Characterizations of advocacy by practicing nurses

Area of Science:

• Nursing
• Healthcare Ethics
• Qualitative Research

Background:

• Patient advocacy is a critical nursing role, yet its practical application and perception among nurses require further exploration.
• Understanding nurses' lived experiences with advocacy is essential for professional development and patient care improvement.

Purpose of the Study:

• To explore hospital and community nurses' perceptions of patient advocacy.
• To identify factors that promote or impede nurses in exercising their advocacy role.
• To develop a conceptual model of client advocacy based on nurses' experiences.

Main Methods:

• Qualitative descriptive study utilizing in-depth interviews.
• Seventeen hospital and community nurses participated in the study.
• Thematic analysis was employed to interpret interview data.

Main Results:

• The nurse-patient relationship, characterized by teaching, informing, and support, was central to nurses' understanding of advocacy.
• Interpersonal dynamics, rather than ethical or accountability concerns, primarily defined the advocacy process for nurses.
• Work environment barriers (time, economics, hierarchy) and personal factors (autonomy, fatigue) hindered advocacy, as did physician dynamics.
• A conceptual model of client advocacy was developed from the findings.

Conclusions:

• Nurses' practice of advocacy is significantly influenced by interpersonal relationships and systemic workplace factors.
• The contemporary practice of nursing advocacy may be evolving beyond traditional academic and professional definitions.
• Further research and curriculum development are needed to align nursing education with the realities of patient advocacy.