Asking nurses about advocating for patients: 'reactive' and 'proactive' accounts

The concepts of the nurse as patient advocate is not new, and the evolution of this role is briefly traced in this paper as a background to presenting the findings from a small-scale qualitative study. However, whilst there is much written there is a lack of empirical work describing nurses' understandings and experiences of advocacy and what there is often derives from the USA and centres on specialized groups such as mental health, paediatric or intensive care patients or those with a learning disability. This study sought to explore understandings of the concept in a group of 15 adult nurses from general medical and surgical wards. Audiotaped semi-structured interviews were used for data collection. Data were analysed using a method appropriate for qualitative studies. Categories were generated and are presented here supported by direct participant quotes derived from the interview transcripts. These include the importance of the therapeutic relationship as the key to advocacy, nurse and patient shared common humanity, the cultural environment of care in which advocacy occurs and descriptions of 'reactive' and 'proactive' levels of advocacy.