Nursing advocacy: how is it defined by patients and nurses, what does it involve and how is it experienced?

THE STUDY'S RATIONALE: Advocacy is an integral part of nursing. However, there is a scarcity of empirical evidence on nursing advocacy process and most of that evidence concerns nurses' views on the care of certain vulnerable patient groups in acute care settings. Before nursing practice can truly adopt advocacy as an inherent and natural part of nursing, a clearer understanding is needed of how it is defined and what activities are needed to accomplish advocacy.

The aim was to describe the way that nursing advocacy is defined, the activities through which nursing advocacy is accomplished and the way that nursing advocacy is experienced by patients and nurses.

Based on a qualitative approach, the study was limited to adult patients experiencing procedural pain in somatic care. Interviews were conducted in a convenience sample of patients (n = 22) and nurses (n = 21) from four medical and four surgical wards in Finland. A qualitative content analysis of the tape-recorded data was then carried out.

The appropriate ethical principles were followed. All the participants gave their informed consent and formal approval for conducting the research was obtained according to national and local directives.

Nursing advocacy seems to integrate aspects of individuality, professionalism and experiences of empowering, exceptional care. It is not a single event, but a process of analysing, counselling, responding, shielding and whistleblowing activities in clinical nursing practice.

In nursing practice the abstract concept of nursing advocacy finds expression in voicing responsiveness, which integrates an acknowledged professional responsibility for and active involvement in supporting patients' needs and wishes.