How Do You Define ‘Patient Advocacy?’

Patient advocacy has been an essential part of nursing since Florence Nightingale’s work during the Crimean War, though she never used the term itself. Even so, her activism for healthcare reform and efforts in making conditions in British military hospitals better for soldiers resulted in a model of advocacy that has been used in nursing ever since.

Depending on where you look, the definition of “advocacy” can vary. In the dictionary, advocacy is defined as the act or process of supporting a cause or proposal: the act or process of advocating. In its Code of Ethics with Interpretive Statements (Provision 3), the American Nurses Association (ANA) offers its own definition of nurse advocacy, stating, “The nurse promotes, advocates for, and protects the rights, health, and safety of the patient.”

In an attempt to provide a comprehensive and clear definition of patient advocacy as a concept, a group of researchers, in their study, “Patient advocacy in nursing: A concept analysis,” reviewed 46 articles and two books published between 1850 and 2016 related to patient advocacy. The researchers used Rodgers’ evolutionary concept analysis that is an “inductive method in which the development of a concept is examined over time.”

Because the definition has developed over time, the researchers used this approach in their study.

Identified Attributes of Patient Advocacy in Nursing

Five major attributes were identified by the researchers:

  • Safeguarding
  • Apprising
  • Valuing
  • Mediating
  • Championing social justice in the provision of health care

The evolution of these five attributes indicated that, until the year 2000, they included the act of nurses tracking medical errors, maintaining patient individualization and humanity, promoting patient self-control, being the patient’s voice, enabling patients to make decisions freely, suggesting alternatives to health care, and protecting patients from incompetency or misconduct of workers or members of the healthcare team.

From 2001 until 2016, additional attributes of nurses were added to the definition of patient advocacy. They were maintaining patient privacy, confronting inappropriate rules or policies in the healthcare system, and identifying and correcting inequalities in the delivery of health services.

Patient advocacy does not happen in a vacuum. It is a dynamic concept.

Thus, the researchers identified precursors that helped support its development and very existence.

The review of articles and books revealed individual and work-related qualities that nurses contributed to patient advocacy, including professional knowledge and skills, independence, work motivation, and the ability to interact with patients and other healthcare team members.

The Outcomes of Advocacy

The study clearly indicated that advocacy has effects on both patients and nurses alike. Patients were able to develop a sense of self-determination and empowerment and were the benefactors of improved patient safety and quality of care, to name just a few.

For nurses, the results include experiencing a sense of feeling worthwhile, enhancement of their public image/reputation, and job satisfaction.

Nurses did experience some negative outcomes, however. Identified negative results included moral distress or dilemmas, being labeled as troublemakers, and feelings of isolation and frustration.

Implications for You

This study is a very interesting one. I suggest all nurses read the entire report to get an in-depth …read more

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