Nurses as Patient Advocates Most

Nurses as Patient Advocates

Most people even in the medical industry think of nurses as individuals who provide direct medical care to patients, within the guidelines of their own profession as well as the orders of the physicians managing care. Yet, there is a great deal more to the profession than the simple provision of direct medical care. The nurse has a distinct advantage, over many other health care professionals in that they often spend the most time with patients. In this role they interact on a clinical as well as social level with the patient and in almost every setting learn things about the patient that others providing care may never know. It is for this reason that nurses are the most logical persons to act as advocates for patients. As an advocate for a patient a nurse might be able to influence care to better meet the holistic needs of patients. This work will address the history of the call for nurses to fill the role of patient advocate and will then explore a particular situation where the concepts are being employed, in this case with epilepsy patients.

Nurses have been called to act as patient advocates as an ideal to patient care needs. Meeting the holistic needs of patients is an outgrowth of the needs of nurses to gain more professional autonomy so as to better use their distinct role, noted above, combining medical and ethical concerns, to better serve the patient and their health and wellness goals. (Bernall, 1992, 18)

Since the 1970s an extensive discussion in nursing literature has been devoted to the suggestion that nurses be "patient advocates" whose primary responsibility is to protect patient rights and interests in the health care setting... those espousing patient advocacy argue that unless nurses achieve greater professional autonomy, patients' rights will not be fully protected in hospital settings. (Bernall, 1992, p.18)

Patients often confide information through natural dialogue with nurses, expressing their understanding of their own health, their concerns about after care and also personal needs they feel are or are not being met by other members of the health care team.

The greatest need for a patient advocate is especially high in circumstances where temporary or chronic psychological diseases or processes reduce the individual's ability to self-advocate. In circumstances of hospital care this would be any time a patient undergoes procedures or treatments that temporarily reduce their ability to speak for themselves. This can be anything from surgical anesthetic, to post care pain medication treatment. At this stage the nurse serves an important role as the advocate of the patient as they not only understand the medical aspects of the circumstances but may be privileged to information, from the patient about their own needs, concerns and wants. This position as advocate may put the nurse into circumstances of conflict with other care providers but the role of the nurse is to advocate for the needs of the client. The American Nursing Association guidelines reflect this belief.

In the role of client advocate, the nurse must be alert to and take appropriate action regarding any instances of incompetent, unethical, or illegal practice(s) by any member of the health care team or the health care system itself, or any action on the part of others that is prejudicial to the client's best interests."[4] (Bernall, 1992, p. 19)

Though historically this role could have strained the nurses professional relationships with other health care professionals, and especially doctors the modern medical industry has afforded a new way of understanding the role, including an emphasis of such a nursing role in medical school. (Bernall 1992, p. 22)

As this belief has proven to be a long-standing one, it is therefore important to explore a greater understanding of the application of its use in patient care. The particular example of the mentally handicapped / epileptic patient is important as the complicated nature of these possibly debilitating diseases often leaves patients feeling helpless to contribute to their own general health and wellness. In one study the application of a nurse, for the specific role of advocacy was used to study it effects of the patients health and wellness outcomes.

A nurse functioning as patient advocate for 21 epileptic mentally handicapped persons was able to win revised drug therapy for 19, while maintaining or enhancing their quality of life. Nurses are skilled, knowledgeable healthcare professionals whose advocacy is likely to have an impact upon neurologists. They should use that influence to increase their patients' quality of life. (Baribeault, 1996, p. 359)

With the holistic needs of the patient as well as the information given to the nurse, by the patient the nurses in this study were able to have profound effects over the well being of the majority of patients they served, resulting in an very effective example of the ways in which a nurse can advocate for a patient, even in a community setting.