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Phoenix Forward magazine

How nurses can advocate for their patients

Nursing advocacy

“Advocating for patients is within [nursing’s] mission,” according to Susan Perkins, MSN, a nurse practice consultant who teaches in the nursing program at the University of Phoenix® Main Campus. She stresses that nurses should ask patients open questions to help determine their specific needs, and then go to bat for them when necessary.

But sometimes, circumstances can make patient advocacy difficult, says Lorie Brown, JD, a registered nurse and practicing attorney specializing in health care law, who also holds a Master of Nursing degree.

Whether it’s because a patient can’t afford a recommended treatment or it’s the result of hospital policy, nurses can find themselves caught between their patients’ needs and employers’ demands. The key to bridging these gaps, Brown emphasizes, lies in their approach.

“To truly advocate for their patients, nurses must always present their case in a positive way,” Brown explains, noting that she teaches seminars on how nurses can develop this skill.

“[Many] nurses are reactive, responding to challenges in a negative way by complaining instead of offering solutions. That almost never does any good,” Brown stresses. “But if you approach these challenges in a manner that shows how you’re going to help the hospital [or doctor], as well as the patient, you’ll often have more success.”

Brown, who’s based in Indianapolis and consults on cases all over the United States, offers an example from early in her own nursing career:

“We had a patient who was [going into cardiac arrest], and I asked our central supply department to send up some lifesaving equipment. They refused, saying it wasn’t their policy to deliver it — nurses had to go pick it up,” she explains. “So I had to … go retrieve it from another floor” and leave that patient and several others unattended.

To truly advocate for their patients, nurses must always present their case in a positive way.

“The next day, I was called into the unit manager’s office,” Brown continues. “I got written up for insisting that central supply bring the equipment,” she says. That experience inspired her to become a health care lawyer for nurses, and her legal training taught her a more constructive way to address such tricky situations.

“If I were faced with it now, I’d go to my unit manager and tell her, ‘Hey, we have a situation where nurses are leaving patients without care. Here’s a way for us to address this problem: Have a hospital volunteer be responsible for transporting equipment where it’s needed so nurses can focus on patient care.”

A proactive, detailed approach that offers potential solutions works in everyone’s favor, Brown points out. “Present it as a win-win and be creative — think outside the box,” she says.

Another example Brown shares comes from a nurse who attended one of her recent training seminars:

“This nurse had a patient who refused expensive, in-home physical therapy that the doctor wanted because her insurance would not cover it,” Brown explains. “This infuriated the doctor and his [physician assistant], but the nurse sat down with the patient and helped her come up with an outpatient solution that kept her safe and that [the patient] could afford.”

The physician complained to the nurse’s supervisor, but because the nurse had focused on helping to meet the patient’s needs instead of criticizing the physician’s approach, her boss backed her up. “This is an example of how nurses can approach these problems in a giving way,” Brown says, rather than a confrontational one.

Both she and Perkins acknowledge that some situations can require nurses to take drastic action.

“I believe there’s a professional obligation to report any conduct [by others] that may be harmful or dangerous to the patient,” Perkins maintains.

Brown goes a step further. “If an employer ever demands that you participate directly in unsafe or unethical practices, leave,” she advises. “Your nursing license is too important to put at risk that way — you can always get another job, but you can’t get another license.”