Advocacy; Unit 14

Front 1

What is advocacy?

Back 1

- Doing what is best for the client.
- Social activism geared toward changing health care policy.
- Mediation and advocating for patients' rights.
- Empowering clients
- Promoting client self-determination or autonomy
- Ensuring informed decision making
- Seeks to redistribute power and resources to people who demonstrate a need.

Front 2

What is required of nurses in order to advocate for patients?

Back 2

Advocacy requires the nurses to speak up for the client's rights and choices, to assist the client to clarify his or her decisions, and to protect teh client's privacy and autonomy in decision making.

Front 3

What is the nurses role in advocating?

Back 3

- Decision-making Consultant
- Translator
- Navigator
- Mediator
- Information provider
- Anticipatory guide
- Referral resource
- Spokesperson
- Public relations

Front 4

Decision-making Consultant Role

Back 4

consultant:
- helping the client decide
- client is the primary decision maker
- advocate provides information about illness and services
- Enable the client to make an informed decision
- Advocate supports the clients decision

Front 5

Translator Role

Back 5

- The advocate helps the client make sense of the health care system
- Translates the terminology and jargon
- For those clients who are unable to communicate in English, an appropriate translator is required (not family member)
- Provide health education reading material in the client's language and at the appropriate reading level

Front 6

Navigator Role

Back 6

- Protect client autonomyy in a potentially overwhelming and intimidating health care system by serving as expert navigator of the system and assisting client to do what he/she would otherwise be unable to do.
- Help client through fragmented health care system to access the right level of care in the right settings to address health care needs.

Front 7

Mediator Role

Back 7

- The advocate listens, clarifies, and makes suggestions to assist parties to understand each other so as to facilitate agreement on a particular action.
- The advocate mediates and clarifies communication between the patient and physician, other health team members, the community, and family and directly or indirectly influences communication.

Front 8

Information Provider Role

Back 8

- The advocate listens to the needs wants, and desires of the client.
- Clients need to be knowledable about their rights and need appropriate and adequate information to make informed decisions.
- Educate: nature of intervention, tx, care, outcome, should be informed of no tx option.
- Anticipatory guide: the advocate is in a position to anticipate problems that may arise in days to week to months.

Front 9

Referral Resource Role

Back 9

- The advocate provides information about available, accessible, appropriate and affordable resources and services in hte community to meed the client's needs.

Front 10

Spokesperson Role

Back 10

- Whem speaking on behalf of a client who is unable or unwilling to speak on his or her own behalf, the advocate must communicate clearly and effectively and be able to state the client's problems from the client's perspective in a succinct manner.
- The advocate must be assertive and at times outspoken.
- The advocate ust be a risk taker for benefit of the client.

Front 11

Public Relations Role

Back 11

- The advocate procides education to community groupes about particular health issues.
- Helsp people to become more aware of the availability of nurse advocacy.

Front 12

Client Factors Affecting Advocacy

Back 12

Lack of Confidence:
- Decreased in a sense of self-worth
- Unable to assess their needs accurately
- Do not protect their self-interest effectively
- At risk for being manipulated or coerced by others

Lack of Readiness:
- Client may not desire an exchange of information owing to a lack of self-esteem, fear of the information, or lack of ability to understand information.

Conflict with family or health care professionals:
- A difference between the client's choices and those that would have been made by family or health care professionals.

Functional Impairments:
- Clients with significant physical or mental impairments may be unable to serve as their own advocate or to enlist the aid of others to be their advocates.
- In some situations a guardian or conservator is appointed by the courts to oversee health care matters.

Social and cultural influences:
- Know how decisions are made within a particular client's family and cultural beliefs on health care.

Front 13

Nursing Factors Affecting Advocacy

Back 13

- Cultural Competence - Understanding one's own culture with enable the advocate to be more open to the world of others. If the nurse is unable or unwilling to honor the cultural values of the client, advocacy will not occur.
- Uncertainty - What is right, legal, moral, or ethical? A dilemma can occur should there be a conflict between personal values and perceived professional obligations of advocacy.
- Role conflict - Having to choose between the interests of the employer and the interests of the client.
- Unwillingness to take risks- may not have the self-confident required to stand up and speak on behalf of the client; fear of job loss, face, status, or respect.
- Appropriateness of the advocacy role - may not be the duty of hte nurse and may interfere with ongoing medical care.
- Time and NRG - advocacy does not need to take additional time since it is the basis of nursing assessment and is done in conjunction with the nursing process.
- Undesirable clients- having less social value than others.

Front 14

Social Factors Affecting Advocacy

Back 14

Culture: clients from diverse cultural and thenic backgrounds. Advocacy is based on a western concept of individualism and a society consisting of autonomous individuals.

Stratification: Inequities in the distribution of wealth and resources.

Stigma

Health care policy: rules and regulations, managed care, saving money may take precedence over delivering quality care.

Health care system: lg, complex, can threaten client individualism and autonomy, gate-keeper.

Paternalism: professionals impose their values and beliefs on the client limits possiblities and creates situations of domination and dependence. can be harmful to clients and self-serving to health care professionals, fails to repsect the individual and the right to participate in care.

Irresolvable problems: problems and issues that are beyond the nurse's authority or ability to solve.