Which Of The Following Is A Component Of Patient Advocacy - T-Tees - Your Answers Await, Life's Questions Unraveled

2. BACKGROUND

Advocacy is a concept that has been widely acknowledged in other professions besides nursing. For instance, the law firm describes advocacy as pleading the cause of a client in the court of justice, while supporting and protecting the interest and rights of individuals in constituency meant advocacy in politics (Graham, 2012). According to Graham (2012), advocacy in nursing in the clinical setting is unique from all other careers in that it strives on a giving off of one’s self (the nurse) to an individual (the patient). Patient advocacy in clinical setting focuses on health conditions, healthcare resources, patient needs and that of the public as well.

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However, the exact interpretation of what nurses perceive as advocacy differs in the literature. Abbaszadeh, Borhani, and Motamed‐Jahromi (2013) described patient advocacy in the clinical setting as an action taken to attain goals on behalf of one’s self or others. On the other hand, Motamed‐Jahromi, Abbaszadeh, Borhani, and Zaher (2012) viewed the concept of advocacy as a philosophical principle in the nursing profession. Motamed‐Jahromi et al. (2012) also argued that the concept of advocacy is an embedded component of nursing practice. Hence, nurses are expected by their professional code of ethics to intercede on behalf of patients in situations of ethical dilemma in the clinical setting.

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Bu and Jezewski (2007) to clarify the concepts of advocacy in the clinical setting concluded on three core attributes. These attributes were safeguarding patient’s autonomy, acting on patients’ behalf and championing social justice in the provision of health care. These attributes support the fact that advocacy enhances patients’ safety and ensures quality of patient care (Kalaitzidis & Jewell, 2015). Historically, patient advocacy has been an ethical responsibility for nurses. Most nurses viewed their daily activities in the clinical setting and measures taken on behalf of a patient as being patient advocate. Choi (2015) revealed patient advocacy in terms of the nurse using his or her professional knowledge effectively to advocate for their patients, as well as challenging the traditional healthcare power structures. Other authors like Davoodvand, Abbaszadeh, and Ahmadi (2016) viewed patient advocacy from the perspective of empowering patients to advocate on their own behalf in the healthcare setting.

Thacker (2008) explored advocacy among nurses in end‐of‐life care and found communication to be a key support to nurses who advocate for patients. Davoodvand et al. (2016) commented that advocacy was more than providing good care. Rather, it included actions that enhanced patient safety and quality care. Hanks (2010) and Choi (2015) also identified unmet needs of vulnerable patients and the work environment as factors that could influence the nurse’s ability to advocate. These authors further warned that the advocacy roles of nurses in the clinical setting were often accompanied by risks, and the implications of such risks include frustrations, feelings of anger and job loss. Besides, Thacker (2008) asserted that successful advocacy resides in the nurse-patient relationship. Thacker (2008) therefore referred to patient advocacy in the clinical setting as providing safe care and improving quality of life for patients and their families. Patient advocacy has been described by Jackson et al. (2010) as “whistle blowing,” meaning the act of exposing institutions or practices deemed unethical or negligent.

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The need for nurses to advocate for patients cannot be over emphasized. Davoodvand et al. (2016) revealed that nurses are able to empower vulnerable patients, delivering them from discomforts, unnecessary treatment, as well as protecting them from actions of incompetent healthcare professionals through advocacy. Graham (2012) argued that even competent patients are also at risk of making wrong decisions due to insufficient information, making nursing advocacy very essential.

Many theorists in nursing tend to agree that patient advocacy by nurses is important and that all healthcare facilities must hold patient advocacy in high esteem (Curtin, 1979; Gadow, 1980; Peplau, 1992). Patients are usually vulnerable in the clinical setting due to either lack of education and severity of their illness or fear due to terminal conditions. Advocacy allows nurses to defend and promote patients’ rights and interest in such situations (Black, 2011; Graham, 2012). Further benefits of patient advocacy included empowerment of patients, positive health outcome (Bu & Jezewski, 2007), preservation and protection of patient’s rights and safety Davoodvand et al. (2016), changing inappropriate rules and enhancing the public image of the nursing profession (Motamed‐Jahromi et al., 2012).

Abbaszadeh et al. (2013) contend that the nurse is always placed in an exceptional position to advocate for the patient because of the strong nurse-patient relationship that exists in healthcare facilities. Abbaszadeh et al. (2013) further confirmed that nurses spend more working hours with patients which provide them the best opportunity to advocate for patients. According to Graham (2012), nurses have a long history of advocating for patients because of their concern about caring for the patient as a whole and not just their physical health condition. Nevertheless, critics are of the view that nurses should not be the ultimate patient advocate due to their conflicting loyalty to both the employer and the patient (Black, 2011). According to Black (2011), nurses may choose not to advocate if the advocacy process becomes very complex and also due to fear of losing their jobs.

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The limited research and documentation about how nurses define and practice patient advocacy in Ghanaian healthcare settings reveal a knowledge gap and pose a threat to patients’ safety and quality care. This study will create the awareness and increase the understanding of patient advocacy. It will also enhance improved advocacy strategies and optimal quality care in the Ghana Health Services. The research question for the study was “How do Registered Nurses describe patient advocacy in the clinical setting?”

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