Ethical considerations in nursing form the basis upon which nursing practice is regulated. Furthermore, the lack of regulation for such a sensitive profession opens the floodgates of malpractice, that would otherwise hamper the sacred role of care provision that the nurses have been afforded. As such, the nursing profession is one guided by principles and core concepts which enable the protection of patient rights in the course of service and care provision. Furthermore, quality of care must be maintained in the course of service provision, ensuring that the patient can appreciate the kind of care that they receive. Some of the core concepts of nursing practice include quality of care, advocacy, confidentiality and respect (Scott & McSherry, 2009). From some of these concepts flow the myriads of theories regarding proper nursing practice. This paper focuses on advocacy as a core concept in the practice of nursing. Implications of this concept in many jurisdictions including the UK will be examined.
The concept of the nurse as a patient advocate comes about following the need for a liaison between the patient and the doctor. This role sits squarely in the authority of the nurse. The nurse is the person of first interaction with the patient, and is thus quite competent to know the patient needs. The role of the advocate is one of intercession and agency. This means that the nurse will often act on behalf of the patient and intercede on matters in which the patient is involved (University Alliance, 2015). In addition, liaisons between the family members and the patient are established on the bridge of the nurse because of the amount of physical, social and emotional interaction that the nurse has with the patient. As such, the nurse has to indulge themselves in the intimate knowledge concerning the patient in a bid to have a workable environment of representing the patients interests in many forums (University Alliance, 2015).
Traditional Advocacy Roles
Nurses act as advocates for many reasons, a key one which is meeting the patient needs and actualizing the goals of quality of care. Depending on the different social orientations of the patient, the nurse may have to know details concerning the patient in order to exact the best quality of care and advice the treating physician on these preferences. Different patients have different beliefs, customs and religions which must be respected even in the course of care, so long as they do not conflict with the best interests of the patient. Research points to the respecting of such social aspects of the patient as a catalyst to patient recuperation (Ross, 2006). The preferences of the patient are most probable to be made known to the nurse during frequent interactions with the nurse (Scott & McSherry, 2009). Therefore, in the course of care, the nurse is responsible for informing the physician of the specific preferences of the patient and thereby acts as the advocate for the patient. As such, potential conflicts between the doctor and patient are averted. Eventually, quality of care standards are achieved when other care practices are factored in.
The nurses role as an advocate further extends to the educational role that the nurse plays when interacting with the patient. As an advocate, the nurse also engages the patient on the differently available methods of treatment following an explanation of the condition which the patient is suffering from. Patient education is one of the key roles of the nurse. The provision of proper and correct information to the patient concerning their area of interest is an important area of the advocacy role of the nurse. Patient education is part of the larger role of mediating between the physician and the patient. The role of the nurse as an advocate is to ensure that the patient properly understands the implication of what the doctor has said. Furthermore, information on the nature of the treatment, available treatment methods, viable treatment methods for the patient based on the provided information among other factors make the nurse practitioner the best educator for the patient on treatment to recovery (Smith & Zsohar, 2013). Procedures that the patient may need to go through, moral support, available patient choices in the course of treatment and recovery among other patient options are revealed by the nurse in the course of care (Herbert, Moore, & Rooney, 2011).
The role of the nurse as the patient advocate further extends to express and enforce the rights of the patient in the course of treatment. The personal information that the nurse has concerning the intimate natures of the individual affords the nurse special positions of influence especially in the course of patient unconsciousness. Consider a patient who is going into surgery and has specific allergic reactions to specific drugs. If the doctor should administer this drug in the course of treatment, then the role of the nurse as an informant and advocate of the patient speaks out to warn the doctor concerning possible concerns that could arise from the pursuit of certain exercises. Furthermore, nurses undertake special privilege information such as the existence of pregnancies, health effects, and other special conditions that may require specialized care and attention from the physician in the course of treatment. These are some of the mainstream advocacy roles that the nurse has taken. However, in recent times, the role of advocacy has extended to other areas of concern for the patient in the course of care.
Modern Approaches of Advocacy
Modern practice in nursing advocacy has seen other aspects of the concept explored in the course of ensuring that patients get the best quality care. Calling of medical errors is one of the roles of nurses that have been brought to attention in recent times (Wood, 2010). The role of the nurse in ensuring quality of care and the best survival changes of the patient means that they look out for the interests of the patient above all others. This means that a direct disregard of nursing duties in directing the physician constitutes part of the job in ensuring that there is proper care offered to the patient. Modern approaches to nursing advocacy have lead to various ethical questions that have rocked the field of nursing. One such contestation is whether, in the divulgence of medical malpractice, the revelation of intimate details of patient treatment goes against the right to privacy of medical care that the patient has.
Furthermore, modern day nursing advocacy includes the ability of nurses to participate in policy making programs that ensure that the practice is strongly regulated. This means that the nurses needs are catered for in the case of conflict between the needs of the patient and that of the doctor. Consider the Nurses and Midwives (NMC) Code that is the hallmark of nursing advocacy participation in the UK. In this code of conduct, the safety of the public is put at the forefront of nursing advocacy roles, ensuring that nursing practice is regulated and well-guided. Professional responsibility is at the top of the nurses and midwives priorities in the UK in a bid to ensure that the public is safeguarded from possible wrongdoing from healthcare providers.
The application of NMC code is not just for the purpose of supervisory and curative purposes, but also for preventive measures. Untold mistakes have occurred following the improper application of medical practice (Goldsmith, 2011). As such, the code comes in as a guide to the advocacy roles, including access to patient information to the public, and a guide for the daily practice for the nurse, midwife and doctor. The NMC is thus a tool for proper application of nursing practice within the reasonable ethical boundaries that has been set by it. Furthermore, nursing leadership, education and research are governed by the guidelines in the code, ensuring that there is adequate coverage of all possible roles of the nurse practitioner, including the advocacy role.
Such measures are put in place in the course of nursing pract6ice to ensure that situation similar to that covered in the Francis report doesnt repeat itself. In a scandal that rocked the entire practice of nursing in the UK, the needless deaths of hundreds of patients between 2005 and 2008 was documented in the report (Triggle, 2013). This was following the neglect of patients and wrongful administration of treatment of a hospital-wide scale. The situation was so grievous that it brought to attention the serious implications of the failure of nursing advocacy roles in the medical field. The situation at the Midfordshire Hospital reveals the evils that happen when the nurses fail in the advocacy roles and the possible implications to the public upon uncovering such events. The role of the nurse practitioner as an advocate was thus underlined as the report was released in 2013. Among other resolutions, nursing roles as advocates was put on the spotlight in a bid to avert possible healthcare disasters that occur when their role is neglected.
In conclusion, the United Kingdom as a respectable leader in healthcare has acknowledged the place of advocacy in the course of provision of care by nurses. The Francis report underscores the need for proper advocacy of patient rights in the course of treatment for the aversion of social and criminal wrongs, and for the improvement of the quality of care standard. Furthermore, the Nursing and Midwives Code ensures that there is a guideline stating what constitutes professional conduct in the course of care. Among other things, the report ensures that the nurse is aware of their duty to the patient and public at large above selfish interests. This saw why the lead nurse was fired in the Francis report row. As scuh, the importance of both traditional and modern methods of nursing advocacy cannot be understated. It is a necessary part of the nurse practice.
Goldsmith, J. (2011). The NMC code: conduct, performance and ethics. Nursing Times.
Herbert, K., Moore, H., & Rooney, J. (2011). The Nurse Advocate in End-of-Life Care. The Oschner Journal, 325-29.
Ross, L. (2006). Spiritual care in nursing: an overview of the research to date. Journal of Clinical Nursing, 852-62.
Scott, K., & McSherry, R. (2009). Evidence-based nursing: Clarifying the concepts for nurses in practice. Journal of Clinical Nursing, 1085-95.
Smith, J., & Zsohar, H. (2013). Patient-education tips for new nurses. Nursing, 1-3.
Triggle, N. (2013). No more covering up errors, NHS told. Retrieved February 26, 2016, from BBC UK: http://www.bbc.com/news/health-21922998.
University Alliance. (2015). Nurses Advocating for Patients. Retrieved February 26, 2016, from Jacksonville University: http://www.jacksonvilleu.com/resources/nursing/nurses-advocating-for-patients/#.VtAiuUDiXIU.
Wood, D. (2010). The Nurse's Role as Patient Advocate. Retrieved February 26, 2016, from Nursing News: http://www.nursezone.com/Nursing-News-Events/more-news/The-Nurses-Role-as-Patient-Advocate_33962.aspx.
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