It’s a no brainer.
Nurses are patient advocates.
It’s what we do.
We advocate for our patients
We help them advocate for themselves by helping them heal physically, mentally, emotionally.
We assess what they know about their condition and we provide information and resources so they can make informed, intelligent decisions about their care.
It’s such a basic tenet of the nursing profession, one would believe it unassailable.
Right?
Not always.
You see, advocacy is fine when it means protecting patients from medical errors or protecting their privacy.
No one has a problem with that.
Not physicians. Not hospital administrators. Not hospital corporations.
But patient advocacy also means assessing the level of the patient’s knowledge of their condition (including any tests or procedures they are undergoing) and assessing if there are any questions or concerns.
If there is a knowledge deficit, or in plain English, if there are gaps in their knowledge and they want more information or have questions, the registered nurse is obligated to provide the patient with access to that information prior to the test/procedure.
Whatever form this takes, whether answering the questions directly, providing literature, arranging a referral to case management or social services, or withholding the signing of the consent form until full information is provided to the patient by the physician, the nurse is obligated as the patient advocate to act.
Now here’s where it can get a bit dicey.
You see, information is power. An informed patient is an empowered patient, able to make informed decisions in their best interests.
When a patient has not been fully informed of their options, becomes informed and then makes a change regarding treatment, it changes the balance of power in the medical relationship.
And there are some who do not take kindly to an empowered, informed patient.
Physicians. Hospital administrators. Hospital corporations.
It’s rare, but it happens.
What happens is a backlash against the nurse for acting as a patient advocate. Within the scope of practice. Within hospital policy.
As nurses, we cannot lose sight of the fact that patient advocacy is our duty, no matter how difficult it becomes.
Not only is it our duty, but it is our right to practice in our role as patient advocate without fear of professional reprisal or abuse from physicians, administrators or corporations.
It’s not just about us.
It’s about the patients.
It’s a no brainer.
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For a look a the case of a nurse fired for exactly the situation described above, check out Arizona Nurse Has License Threatened by Doctor After Providing Patient Education at The Nerdy Nurse, and Fellow Nurse In Jeopardy – Call to Action at iCoachNurses.
Great to see the support for our patients, and our fellow nurse advocates. Collaboration must begin in our training (docs and nurses), and then implemented into our practices. The balance of power should always shift to the patient, they are at the top of the hierarchy, and ultimately make the final decision.
#NurseUp
Kevin
http://innovativenurse.com
This article perfectly summarized the commitment nurses have to patients. There are several stumbling blocks which may continue to stand in our way, but we must continue to do what’s right for the sake of patient safety. Nurses must ocntinue to make sure patients have correct information which helps them make informed decisions regarding their health. This is why nurses must continue to enhance their bedside manner and cnotinue to let the caring hearts guide them to make decisions which have an overall impact on the patient.
“You see, information is power. An informed patient is an empowered patient, able to make informed decisions in their best interests.”
Agree. The information that Amanda Trujillo had given to her patient is a kind of power that gives her patient the freedom to choose. Yet, this freedom of the patient consequently may hinder the freedom of Nurse Amanda to practice her career. Indeed, Ms Trujillo is courageous enough to face this consequence, and every nurses must be like this. Fighting for patient advocacy is always worth it, eh.
Thanks for sharing,
Peny@Nurse Up for Nurse Amanda!
Does this ever hit the spot. I started nursing in the 70′s. The doctor patient relation ship was the doctor didn’t explain much to the patient because it just wasn’t necessary. As long as the doctor knew what was going on, he was doing his job. I got so sick and tired prompting the patients to ask certain questions when their doctor did his rounds. So, I started rounding with the doctor and when he was with his patient I would end up saying ” so and so asked me about whatever.” ( The patients usually wouldn’t ask the questions I told them to ask. They just froze up.) I kept up with lab results, progress notes, and studied the side effects of any meds I had to give. I would teach the patients about their meds and what side effects might occur and ask them on future rounds how the meds were working. I never gave a med that I had not looked up and studied about.
Gosh, I wonder what they are going to do about all of those nursing textbooks that teach nurses that their roles and functions include patient/client educator and advocate? Hmmm? Oh, and what about the fact that KNOWLEDGE DEFICIT is a NURSING DIAGNOSIS according to NANDA? AND nurses write care plans that address the nursing diagnoses with interventions that are NURSING FUNCTIONS. (In this case, the diagnosis was knowledge deficit, and the intervention was education.) It is hard to believe that a nurse can not only be fired but also INVESTIGATED for doing what all nurses are taught are their RESPONSIBILITIES!! It would be different if she made a medical diagnosis and tried to order a medication for the patient, but she did NOT do that. NOTHING she did overstepped her scope of practice. She made a nursing diagnosis of knowledge deficit and did exactly what a nurse is supposed to do: assessed the patient, made a nursing diagnosis based on that assessment, and performed the interventions appropriate for that diagnosis. Once the patient had been given some education, the patient asked for MORE EDUCATION in the form of a hospice consult. (No one ever said she ordered hospice CARE for the patient. She merely ordered a Hospice CONSULT, which is EDUCATION and evaluation. It does NOT mean that she ordered the patient to suddenly become a hospice patient. That WOULD be out of her scope of practice.) An order like this is an order to have someone else with expertise in a particular area come in and further assess and teach the patient. I think the public does not understand that she was doing her job exactly as all nurses are taught to do their jobs. I’m sorry, but getting fired for doing your job is ludicrous, and it is beyond scary that the Arizona BON is actually investigating this at all.