Case Study Or Share An Experience

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Patient advocacy in nursing is relatively new concept (1), yet its origins can be traced back to Florence Nightingale’s time (2). 
It is so important that it has been written into the moral codes of nursing schools (1, 3). 
Justice is one of the most basic human needs (4), and nurses, more than anyone else, are in direct contact with patients and their issues (5); thus, they are better equipped to offer justice for patients than anyone else (6). 
Nurses are the patient’s first advocate and the link between the patient and the health-care system (7). (8). 
One of the most crucial tasks of nurses is patient advocacy (9-12).

The patient or customer is weak and has suffered varied degrees of harm (13). 
As result, many opportunities for patient advocacy enforcement exist in nursing, transforming the nursing profession into the most dependable profession in terms of patient advocacy. 
The community’s trust and respect for nurses will grow as result of the nurses’ proper fulfillment of this duty (7). 
Even when they have successfully completed their duty, they may face issues such as dread, rage, frustration, pessimism, and sense of alienation from their peers (1, 9). 
Effective advocacy, on the other hand, increases the quality of patient care while also enriching the nursing profession. 
As result, failure to adequately play this function may detract from the richness of this profession (14) and lead to nurses quitting the field (15).

Defending the rights and property of others is what advocacy is all about (3). 
It has been defined in nursing as being patient advocate, defending the patient’s rights and universal rights, protecting the patient’s interests, contributing to decision-making and supporting the patient’s decisions (3, 11, 16), ethical-centered skills for the ‘professional self'(17), and ‘being voice for the vulnerable’ (3, 18). 
Informing and educating, valuing and respecting, physical, emotional, and financial assistance, safeguarding and representing the patient, and continuity of care are the elements of patient advocacy in Iranian nurses, according to Negarandeh et al (13). 
It is, however, impossible to provide single definition for the phrase (8, 11).

Today, patient advocacy encompasses broader range of activities. 
Ware et al., for example, believed that patient advocacy included just safeguarding patients against unethical and unlawful behaviors (12). 
Although supporting the patient is primary goal, Mahlin argued that this strategy cannot solve the bigger challenges of patient advocacy, and that the patient’s advocate should address the systemic problems of care and administrative institutions (19). 
Maryland and Gonzalez argued that nurses should support patients and their families in other social environments, such as economic, educational and research, healthcare delivery, and legislative environments, in terms of access to health care, cost control, and health care quality, in addition to hospitals (8). 
This category now includes the protection of patients in clinical trials (20), the support of organ donation volunteers, and the protection of patients’ fundamental rights and welfare (16).

In the nursing profession, patient advocacy is ideal (21). 
Many things influence it, including social relationships, human interactions (22), and moral anguish and its consequences. 
Many features of this notion, however, have yet to be identified (23). 
The failure to define and explain the notion of nursing advocacy has been the subject of numerous research, with mixed findings (8, 10). 
The nursing profession is hampered by these ambiguous conceptions of patient advocacy (21). 
Given nurses’ lack of awareness about patient advocacy in nursing and the ramifications of this lack of information, it is vital to train nurses in patient advocacy (9, 11).

Option #1 – Share a Related Experience

Ann and Michael have been married for 55 years. Ann is 80 years-old, and suffers from lung cancer and advanced Alzheimer’s disease. She currently resides in a nursing home, and often does not recognize Michael when he visits. Last night she was admitted to the hospital with difficulty breathing. Today, you are the nurse caring for Ann, and her physician is suggesting surgery to remove part of her lung to potentially slow the progression of her cancer. Michael is feeling unsure about this course of treatment, and asks for your advice and guidance.

How would you respond to Michael and serve as advocate for your patient?


Share with your classmates a time when you cared for a patient at the end of their life. This may be a time when you assisted the patient (or their support system) with decisions related to end of life care; or a time when you were present for the death of a patient.

What were your observations related to this experience? Do you believe it was a peaceful death? What went well? Can you think of anything that could have made the experience better for the patient and/or family?


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