As highly respected healthcare professionals who often go above and beyond the call of duty, we nurses are natural patient advocates. Advocacy is in our nursing DNA. The nursing process may begin with an assessment, but where the rubber hits the road is when nurses go to bat for their patients to ensure they receive the best possible care when they need it most.
Protecting the Vulnerable
What does patient advocacy mean? Our patients may be defenseless children, impoverished single mothers, or chronically mentally ill adults. From neglected seniors to isolated combat veterans with PTSD, patients often need nurses to be their voice and speak up when they see injustice, unfairness, and poor care.
Patients are vulnerable. They may be diagnosed with life-threatening illnesses, weak from post-anesthesia recovery and pain, faced with homelessness and hunger, or be victims of violence, trafficking, or exploitation. Patient vulnerability comes in many flavors, and all deserve nurse advocacy.
When a physician and a crowd of medical residents stand over a patient’s bed, speak in medical jargon, and act as if the patient isn’t a real live human being, the patient can feel alone and confused.
A homeless schizophrenic patient enters the clinic, and everyone rolls their eyes and complains about the smell and the loud, irrational behavior. One nurse can defend that patient’s right to receive dignified, respectful care.
A fearful young woman who doesn’t speak English is admitted to the emergency department after a brutal attack. The nurse can advocate that an examination must be immediately performed by a Sexual Assault Nurse Examiner (SANE) in order to collect crucial evidence. We may also need to build a case if human trafficking is suspected; thus, a sensitive yet probing interview is high on the priority list.
When it comes to vulnerable patients, the nurse dedicated to being a powerful patient advocate can make a difference.
In Our DNA
When we say that patient advocacy is in our DNA, we mean it. Nurses spend more time at the bedside than doctors, surgeons, and pretty much any other clinical healthcare team member, which means we get to know our patients and their families more intimately than anyone else. We know their fears, triumphs, concerns, histories, and vulnerabilities. We see them for who they are: as holistic beings with multifaceted lives.
Advocacy is in our DNA because we are charged with their care on every level — physical, emotional, spiritual, psychological — and that means our responsibilities run wide and deep. Being fierce patient advocates is instilled in our nursing brains from the moment we begin nursing school, and the patient remains the center of our world throughout our career at the bedside. Advocacy is in our blood, our bones, and our very nursing DNA, and we can’t help but do it: it’s who we are.
The Patient Matters
Healthcare is all about the patient, and if nurses weren’t there like fierce tigers ready to fight for patients’ best interests, who would be there to do so? The patient’s feelings matter. The patient’s experience matters. The patient’s opinions matter. The patient’s choices matter.
It can sometimes seem like the healthcare system doesn’t care about patients’ choices, feelings, experiences, or opinions at all. It can seem like the system does what it wants to, and patients are just inconvenient obstacles that pay the bills.
Some nurses’ job descriptions officially include advocacy as part of their responsibilities, but often, the nurse will write advocacy into their job description because it simply must happen during every shift.
We may think of the nurse’s natural habitat as the emergency department, the operating room, the school office, or the community health center. Wherever they work, the nurse’s natural aim is to be like a lion or lioness, ready to pounce at a moment’s notice with claws and teeth out.
That condescending medical intern who talks to a grown male patient as if he’s a child? The nurse bully who sabotages other nurses’ patient care just to feel powerful? The surgeon who yells at a patient who doesn’t understand her condition? They’re all at risk of being on the receiving end of the nurse advocate’s fangs as they spring from the grass and go for the jugular.
“Don’t you even think about talking to my patient and his family like that.”
“My patient says his pain is 9 out of 10, and I believe him.”
“Would you want your mother treated the way you’re treating my patient right now?”
“What do you mean, my patient has to be discharged? He’s post-op, has no family or friends, and lives alone in a third-floor walk-up. He’s being discharged over my dead body. Find him a rehab placement, and he stays here in this bed until you do.”
The nurse may also advocate in the state house or Congress, talking with legislators and trying to create change. It’s all about the patients and the quality of care they receive. Whether the conversation is about safe staffing or access to health insurance, it still boils down to the same basic aim.
The Nurse Advocate Never Rests
The nurse advocate can truly never rest. There’s always another patient, another situation, and something new to champion. Healthcare is constantly evolving, and nurses need to develop their advocacy in response to the times.
Patients may not truly understand how nurses advocate for them, but it doesn’t matter to most nurses. If patients receive high-quality care with their dignity, rights, and best interests intact, then we nurses can rest assured that one of our deepest, most crucial missions has been accomplished.
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