Patient advocacy is a hallmark of a nurse’s responsibility as well as a central tenet of the profession itself.
In these days of high nurse-patient ratios, staffing challenges, and increased reliance on technology, the importance of patient advocacy can be lost in task-based nursing environments. Nonetheless, the centrality of patient advocacy remains.
21st century hospital nursing can seem like a race against the clock. A nurse may be caring for an inordinate number of patients, and there may be a significantly inadequate amount of nursing support.
In facilities where documentation is redundant and oppressively time-consuming, the ability of the nurse to serve as a patient advocate can be significantly curtailed. While technology may be promoted as a way to make nurses’ lives easier, bedside computer-based documentation can hinder actual nurse-patient interaction.
A harried and overworked nurse will focus on the most pressing tasks which would generally include scheduled meds and treatments, as well as treatments triggered by symptoms or complaints.
Task-based nursing is understandably often a necessary focus, yet it can be a hindrance to nursing care relying on communication and observation. The capacity of the nurse to have substantive conversations with patients can be curtailed by tasks that must be completed and documented. And in this form of interrupted nursing care, what is potentially missed?
Patient Advocacy and Nursing
The history of nurses’ patient advocacy harkens back to the days of Florence Nightingale and her bid for sanitation, fresh air, and other simple yet effective interventions that significantly decreased morbidity and mortality among the soldiers she and her colleagues cared for.
In the 21st century, patients need nurse advocacy related to health insurance woes and socioeconomics, complicated medication regimens, psychosocial complications, and illness and symptom management.
Since nurses generally spend more time with patients than any other medical professionals, the onus falls on nurses to ascertain the deeper struggles and concerns of patients and their families (Delucia et al. 2009).
When advocacy fails in the face of hospital bureaucracy, poor time management, or other factors, nurses have a responsibility to remedy the problem and reassert their place as primary advocates for vulnerable patients and populations.
Reasserting Nurse Advocacy
Nurses grappling with a lack of resources and time to advocate for patients have the choice of addressing or ignoring the problem. Doctors and other colleagues won’t do the work – this is a singular nursing problem calling for nurse-generated solutions.
If staffing issues and nurse-patient ratios are central issues, nurses must advocate for improved staffing practices. Nurses with fewer patients to care for will naturally have more time for the things that have been lost by default. Nurses who have personal struggles with time management can request assistance in improving their skills.
When burdensome documentation requirements interfere with actual patient care, nurses must again stand up and demand a solution.
Participating in committees and networking within the organisation are ways for nurses to gain power, influence, and the means to push for change. Nurses can also meet with colleagues at other facilities in order to learn how those individuals and institutions address similar issues.
In the end, if nurses feel that patient care and advocacy are impeded or made less effective for a specific reason, it is imperative to take the bull by the horns and work towards an acceptable resolution. And when a facility is completely entrenched and resistant to change, nurses have the prerogative to seek work in more progressive environments.
The need for patient advocacy on the part of nurses will not go away, even as nurses’ time for such is increasingly challenged. Thus nurses must push back against the tide that has chipped away at their ability to be fully present for patients. Nurses can advocate for themselves, for patients, and for the integrity, safety, and effectiveness of patient care.
- Delucia, PR, Ott, TE & Palmieri, PA 2009, ‘Performance in Nursing’, Reviews of Human Factors and Ergonomics, vol. 5, no. 1, viewed 24 August 2017, http://journals.sagepub.com/doi/abs/10.1518/155723409X448008