Nursing Advocacy in Procedural Pain Care

Abstract

In nursing, the concept of advocacy is often understood in terms of reactive or proactive action aimed at protecting patients' legal or moral rights. However, advocacy activities have not often been researched in the context of everyday clinical nursing practice, at least from patients' point of view. This study investigated the implementation of nursing advocacy in the context of procedural pain care from the perspectives of both patients and nurses. The cross-sectional study was conducted on a cluster sample of surgical otolaryngology patients (n = 405) and nurses (n = 118) from 12 hospital units in Finland. The data were obtained using an instrument specially designed for this purpose, and analysed statistically by descriptive and non-parametric methods. According to the results, patients and nurses have slightly different views about which dimensions of advocacy are implemented in procedural pain care. It seems that advocacy acts are chosen and implemented rather haphazardly, depending partly on how active patients are in expressing their wishes and interests and partly on nurses' empowerment.

Nursing Actions in practicing inpatient advocacy in a Burn Unit

“…Similarly, studies in different contexts and clinical situations have shown that patient advocacy can be considered a moral commitment of nurses, aimed especially at counseling patients about their rights and helping them in the decision-making process and ensuring the exercise of their autonomy (7)(8)(9)(10)14,17) .…”

“…Despite evidence indicating the need to pursue it as a career goal in nursing, there still is not a defined concept for patient advocacy. In 1973, international nursing practice codes included patient advocacy as an ethical and legal role for nurses and since then several studies have pointed to actions and features that are intended to assist and expand the exercise of patient advocacy in nursing practice (7)(8)(9)(10)(11)(12) .…”

“…Thus, several investigations have shown that the actions of nurses as patient advocates are intended to help them in obtaining appropriate health care; defending their rights, ensuring the quality of care; and serving as a link between the patient and the health care environment (7)(8)(9)(10)(11)(12)(13)(14) . However, it is emphasized that in order to define and describe the actions of nurses in patient advocacy, it is necessary to consider that such actions are not static and fixed, but influenced by particular characteristics of individuals, organizations, relationships, medical conditions and environments (15) .…”

Moral distress: challenges for an autonomous nursing professional practice

“…Advocacy seems to have a close relation with power, and it can be seen as a motivational construct for nursing, enabling the facing of the physical and social demands of the health environments (17) .…”

“…It can no longer be neglected the fact that the classroom is still the most radical environment to start the process of resistance of the nursing professionals, so that they become more critical, reflective and, mainly, with actively reverberating voices in society (17) .…”