Nursing Advocacy

Group 1 :

Muhammad Ilham Zul (1511314001)

Rozi Ardi Tamala (1511314002)
Annisa Mirda (1511314003)
Faradilla Lorenza (1511314004)
Cici Novelia Manurung (1511314005)
Dwi Yani Adinda (1511314006)
Nurfa Rahim Harningsih (1511314007)
Vionita Safitri (1511314008)
 Nursing Advocacy is...
The role of a nurse as a patient advocate is an important
one. Nurses provide 24-hour continuity of care and close
surveillance, and are regarded as gatekeepers for
patients. There is growing support for the idea that
advocacy is inherent to nursing (Vaartio et al 2006, Bu
and Jezewski 2007, Negarandeh et al 2008).
Nurses possess necessary technical knowledge and are
viewed as being in the best position to advocate for the
interests and wellbeing of patients and their families,
where appropriate systems are in place (Mallik 1997).
Common areas requiring patient advocacy :

End of life decisions.

Respect for patient dignity.
Cultural and ethnic diversity and sensitivity.
Provider-patient conflicts in regard to expectations and desired outcomes.
Withholding of information or lying to patients.
Healthcare reimbursement.
Insurance authorisation, denials and delays in coverage.
Patient information disclosure (privacy and confidentiality).
Medical errors.
Patient grievance and appeal processes.
Inadequate consent.
Incompetent healthcare providers.
Complex social problems such as teenage pregnancy and violence.
(Marquis and Huston 2012)
Case Study :
A 67 years old female is diagnosed with acute myeloid leukimia
(AML). Treatment program is standard chemotherapy and
hematopoietic stem cell transplantation. Patient and family
were explained about the program as well as risks of this
program including opportunity to reach treatment outcome
which is low.

Patient is predicted to reach low treatment goal in relation to

old age and the presence of comorbid conditions of diabetes
mellitus. Patient has medical insurance that covers all patient
needs. Patient is agree to treatment, but family disagree with
treatment program.

As a nurse, how do you advocate the patient and family ?

The process of advocacy may be considered in four
stages:
1) Assessing the need for patient advocacy
Engagement in patient advocacy commences
with an assessment of the need for advocacy or, more
specifically, with an assessment of the antecedents of
advocacy. The assessment should primarily focus on
the patient, situation, setting, available resources and
risks (Ellis and Hartley 2005).

2) Identifying the goals of patient advocacy

Following the assessment stage, the goals of
patient advocacy should be identified. Most goals in
patient advocacy are aimed at empowering patients in
decision making and ensuring that safe and quality care
is provided.
3) Planning and implementing advocacy actions
After identifying the goals of patient advocacy,
nurses make plans and adopt a variety of practices
to advocate for the rights, values, wellbeing and
best interests of patients. Nurses should present
themselves clearly as advocates, and not as
rescuers who disregard the rights and
responsibilities of patients in health care (Ellis and
Hartley 2005, Earp et al 2008).
4) Evaluating the outcomes of patient advocacy
The last step in the advocacy process is to
evaluate the outcomes of patient advocacy. The
participation of nurses in effecting changes in
healthcare policy may enhance the public image of
nurses, their satisfaction and autonomy (Spenceley
et al 2006, Bu and Jezewski 2007).
 Case analysis
A 67 years old female is diagnosed with acute myeloid leukimia (AML) and
diabetes mellitus.
Patient choose chemotherapy but family disagree
So we are nurse can give a information about chemotherapy , advantage
and disadvantage,
If the family diagree with therapi, you are nurse can give sugestion and
you can be mediator with the patient and family
And then you can tell their family , the first you must handle or solving is
myeloid leukimia (AML) , becouse aml can cause diabetes.
based on the role of advocate, the nurse can help patients through two
actions. namely the role of action and the role of non aksi.pada this case
action roles that nurses can do is help patients in communicate with
psychotherapy to chemotherapy. But role of non-action is a suggestion
and encouragement given to patients and families, in order to keep the
spirit and never desperate to be cured.
Thank you
 Reference
Vaartio Turun, Nursing Advocacy, Turki 2008