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Ep002: Advocating for Your Patient – What Does it Mean?

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Advocating – help the patient and their support system understand the clinical picture and identified treatment options, identify their wants/needs, support the patient, speak on their behalf if needed, and uphold and protect their rights

The foundation of being an advocate is checking your personal beliefs at the door to help the patient figure out what is best for them

Use resources to facilitate their decision-making process and decisions. Examples include:

  • Interpreter if not English-speaking
  • Case manager to facilitate identified agreed-upon discharge needs (hospice, SNF, nursing home, and so forth)

Educate staff as appropriate

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Podcast Transcription

Welcome to the unofficial NCLEX Prep Podcast by nrsng.com where our goal is to give you the tools and the confidence that you need to succeed in nursing school, on the NCLEX, and in your life as a nurse. To get the massive PDF guide that goes along with this podcast, head over to nrsng.com/nclexprep. That’s nrsng.com/nclexprep. Thank you so much for joining us today. We want you to succeed. We’re here to help you along in the process Now let’s roll into the show.

 

What’s up guys? Welcome to Episode 2, Advocating for Your Patient – What Does it Mean? We’re gong to go over exactly what advocacy is, patient advocacy. This is like one of those nursing school buzzwords. Be a patient advocate. Advocate for your patient. Really, what does that actually look like? Also, what does the NCLEX care about when talking about advocacy? Let me just give you a basic definition, broad picture. Advocacy is helping the patient and their support system understand the clinical picture and identified treatment options. Also help them identify their wants and needs. Support the patient and speak on their behalf if needed. Always uphold and protect their rights. This can look very different.

 

Sometimes you’re advocating for your patient to the physician. I feel like, as a nurse, that’s probably where I most frequently am advocating for me patient is to maybe the physician. This is something maybe the patient said, “Hey, I actually don’t want to have this surgery.” The patient doesn’t feel comfortable saying that to the physician. I will advocate for them to the physician to say, “Hey, this isn’t something they actually really want to do.”

 

Sometimes you’re advocating for the patient to their loved ones. A little bit of a touchy situation. Sometimes you find yourself there. That’s another way of advocating. Even just other members of the healthcare team. That’s what that can look like practically. In that role it’s kind of challenging. What’s a really important aspect of being an advocate, and actually just really being a nurse, is checking your personal beliefs at the door to help the patient figure out what’s best for them. Maybe I wouldn’t want that, but that’s what the patient wants. The patient wants this. This is what’s important to them and they want to make sure they have that.

 

I have a good example. I had a patient. Actually, you know what? It wasn’t my patient, but I observed and was interested in the situation. The patient was Muslim and so was his family, and very, very, educated. I think they were multiple physicians and everything. What was really important to the patient was longevity of life. Every day that they were alive was very important even if it was in suffering. That was really important to his belief system. To me as a nurse, seeing multiple codes, multiple tubes, drains, airways, that kind of stuff. The patient was clearly suffering a lot. For me, I personally would not have wanted that. It was really kind of hard to see that, not as a nurse but just observe that. Also, for me to observe the other nurses caring for this patient and the duress they were under. That’s what the patient wanted. They had it very clearly spelled out in a living will and documents. The family was very well aware of that. That was something that was very important to them.

 

This was something I didn’t really understand. I actually spoke with another case manager who was of the same faith. She helped me understand that and explained how that’s part of her faith and how, if she was in the same situation, she would want that. It really made me feel like, okay, this is what the patient wants. Even though it’s hard for me, I need to advocate for them. If that was my patient, knowing beyond a shadow of a doubt that that’s what they would want, it’s easier to do that I feel like. It’s always important to check your personal beliefs at the door and really advocate for the patient to what’s best for them. Not what’s easiest for me and not what’s in line for my belief system or what I want as a nurse, but what is important to that patient and their belief system and what is best for them.

 

Another way that I feel like nurses really step into this role is helping the patient and their loved ones understand the clinical picture and the treatment options. A lot of times what this looks like, a physician comes by. I work in neuro intensive care. Neurology is very complex. The physician can come by and say these really big neuro … “You have a subarachnoid hemorrhage with vaso spasms and intraventricular hemorrhage. You’re going to have an extraventricular drain and you’re going to be in the unit for a while. We’re going to be doing this and this and this.” To me that makes total sense, but to someone who doesn’t know medical anything, let alone complex neurology, that’s just … “What? I have no idea what you just said. I don’t know what any of that means.”

 

The physician will come by and say stuff. Some physicians are really great educators, but still it’s really hard to put that big clinical picture together, especially if you have multiple physicians onboard. They each come in and say their little piece. Then the patient and the family are left there to try to put it together. It’s still confusing. A lot of times the nurse is the one that they’re going to ask the questions to, the clarifying questions. “Hey, this doesn’t make sense to me. What did he mean when he said that? I don’t understand. I don’t know what this means.” You sit there and say, “What did you hear him say?” Or “What did you hear her say?” Help put the clinical picture together so they can make more informed decisions.

 

Advocacy is important to empower patients to make the best decisions possible for themselves. The only way you can do that is if you’re informed and you know what’s going on. Just because some one comes by and tells you, that doesn’t mean you really know what’s going on, especially to a point where you can make appropriate decisions. That’s a really important aspect of advocacy.

 

Another aspect is utilizing your resources. One of the big ones is if the patient’s primary language is not English, you’ve got to make sure you’ve got that interpreter there. Remember, family members don’t count. If possible, it’s really important to use a hospital medical interpreter. There are a lot of really complex medical terms that maybe family members don’t know. You could, heaven forbid, run into a situation where you’re saying something, but the family is not translating it appropriately because they don’t want the patient to hear that. That’s really important.

 

Another great resource is your case manager. Super awesome. And social work. If we’re looking at like some decision-making situations, palliative care is always really helpful. Case management can really help you facilitate. “Hey, this is what discharge may look like and where you could potentially be going and what it would look like.” Maybe it’s hospice. Maybe it’s skilled nursing. Maybe it’s a regular nursing home. They can really help say, “Hey. If you make this decision, this is what discharge would really look like.”

 

Maybe they know that their mom needs to go into hospice, but they’re hesitant to make that decision. They’re scared about what the death will look like and where it will be. We can have the case manager come in and say, “Hey, you know, there’s these few great options nearby. I can facilitate a tour where you can go walk through each of them and see where you’re most comfortable.” That’s really advocating for the patient and supporting them and providing the resources that the patient and the loved ones really need to make the decisions that they need to.

 

At the end of the day, you’ve got many members of the healthcare team coming in and out of their room. The physical therapist, occupational therapist, they all have this list of patients that they have to come see, including the physician. They come see them for the short period of time and then they leave. You are there all day. You are home base. You are their advocate, the one that says, “Hey, wait. This member of the healthcare team said this. This one said this. Let me put this picture together and let me clarify what didn’t make sense. Let me go speak to them if what they said today didn’t line up with what they said yesterday.”

 

You are home base for your patient. That is Advocacy 101.  Thank you for listening to Episode 2, Advocating for Your Patient – What Does it Mean?

 

This has been another episode of the unofficial NCLEX Prep Podcast by nrsng.com. To get the massive cheat sheet PDF guide that goes along with this podcast, head over to nrsng.com/nclexprep. That’s nrsng.com/nclexprep. Thank you so much for joining us today. Thank you for being part of the NRSNG family. We appreciate you guys. We love you guys. We’re here to hold your hand and help you reach that goal of becoming an RN. Our goal is to create a generation of nurses that is focused, that is dedicated, and that really understands what’s going on. Thank you for being here. Thank you for being a part of the NRSNG family. You guys know what time it is now. It’s time to go out and be your best self today. Happy nursing.

 

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