01.05 Advocating For Your Patient

Hi guys. Today we’re going to talk about Advocating for your patient.

In this lesson, we will cover exactly what being a patient advocate is, what kind of skills you should have to be an effective patient advocate, and most importantly, how we can be a patient advocate. Let’s get started.

So what does it mean to be a patient advocate? It means you are supporting, protecting and speaking out for the rights and interests of your patients, particularly those who can’t fight or speak for themselves. As nurses, we have a commitment to empower and protect our patients and their families during our time caring for them. This means sometimes we have to make waves when it comes to doing the right thing.

So as we’re talking about doing the right thing for our patients, we should talk about how and why every nurse should be an advocate. There are times where difficult choices have to be made, and sometimes the information isn’t as understandable or free-flowing as it may need to be. Nurses as patient advocates are there to facilitate those tough discussions and the decision-making process. The reason we advocate is to enhance patient safety and care and to also promote patient rights. Evidence-based practice is the basis of facility policies and procedures. Through trial and error sometimes, we find that those practices aren’t always in the best interest of all patients and changes need to be made. Without recognizing the problem and pushing for changes to correct that problem, those policies stay unchanged. It’s the voices of patient advocates that often get those policy changes that are necessary to provide patients with optimal care.  

So what does it take to be an effective patient advocate? First, you need to have good problem-solving skills. What this means is you have the ability to identify an issue and develop a plan and strategy to correct that issue. Most people have this ability, but tend to rely on someone else to get the ball rolling. Understand that in advocacy, sometimes you have to step up and be the change agent. Advocates are good communicators as well. They adapt their methods of communication to their audience and know how to present the facts of the situation and address their goals clearly, while commanding the attention of that audience. Advocates have to be influential. Look at what they are trying to do! They radiate confidence and competence, and they are proven to be trustworthy, particularly when it comes to collaborating with others. In patient advocacy, there has to be compromise more often than not. We will not always get everything we want right away, but whatever positive steps we can make to support and protect our patients is always a win. This is also why patience is a necessary skill to have. Because of those compromises and negotiations, some ideas will take time to come to fruition and we need to be cognizant of that idea.

So now that we have all that down, let’s talk about what it means to be a nurse advocating for patients. You’ve all probably heard of the ANA’s Code of Ethics by this point, which is a guide for nurses to really provide care and maintain ethical standards. The ANA actually uses the terms protection, promotion and advocacy in their definition of nursing, so patient advocacy and everything that we’ve discussed up to this point is included in our scope of practice. The code of ethics is an extension of the nursing definition and gives us a closer look at our responsibilities in relation to it. Another extension of the ANA Code of Ethics is the Health Advocate Code. This code is a statement of ethics and expectations for best practice of patient advocates. There are several pieces of this code that match ANA and then there are others that add on to it. You can find both codes online for review and see how they compare with each other.

Nurses can be patient advocates in various forums, one of which being as committee members. Every facility has a choice of committees nurses can sit on to discuss policy and initiatives around the facility. These discussions can be related to adverse events, like quality assurance for medication errors or falls, or just bouncing ideas off one another to improve patient care and safety, like shortening time frames for answering call bells or restrictive measures. These committees are also used for resource development for staff. Maybe there’s an equipment upgrade we need to take a look at or maybe the staff requires professional development in the form of classes or organizational events. At my job, we have nursing expos to help nurses refresh their clinical skills, because maybe they don’t use them all the time, or maybe a committee recognizes it’s an area that needs improvement across the board. There will also be times that changes are made to facility protocols and policies dependent on the specific goals of the committee. Either way patient care and safety are always a collaborative effort, and they start with someone, hopefully you, recognizing a problem.

The other ways we can advocate as nurses is in the actual organization we work in. More often than not, this type of advocacy will come directly from the patient care area. Nurses spend the most time in a day with patients than anyone else and get to know certain aspects of those patients pretty well. We are the patient’s first line of defense, so it’s important to understand we should always be assessing our patients and anything concerning their care. This includes medications and treatments all the way up to and probably past diet. As a nurse caring for a patient, anything that is not normal, including patient complaints, should be reported using the chain of command. In some cases, this chain may require the physician to be the first point of contact. In others, it can be a supervisor or manager. For instance, a patient who has abnormal bleeding for an extended period of time and is being discharged despite abnormal labs or treatment that wasn’t performed, you may want to speak up to the physician about your concerns. Because advocating in this nature can sometimes become more passionate, it’s interchangeably used with fighting for the patient. This name change sometimes creates a reluctance for others to follow suit, because they can be labeled as problematic or aggressive, so there will be some who are afraid to speak up. New nurses, in particular tend to be less likely to speak up, because they are still learning and they’re new and fear being wrong so they often second guess what they see, and it is possible that there’s a knowledge deficit. Understaffing units can cause nurses to overlook something in their patients. Having lopsided assignments generates a different level of care where attention is not provided adequately enough to catch small issues all the time. These are all barriers that can potentially be detrimental to patients, staff and very possibly the facility if not rectified.

Let’s review some key points. The whole idea behind advocacy is that someone saw something that wasn’t right one day and fought to make sure that no one else endured that issue again. If you see something, say something! Communication is a must have skill when it comes to advocating! You are the patient’s first defense and will need to speak up especially when they can’t. Lastly, you can choose to be an advocate in many different arenas. If you want to see changes made throughout the organization, find the committee you are interested in and join up to work those policies and initiatives. If you are advocating for a specific patient, be sure to understand how to navigate through those barriers. It could mean the difference between a positive or negative experience for that patient.

That’s all for now! We love you guys! Go out and be your best self today! And as always, Happy Nursing!