Patient Advocacy - an Important Part of the Daily Work of the Expert Nurse

By Segesten, Kerstin Rn, PhD | Scholarly Inquiry for Nursing Practice, January 1, 1993 | Go to article overview

Patient Advocacy - an Important Part of the Daily Work of the Expert Nurse


Segesten, Kerstin Rn, PhD, Scholarly Inquiry for Nursing Practice


Over the past two decades, patient advocacy has been recognized as a part of nursing. For the most part, the issue has been treated by means of theoretical reasoning and case studies. Narratives describing lived experiences of nursing by expert nurses from Sweden were analyzed in this study. The nurses were identified by their superiors as expert nurses, as having a special gift, a "green thumb" for nursing. One third of the narratives concerned patient advocacy situations. The analysis of the narratives showed that the patient advocacy situation is composed of the following elements: apowerless patient, aproblem concerning the patient's own will or what is good for him or her, and an adversary. Further, it includes a trigger situation, and a prompt decision and action by the nurse. The nurse acts out of conviction, accepts an additional work load, and takes the risk of being punished.

Patient advocacy has received international recognition over the past two decades. According to Clark (1982), patient advocacy means informing the patients about their rights in a particular situation, making sure they have all the information necessary to make informed decisions, supporting them in the decisions they make, and protecting and safeguarding their interests. Stated more simply, to be an advocate means to speak up for someone who is unable to speak for him or herself. In the Concise Oxford Dictionary, an advocate is defined as "one who intercedes or pleads the cause of another." Patient advocacy implies that this other, in some respect, is dependent on the health care system, that is, that he or she is a patient The dictionary definition was used in this paper.

The person in need of advocacy has been described as vulnerable (Copp, 1982), ill-treated (Bangs, 1986), powerless, helpless, and dependent (Ashby, 1987), threatened by the system (Sawyer, 1988), ignored, shunned, or abandoned (Selby, 1988), and unable to speak for him or herself (Sawyer, 1988). The connection between the need for advocacy and the Patients' Bills of Rights is focused on by some authors (Ashby, 1987; Musgrave, 1987). Others focus more directly on the patients' needs and their right to decide for themselves (Beaman, 1989; Copp, 1986; Schaefer, 1989). Patient advocacy on the political level is also mentioned (Clarke, 1989). In this respect, the concept of advocacy is related to the concepts of powerlessness and empowerment.

Hokanson Hawks (1991, p. 760) defines power as "the actual or potential ability or capacity to achieve objectives...." The author also identifies antecedents to power. Power skills such as communication skills, knowledge, and concern are mentioned, and so are power sources such as informational, referent, and expert or legitimate ones. Powerlessness is identified as a harmful state for the person to be in. Empowerment is defined by Gibson (1991, p. 359) as "a social process of recognizing, promoting, and enhancing people's abilities to meet their own needs, solve their own problems... ." One aspect of the empowerment process, according to Gibson, is to act as a patient advocate.

Patient advocacy has been viewed by some authors (Nelson, 1988; Schaefer, 1989; Selby, 1988) as a fundamental duty of nurses and an integral part of nursing. Others have discussed advocacy as an extended role of the nurse, a role to be considered and included in the nursing care arena (Christy, 1973; Jenny 1979; Kosik, 1972; Sawyer, 1988). In a Canadian survey of nurses, 95% stated that nurses should act as patient advocates. The most frequently mentioned rationale was that good nursing care was not possible without such advocacy (Romaniuk, 1990).

It has also been argued that patient advocacy should not be the duty of the nurse. Three main reasons have been stated: 1) Nurses are in a dependent position in relation to the physicians and to their employers, who expect obedience and loyalty from them (Nelson, 1988). It could be difficult for them to disobey orders given by their superiors. …

The rest of this article is only available to active members of Questia

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Patient Advocacy - an Important Part of the Daily Work of the Expert Nurse
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Author Advanced search

    Oops!

    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.