9. Individual and Interpersonal Advocacy

As discussed previously, the American Nurses Association (ANA) defines advocacy at the individual level as educating health care consumers so they can consider actions, interventions, or choices related to their own personal beliefs, attitudes, and knowledge to achieve the desired outcome. In this way, the health care consumer learns self-management and decision-making.^[1] Advocacy at the interpersonal level is defined as empowering health care consumers by providing emotional support, assistance in obtaining resources, and necessary help through interactions with families and significant others in their social support network.^[2]

What does advocacy look like in a nurse’s daily practice? The following are some examples provided by an oncology nurse^[3]:

• Ensure Safety. Ensure the client is safe when being treated in a health care facility and when they are discharged by communicating with case managers or social workers about the client’s need for home health or assistance after discharge so it is arranged before they go home.
• Give Clients a Voice. Give clients a voice when they are vulnerable by staying in the room with them while the doctor explains their diagnosis and treatment options to help them ask questions, get answers, and translate information from medical jargon.
• Educate. Educate clients on how to manage their current or chronic conditions to improve the quality of their everyday life. For example, clients undergoing chemotherapy can benefit from the nurse teaching them how to take their anti-nausea medication in a way that will be most effective for them and will allow them to feel better between treatments.
• Protect Patient Rights. Know clients’ wishes for their care. Advocacy may include therapeutically communicating a client’s wishes to an upset family member who disagrees with their choices. In this manner, the client’s rights are protected and a healing environment is established.
• Double-Check for Errors. Know that everyone makes mistakes. Nurses often identify, stop, and fix errors made by interprofessional team members. They flag conflicting orders from multiple providers and notice oversights. Nurses should read provider orders and carefully compare new orders to previous documentation. If an order is unclear or raises concerns, a nurse should discuss their concerns with another nurse, a charge nurse, a pharmacist, or the provider before implementing it to ensure patient safety.
• Connect Clients to Resources. Help clients find resources inside and outside the hospital to support their well-being. Know resources in your agency, such as case managers or social workers who can assist with financial concerns, advance directives, health insurance, or transportation concerns. Request assistance from agency chaplains to support spiritual concerns. Promote community resources, such as patient or caregiver support networks, Meals on Wheels, or other resources to meet their needs.

Nurses must recognize their unique position in client advocacy to empower individuals to provide them with the support and resources to make their best judgment. The intimate and continuous nature of the nurse-patient relationship places nurses in a prime position to identify and address the needs and concerns of their patients. This relationship is built on trust, empathy, and consistent interaction, which allows nurses to gain a deep understanding of their patients’ values, preferences, and personal circumstances. By leveraging this close proximity and strong rapport, nurses can effectively advocate for their patients, ensuring that their voices are heard, and their wishes are respected in all aspects of care.^[4]

The power of the nurse-patient relationship extends beyond the immediate clinical environment. Nurses often act as liaisons between patients and the broader health care team, facilitating communication and ensuring that patient preferences are integrated into care plans. This advocacy role is crucial in navigating complex health care systems where patients may feel overwhelmed or marginalized. Nurses can help demystify medical jargon, explain treatment options, and support patients in making informed decisions that align with their values and goals. Through education and emotional support, nurses empower patients to take an active role in their own care, enhancing patient autonomy and satisfaction.^[5]

In addition to direct patient care, nurses play a pivotal role in identifying systemic issues that affect patient outcomes. Their frontline perspective provides valuable insights into the barriers patients face in accessing quality care, such as socioeconomic challenges, cultural barriers, and institutional policies. By advocating for policy changes and improvements in health care delivery, nurses contribute to creating a more equitable and patient-centered health care system. Their advocacy efforts can lead to the implementation of practices and policies that better address the needs of diverse patient populations, ultimately improving health outcomes on a broader scale.^[6]

Nurses’ advocacy is also essential in situations where patients are unable to speak for themselves, such as in cases of severe illness, disability, or end-of-life care. In these instances, nurses must be vigilant in recognizing and addressing the needs of vulnerable patients, ensuring that their rights and dignity are upheld. This may involve working closely with families and caregivers, coordinating with interdisciplinary teams, and navigating ethical dilemmas to provide the best possible care for the patient.