Advocacy
helping others to grow and self-actualize�is a critically important leadership role.
The actions of an advocate
are to inform others of their rights and to be sure they have sufficient information on which to base their decisions.
Nurses
may act as advocates by helping others make informed decisions, by acting as an intermediary in the environment, or by directly intervening on behalf of others.
caring, autonomy, respect, and empowerment
The nursing values central to advocacy emphasize
Nursing Values Central to Advocacy
Each individual has a right to autonomy in deciding what course of action is most appropriate to meet his or her health-care goals. Each individual has a right to hold personal values and to use those values in making health-care decisions. All individual
Provision 2
suggests that the nurse's primary commitment is to the patient, whether an individual, family, group, community or population. Provision 3: suggests that the nurse promotes, advocates for and protects the rights, health and safety of the patient.
the American Hospital Association (AHA) Committee on Research released a report entitled Engaging Health Care Users
A Framework for Healthy Individuals and Communities, suggesting that health-care user engagement is a key ingredient in reaching the triple aim of better population health, enhanced patient experience, and lower costs
Advocacy
helping others to grow and self-actualize�is a critically important leadership role.
The actions of an advocate
are to inform others of their rights and to be sure they have sufficient information on which to base their decisions.
Nurses
may act as advocates by helping others make informed decisions, by acting as an intermediary in the environment, or by directly intervening on behalf of others.
caring, autonomy, respect, and empowerment
The nursing values central to advocacy emphasize
Nursing Values Central to Advocacy
Each individual has a right to autonomy in deciding what course of action is most appropriate to meet his or her health-care goals. Each individual has a right to hold personal values and to use those values in making health-care decisions. All individual
Provision 2
suggests that the nurse's primary commitment is to the patient, whether an individual, family, group, community or population.
Provision 3
suggests that the nurse promotes, advocates for and protects the rights, health and safety of the patient.
The Guide (AHRQ, 2013) outlines four strategies hospitals can use to connect with patients and families
Encourage patients and family members to participate as advisors. Promote better communication among patients, family members, and health-care professionals from the point of admission. Implement safe continuity of care by keeping the patient and family i
Entry Points for User Engagement in the Health-Care System Individual
The aim is to increase the skills, knowledge, and understanding of patients and families about what to expect when receiving care. Health-care team: The focus is to promote shared understanding of expectations among patients and providers when seeking car
Technology
Managers also must advocate for patients with regard to distribution of resources and the use of this
Consumer Bill of Rights and Responsibilities
also known as the Patient's Bill of Rights (1998) This document had three key goals (a) to help patients feel more confident in the US health-care system, (b) to stress the importance of a strong relationship between patients and their health-care provide
Confidence in US healthcare, strong relationship, patient's role in staying healthy
Patient's Bill of Rights (1998) three key goals
Insurance company changes ACA
These protections, which phased in between 2010 and 2014, included the elimination of annual and lifetime coverage limits; provided for choice of physician from a plan's network; allowed children to get health insurance in spite of existing medical condit
Reimbursement
The government, in its role as the single largest insurer of health care, has also influenced the protection of patient rights by linking this with patient right provisions.
the American Recovery and Reinvestment Act of 2009 (ARRA)
maintains and expands HIPAA guidelines as they are related to patient health information privacy and security protections.
Medical Patient Rights Act
In 1994, the Illinois General Assembly established this that established certain rights for medical patients and provided a penalty for violations of these rights (not legally binding)
Genetic Information and Nondiscrimination Act (GINA)
is a federal law passed in 2008, making it illegal for health insurers or employers to discriminate against individuals based on their genetic information
The Deprivation of Liberty Safeguards and Mental Capacity Act
was legislated in the United Kingdom in 2005, providing some protection for residents in care homes from unneeded use of physical restraints and other loss of liberties.
Legal physician assisted suicide
In 1997, Oregon became the first state to allow terminally ill people to receive lethal doses of medication from their doctors. By early 2016, three other states had followed suit (Washington, Vermont, and California), and Montana allowed it by court deci
Right to die laws
Typically, these laws apply only to patients who are at least 18 years old, with the capacity to make medical decisions, with a terminal disease expected to result in death within 6 months.
The California End of Life Option Act
requires the patient to make two verbal requests at least 15 days apart and one written request that is signed, dated, and witnessed by two adults. The patient may rescind the request for an aid-in-dying drug at any time and in any manner and a request fo
Once the prescription is filled, the patient must complete a "Final Attestation for an Aid-in-Dying Drug to End My Life in a Humane and Dignified Manner" form within 48 hours before self-administering the drug.
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PAS
Physicians do have the legal right to choose whether they will participate in this. Physicians who do participate are protected from criminal, civil, and administrative liability if they follow the requirements.
Leader-managers
have a responsibility to see that all patient rights are met, including the right to privacy and personal liberty, which are guaranteed by the Constitution.
Subordinate advocacy
is a neglected concept in management theory but is an essential part of the leadership role.
Standard 16 of the ANA (2009)
suggests that nurse administrators should advocate for other health-care providers (including subordinates) as well as patients, especially when this is related to health and safety.
workplace advocacy
is a critical role managers assume to promote subordinate advocacy. In this type of advocacy, the manager works to see that the work environment is both safe and conducive to professional and personal growth for subordinate (i.e. following OSHA guidelines
violence
workplace advocacy is needed to address workplace this an ever increasing problem in contemporary society.
Upper level managers
must advocate for subordinates in solving problems and making decisions about how best to use limited resources. These decisions must be made carefully, following a thorough examination of the political, social, economic, and ethical costs
Risk taking and leadership
Another way leaders advocate for subordinates is in creating a work environment that promotes these 2 things. For example, administrators should foster work environments that promote subordinate empowerment so that workers have the courage to speak up for
environment that promotes subordinate advocacy
Invite collaborative decision making. Listen to staff needs. Get to know staff personally. Take time to understand the challenges faced by the staff in delivering care. Face challenges and solve problems together. Support staff as needed. Promote shared g
Internal whistleblowing
occurs within an organization, reporting up the chain of command.
External whistleblowing
involves reporting outside the organization such as the media and an elected official.
Whistleblowing
It is important, however, to remember that this should never be considered the first solution to ethically troubling behavior. Indeed, it should be considered only after other prescribed avenues of solving problems have been attempted. This is true, howev
Speaking out as a whistleblower
is often honored more in theory than in fact.
Guidelines for Blowing the Whistle
Stay calm and think about the risks and outcomes before you act. Know your legal rights, because laws protecting whistle-blowers vary by state. First, make sure that there really is a problem. Check resources such as the medical library, the Internet, and
Federal level
Although whistleblower protection has been advocated at this level and has passed in some states, many employees are reluctant to report unsafe conditions for fear of retaliation. Nurses should check with their state association to assess the status of wh
US
At present, there is no universal legal protection for whistleblowers in the
Advocate for the profession
When nurses find a discrepancy between their perceived role and society's expectations, they have a responsibility to do this
A professional commitment
means that people cannot shrink from their duty to question and contemplate problems that face the profession.
Political action committees (PACs)
attempt to persuade legislators to vote in a particular way.
Lobbyists of the PAC
may be members of a group interested in a particular law or paid agents of the group that wants a specific bill passed or defeated. Nursing must become more actively involved with PACs to influence health-care legislation, and PACs provide one opportunity
nursing lobbyists
currently influencing legislation on quality of care, access to care issues, patient and health worker safety, health-care restructuring, direct reimbursement for advanced practice nurses, and funding for nursing education.
network groups
colleagues meet to discuss professional issues and pending legislation.
Tips for Interacting With the Media
Establish proactive, routine communication with local, regional, and national media to promote cooperation and transparency. Attend media training and/or practice speaking in front of a camera with a microphone. Dress professionally for interviews. Respec
Manager
When working conditions are less than favorable, the ________ is responsible for relaying these concerns to higher levels of management and advocating for needed changes.
Leader
this role is the one who proactively steps forth to be a role model and active participant in educating the public and improving health care through the political process.
Advocacy
is helping others to grow and self-actualize and is a leadership role.
Patient advocate
It is important for this person to be able to differentiate between controlling patient choices (domination and dependence) and assisting patient choices (allowing freedom).
Bill of Rights for Patients
Since the 1960s, some advocacy groups, professional associations, and states have passed this for patients. Although these are not legally binding, they can be used to guide professional practice.
workplace advocacy
the manager works to see that the work environment is both safe and conducive to professional and personal growth for subordinates.
Whistleblowers
Although much of the public wants wrongdoing or corruption to be reported, such behavior is often looked on with distrust, and these people are often considered disloyal and experience negative repercussions for their actions.
Leader-managers
must be willing to advocate for whistleblowers who speak out about organizational practices that they believe may be harmful or inappropriate.
Ethical issues
Professional issues are also these. When nurses find a discrepancy between their perceived role and society's expectations, they have a responsibility to advocate for the profession.
Sociopolitical knowledge base
If nursing is to advance as a profession, practitioners and managers must broaden their this to better understand the bureaucracies in which they live.
Nurses as a group
need to exert their collective influence and make their concerns known to policy makers before they can have a major impact on political and legislative outcomes.