospitals, long-term care centers, outpatient clinics, and other medical facilities.

Being part negotiator, counselor, and healthcare advisor, nurse advocates (also known as independent RN patient advocates) fill a key role in provider-patient relations and care quality monitoring.

Visit our career overview page for additional information about nurse advocacy, including salary and job growth projections.

Steps to Becoming a Nurse Advocate

Nurse advocates need an RN license, which requires an associate degree in nursing (ADN) or a bachelor of science in nursing (BSN). Once you have your degree, you will be eligible to take the National Council Licensure Examination (NCLEX-RN).

State licensure requirements vary, so check with your state’s nursing board for specifications. Optional nurse advocacy training and certification can enhance job prospects and salaries.

The list below details the steps to becoming a nurse advocate.

Earn an ADN/BSN Degree

An ADN is the entry-level RN requirement, but many nurses pursue a BSN to further their career and increase their pay. Students typically earn an ADN in two years and a BSN in four years.

Some learners decide to earn their ADN, obtain their RN license, and then return to school for their BSN after working for a few years. RN-to-BSN bridge programs allow completion in 9-24 months. An accelerated BSN (ABSN) — for those with a bachelor’s degree in a non-nursing field — takes 11-18 months to earn.

Pass the NCLEX Exam

State nursing boards require a passing score on the NCLEX-RN exam for RN licensure. The exam comprises 200 questions on care management and supervision. Candidates usually take the exam about a month after graduating from their nursing program.

Consider Patient Advocacy Training

Nursing programs don’t always include patient advocacy in their curriculums, but post-graduate training programs, such as the RN Patient Advocates Learning Intensive, can fill in any knowledge gaps. The additional training, usually offered fully or partially online, takes a few extra months to complete and equips students with the tools needed for their new career.

Training courses cover patient advocacy delivery models, integration of treatments and care plans, negotiating skills, and healthcare systems navigation.

Improve Job Prospects by Becoming Certified

Nurse advocate certification isn’t required, but it can improve an RNs’ job prospects and patients’ quality of care. Patient Advocate Board Certification credentials nurse advocates by examination.

Healthcare Liaison offers a nine-month program that provides credentials for healthcare advocates. Candidates meet in small groups and private sessions through video conferencing. Topics include informed decision-making, ethical dilemmas, care management, and cultural diversity. Both organizations offer continuing education resources for recertification requirements and to stay current in the field.

Find employment

Once nurse advocates obtain their RN license and receive training, employment options include hospitals, long-term care facilities, and outpatient clinics, along with rehabilitation centers, correctional institutions, and palliative care. Nurse advocates also become independent RN patient advocates and start their own private practices.
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Nurse Advocate Schooling

The time needed to complete the education required to be a nurse advocate varies depending on several factors: whether you pursue an ADN or a BSN, whether you complete post-graduate training or certification, and your previous educational background and work experience.

This section discusses typical requirements, topics covered, and completion times.

BSN Degree

Nurse advocates need an undergraduate nursing degree — either an ADN or a BSN — to register for the NCLEX-RN exam and apply for RN licensure. Students who want to continue their education and earn a graduate nursing degree should opt for a BSN.

  • Admission Requirements: High school diploma or GED certificate; SAT or ACT scores; and transcripts showing 2.5-3.0 GPAs and coursework in anatomy, chemistry, microbiology, and physiology.
  • Program Curriculum: Instruction takes place in the classroom and through clinical rotations. Topics include community health, leadership, nursing informatics, research, and statistics, along with anatomy, pathophysiology, pharmacology, psychology, and upper-division nursing specialization areas.
  • Time to Complete: Completion of a BSN typically takes four years, but for licensed RNs or ADN-holders, the time to a BSN can be closer to two years through bridge programs and application of transfer credits.
  • Skills Learned: Through their classroom work and clinical experiences, students learn to be critical thinkers and decision-makers, and they hone skills in assessing and diagnosing patients, administering medications, and formulating treatment and intervention plans.

Post-College Training

Nurse advocacy post-college training can fill in any gaps that standard, non-specialized nursing programs might leave out. This section details the typical requirements and timelines of programs like RN Patient Advocates.

  • Admission Requirements: Applicants submit a registration form, complete a questionnaire about their experience and interests, and participate in a telephone interview. Prerequisites include five or more years of clinical RN work and familiarity with internet data mining and research.
  • Program Curriculum: Topics include an introduction to the medical timeline, which takes a forensic approach to medical records analysis and areas of investigation development; motivational interviewing techniques; and understanding integrative and functional medicine.
  • Time to Complete: The RN Patient Advocate program encompasses seven months of online learning and a seven-day residential immersion program at a ranch near Tucson, Arizona. Most nurse advocate training programs span 7-9 months.
  • Skills Learned: Students explore implementing a nurse advocate patient care delivery model, integrating different systems of care, and helping patients attain optimal health and wellness. They also learn how to launch an independent RN patient advocacy practice.

Nurse Advocate Certification

Optional nurse advocate certification can open doors to increased job opportunities, career advancement, and higher pay. Nurse advocates can become certified through examination or additional training and maintain their credentials with continuing education. Two examples of certifying organizations are highlighted below.

Certifications: Board Certified Patient Advocate

  • What is a certification? This credential fosters quality and safety of care and ethical conduct of practitioners.
  • Are they required? Certification is optional but recommended.
  • Who provides certification? The Patient Advocate Certification Board endorses certification by examination.
  • How do professionals maintain certification? Board Certified Patient Advocates (BCPA) certification renews every three years and requires 30 units of continuing education or exam retake.

Certifications: Healthcare Advocate

  • What is a certification? This credential provides assurance to consumers of nurse advocate qualifications and training.
  • Are they required? Credentialing is optional but recommended.
  • Who provides certification? Healthcare Liaison, Inc. credentials nurse advocates after completion of a nine-month program in healthcare advocacy.
  • How do professionals maintain certification?Continuing nursing education through an accredited provider.

Working as a Nurse Advocate

Nurse advocates have a variety of options when looking for employment, including positions in patient care coordination, discharge planning, risk management, and legal advocacy. According to Payscale data from November 2021, nurse advocates earn an average annual salary of $72,240.

Three of the most common workplaces are hospitals, long-term care facilities, and outpatient clinics.


Liaise between patients, physicians, and families; educate patients about their conditions and treatments; assist patients with understanding their medical bills and insurance coverage

Long-term care facility

Advocate for patients with a terminal illness; assist patients with end-of life-decisions; help patients navigate healthcare options

Outpatient clinic

Explain patients’ rights; educate patients about their conditions and care; represent patient interests to medical billers and insurance companies

Becoming a Nurse Advocate: FAQs

What does it mean to be a nurse advocate?

Nurse advocacy involves advancing patients’ interests in several areas, including their care and treatment, navigating the healthcare system, understanding their legal rights, and receiving fair and accurate treatment from medical billers and insurance providers. Nurse advocates educate, represent, and assist their patients with whatever help they need.

How do I become a nursing advocate?

A nurse advocate must hold an RN license and undergo nurse advocacy education. Educational options include earning an ADN or a BSN, followed by a nurse advocacy training program if needed. To obtain an RN license, an aspiring nurse advocate must take and pass the NCLEX-RN exam.

How can nurses advocate for their patients?

Patients often struggle to understand the U.S. healthcare system, along with billing and insurance practices. Nurse advocates help them by acting as liaisons with healthcare staff and insurance providers. They educate and explain how things work, what their patients’ rights are, and what their treatment and care will entail.

What is an example of a nurse advocating for a client?

Here is an example of how a nurse can be a patient advocate: A patient needs surgery, but the insurance provider refuses to cover it. The nurse advocate assembles the patient’s medical records and doctor’s orders, contacts the insurance company and provides the necessary documentation to advocate for coverage.

Learn More About Nurse Advocates

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