AAHFN Leadership Message

Abstract

With the ever changing, uncertain healthcare system, nurses must remain diligent as advocates for patients and families. Advocacy is not a new role in nursing. Since the early development of the nursing profession, Florence Nightingale incorporated the role of advocating for both patients and nurses. Throughout her career she advocated for optimal care and a safe work environment while confronted by multiple obstacles.1Selanders L. Crane P. The voice of Florence Nightingale on advocacy.Online J Issues Nurs. 2012; 17 (Accessed 11 December 2016): 1-10PubMed Google Scholar Understanding what advocacy is, the role in nursing and key strategies are critical to ensuring optimal patient outcomes. An “Advocate” is defined as one that pleads the cause of another or one that supports or promotes the interest of another.2Merriam-Webster.com. Merriam-Webster Collegiate Dictionary, n.d. Web. 11 Dec. 2016.Google Scholar The Code of Ethics set forth by the American Nurses Association (ANA) outlines the ethical obligations of all registered nurses regarding patient advocacy.3Winland-Brown J. Lachman V.D. O'Connor Swanson E. The new code of ethics for nurses with interpretive statements. 2015: Practical clinical application, Part I.MEDSURG Nurs. 2015; 24 (http://nursingworld.org/MainMenuCategories/EthicsStandards/CodeofEthicsforNurses/Code-of-Ethics-2015-Part-1.pdf, Accessed 11 December 2016): 268-271PubMed Google Scholar The Code of Ethics states, the nurse promotes, advocates for and protects the rights, health, and safety of the patient.3Winland-Brown J. Lachman V.D. O'Connor Swanson E. The new code of ethics for nurses with interpretive statements. 2015: Practical clinical application, Part I.MEDSURG Nurs. 2015; 24 (http://nursingworld.org/MainMenuCategories/EthicsStandards/CodeofEthicsforNurses/Code-of-Ethics-2015-Part-1.pdf, Accessed 11 December 2016): 268-271PubMed Google Scholar Patient advocacy is a key role within nursing and is an ethical obligation, which goes beyond the basic definition of advocate. Nurses are frequently in the forefront in matters of patient advocacy. There are several issues the nurse must advocate for which include, promoting access to quality evidence-based care for all patients, regardless of age, ethnicity, socioeconomic class or personal attributes. In addition, advocating for patient safety across the continuum is critical in the current fragmented healthcare system. Patients are often seen by multiple healthcare providers and through communication and coordination of care, nurses can facilitate patient safety. Nurses must also inform and educate patients and families regarding their diagnosis, care and treatment in a manner that is meaningful. Sharing of information allows the patient to make informed decisions regarding their care. Finally, advocacy is supporting patients and families in their care decisions. Patients maintain the right of self-determination and only they can say what is best for them. This requires the nurse to support patients in an objective manner. Support may be in the form of speaking on behalf of the patient and/or facilitating communication with other professions and the healthcare system. Barriers to patient advocacy may exist and can vary from individual to organizational, and beyond. There is no single solution to address patient barriers. However, nurses must seek to resolve the barriers when possible to promote optimal outcomes. Several strategies may be incorporated to facilitate patient advocacy as follows:1.Maintain a patient-centered focus2.Establish a therapeutic relationship with the patient and/or family3.Clearly identify and understand the issue4.Encourage patient self advocacy5.Foster interaction and collaboration with the patient, family and other team members6.Maintain effective communication7.Identify organizational leaders who can facilitate resolution8.Be familiar with the bureaucracy of the organization and/or healthcare system, and question ineffective policies4Choi P.P. Patient advocacy: the role of the nurse.RCNi Nurs Stand. 2015; 29: 52-58https://doi.org/10.7748/ns.29.41.52.e9772Crossref Scopus (24) Google Scholar9.Pursue professional development on patient advocacy10.Become actively involved in professional nursing organizations to advocate for patient care issues Nurses are in a key position to observe both the positives and negatives of the current healthcare system and recognize the shortcomings. As a patient advocate, nurses have the opportunity to make a significant difference in the lives of patients and their families every day. Similar to Nightingale, all nurses must uphold the idea that safe, quality, evidence-based patient care is a basic human right that all patients should receive. Dr. Marilyn Prasun is a Clinical Nurse Specialist, researcher and coordinator of the Heart Failure Disease Management program at Memorial Medical Center, Springfield, IL. Her primary responsibilities in the Heart Failure Disease Management program are to work with patients transitioning home following hospitalization and managing patients that require additional assistance to reduce heart failure hospitalization. She has worked with hospitalized cardiac patients as well as outpatients for the past 20+ years as an advanced practice nurse. She also is a Clinical Associate Professor at the University of Illinois Chicago, where she works with graduate students and collaborates on research initiatives. She is a charter member of the American Association of Heart Failure Nurses (AAHFN) where she is the immediate past president.