Study Bay Coursework Assignment Writing Help<\/p>\n
The purpose of this concept analysis is to identify, focus, and refine how patient advocacy is perceived by professional nurses in the nursing community. \u00a0 This paper will follow the Walker and Advant (2011) method of concept analysis to identify the concept of patient advocacy from existing literature with the aim to analyze and provide clarity and direction for enhancement of advocacy in nursing. \u00a0 Further, steps will include the process of identifying attributes of the concept, describing all model cases selected, identifying antecedents and consequences regarding the concept, and lastly, identifying examples of empirical referents of the concept (Walker & Avant, 2011). \u00a0 \u00a0<\/p>\n
Identification of Concept and Aim of Analysis<\/p>\n
Patients often have an inadequate knowledge of illness and medicine, yet they desire more control over their personal healthcare. \u00a0 In many healthcare settings, patient care is unpredictable and patient\u2019s right to self-determine and quality-of-life has a tendency to be ignored (Bu & Jezewski, 2006). \u00a0 Advocacy is understood as the act of pleading for, supporting, or recommending (Webster\u2019s Online Dictionary, n.d.). \u00a0 Moreover, the concept most often noted in literature as a component of nursing advocacy involves acting on behalf of patients, including nurses\u2019 activities<\/p>\n
of speaking, fighting, and standing up for their patients (Hanks, 2007). \u00a0<\/p>\n
Nurses are in a unique position to support their patient\u2019s interests in the re-establishment of health and well-being through patient advocacy. However, due to the limited number of quantitative empirical studies of patient advocacy in nursing, the definition of patient advocacy is not consistent, and many nurses have a limited view of what patient advocacy is and how to perform the challenging task of protecting and supporting patient\u2019s rights. (Bu & Jezewski, 2006). \u00a0 The aim of this analysis is to clarify, define, and refine the concept of patient advocacy in order to expand understanding of this concept in nursing practice.<\/p>\n
Defining Attributes<\/p>\n
According to much of the literature, defining attributes of patient advocacy involves a series of specific actions by nurses to protect, represent, and safeguard the patients\u2019 rights, best interests, and values within the healthcare system (Bu & Jezewski, 2006). \u00a0 As well, safeguarding patient\u2019s autonomy, acting on behalf of patients, and defending social justice in the delivery of health care are all core attributes of patient-care advocacy (Bu & Jezewski, 2006). \u00a0 The title of patient supporter and patient representative is also used frequently in research literature to describe the role of the nurse advocate (Hank, 2007). \u00a0 These attributes place patients at the center<\/p>\n
of the of the healthcare system, emphasizing patients\u2019 legal rights and well-being, and nurses\u2019 humanity, kindness, and fairness in the delivery of health care (Bu & Jezewski, 2006).<\/p>\n
Cases of Patient Advocacy<\/p>\n
Cases of patient advocacy can be examples of several main factors that define and challenge the attributes that facilitate or hinder nurses as patient advocates. \u00a0 A model case is defined as \u201can example of the use of the concept that demonstrates all the defining attributes of the concept\u201d (Walker & Avant, 2011, p. 163). \u00a0 In addition to the model case exemplar, the attributes of patient advocacy will be defined and challenged through case examples of borderline, related, and contrary cases.<\/p>\n
Model Case<\/p>\n
An example of a model case for patient advocacy involves a Registered Nurse who has been working as the charge nurse of a busy Emergency Department for 15 years. \u00a0 P.B. has just come on shift, when an air emergency vehicle lands on the helipad with a 22-year-old, male, trauma patient. \u00a0 The paramedic reports that the patient was involved in a two vehicle head-on collision, the patient was ejected from the vehicle, and that there is a possibility of a spinal cord injury. \u00a0 Immediately, the trauma team attends to any life-threatening injuries, while P.B. quietly and efficiently attends to the patient\u2019s emotional and safety needs. \u00a0 She quickly determines that the patient would like his mother contacted<\/p>\n
only, that he would like to know the extent of his injuries, and that he suffering a considerable amount of pain. \u00a0 After the patient\u2019s primary care is complete, P.B. explains spinal shock to the patient, allows the previously-contacted mother to enter the Emergency Department, and carefully reviews the plan-of-care with both the patient and the mother. \u00a0 She then offers to contact further family as needed, and presents herself available for any further questions. \u00a0 Further, after administering ordered pain medications, P.B. is very astute with timed, follow-up, assessments regarding effective pain control. \u00a0<\/p>\n
The above nurse demonstrates the core attributes necessary when a nurse is successful in the role as patient advocate. \u00a0 The nurse acted as a patient protector from pain and fear, representing and safeguarding the patient\u2019s rights and autonomy through contacting the appropriate family members, and addressing the patient\u2019s pain with medication and personal reassessment of patient\u2019s pain control. \u00a0 As well, the nurse showed kindness, fairness, and humility with congruity of care by personally providing the patient and the patient\u2019s family with compassion and education regarding the patient\u2019s injury and treatment.<\/p>\n
Borderline Case<\/p>\n
An example of a borderline case regarding the role of a nurse as a patient-advocator would involve the same scenario, but slightly different reactions from the above charge nurse.<\/p>\n
\u00a0 As the helicopter lands and the patient\u2019s life-threatening injuries are attended to by the trauma team, P.B. offers to contact the family members of the patient. \u00a0 The patient asks that only his mother be notified, that he is afraid, and that he is in tremendous pain. \u00a0 P.B. quickly reassures the patient that she will contact his mother, that being afraid is natural, and that as soon as she is given the order, she will provide the patient pain medicine. \u00a0 When the patient\u2019s mother arrives in the Emergency Department, P.B. explains the nature of the patient\u2019s injuries, assures the mother that her son is going to be fine, and then leaves the two alone to discuss their options for care.<\/p>\n
The above example represents a borderline case due to the mid-range of appropriate reactions by the nurse attending the needs of a patient. \u00a0 The patient\u2019s autonomy, privacy, and rights were safeguarded when the nurse contacted the appropriate family members. \u00a0 However, the nurse did not demonstrate effective fairness when assuring the patient and the patient\u2019s mother that everything would be fine with regard to the patient\u2019s injuries. \u00a0 Further, the nurse did not display kindness and compassion when leaving the patient and his mother alone without first determining that their educational and emotional needs were met.<\/p>\n
Related Case<\/p>\n
An example of a related case using the previous scenario involves a variance in the actions of the<\/p>\n
charge nurse. P.B has just begun her role as charge nurse on the night shift in the Emergency Department. \u00a0 One of the trauma nurses has called in sick, and she is now required to provide care as a nurse on the trauma team as well as fulfill the role as charge nurse. \u00a0 Shortly after her shift begins, a 24-year-old, male, trauma victim arrives via air transport, and P.B. realizes that she will have to be the primary nurse on this patient\u2019s case. \u00a0 The patient is quickly stabilized, but a spinal cord injury with possible paralysis is soon diagnosed by the trauma physician. \u00a0 The patient is very frightened, in pain, and requests that P.B. phone his mother. \u00a0 P.B. calmly assures the patient that she will contact his mother, administers ordered pain medication, and then assures the patient that she will return to check on him shortly. \u00a0 However, due to P.B.\u2019s charge nurse status, she is needed in another trauma case and the 24-year-old trauma victim is replaced by another trauma nurse.<\/p>\n
This case appears to demonstrate the concept of patient advocacy. \u00a0 However, when examined closely, the trauma patient may have felt that P.B. did not provide kindness, compassion, and congruity of care when failing to return to his bedside after stating that she would. Unknown to the patient, P.B.\u2019s responsibilities as a charge nurse kept her busy for the rest of the shift, and in fact, P.B. explained the transfer of nursing care to the<\/p>\n
patient\u2019s mother. \u00a0 However, the patient\u2019s mother left the department while the patient was asleep, and no explanation was ever made to effectively relieve the patient\u2019s feeling of desertion. \u00a0 This exemplar may simply be a demonstration of a nurse who is very busy with patient care rather than the absence of patient advocacy.<\/p>\n
Contrary Case<\/p>\n
Using the scenario provided above, the contrary case example involves P.B. as she has just arrived to work as the Emergency Department charge nurse for the evening shift. \u00a0 A trauma victim has been transported into the emergency bay, and he is suffering paralysis due to a spinal cord injury. \u00a0 The victim is 24-year-old male, appears extremely frightened, and is in pain. \u00a0 As the charge nurse, P.B. does not typically have individual patients assigned to her, and this is no exception. \u00a0 However, the nurse assigned to the patient asks P.B. to contact the patient\u2019s mother and to stay with the patient until his anxiety and pain have lessened. \u00a0 P.B. calls the number provided on the patient\u2019s chart, and asks the patient\u2019s father to immediately come to the Emergency Department, relaying that he should contact the victim\u2019s mother as well. \u00a0 Following the phone call, P.B. stays with the patient for a short time, but does not provide any comfort measures; instead, P.B. frequently leaves the patient\u2019s bedside, avoids speaking with patient, and denies any knowledge of his condition when asked<\/p>\n
for updates by the patient.<\/p>\n
The above nurse does not demonstrate the core attributes identified when a nurse is successful in the role of patient advocate. \u00a0 The nurse fails to act as a patient protector from fear or to represent and safeguard the patient\u2019s rights and autonomy through contacting the inappropriate family member. \u00a0 Further, the nurse does not attempt to exude kindness, humanity, or supporter-of-patient\u2019s needs by frequently leaving his bedside and failing to offer reassurance or education regarding the patient\u2019s injuries. \u00a0 This is clearly not the concept of a patient advocate role.<\/p>\n
Identification of Antecedents<\/p>\n
Antecedents are those incidents or events in place prior to the occurrence of the concept being researched (Walker & Avant, 2011). \u00a0 Antecedents of patient advocacy occur at all levels of the healthcare system, and appeal for nurses to advocate for patients. \u00a0 Advocacy for patients stems from a need to protect a vulnerable population that loses power to represent or defend itself (Hank, 2007). \u00a0 Vulnerable patients are the most frequently mentioned situation demanding nurses\u2019 advocacy actions (Bu & Jezewski, 2006). \u00a0 Populations of vulnerable people include groups or individuals who cannot fully embody and defend their own rights, needs, welfares and wishes, are unable to make suitable choices, or unable to carry out their choices (Bu & Jezewski, 2006). \u00a0<\/p>\n
Identification of<\/p>\n
Consequences<\/p>\n
The consequences of patient advocacy are a result of nurses\u2019 patient advocacy and can be either positive or negative (Bu & Jezewski, 2006). \u00a0 Successful patient advocacy actions produce positive consequences through the protection of patients\u2019 rights, needs, welfares, and wishes (Bu & Jezewski, 2006). \u00a0 The nursing profession may also have positive consequences as a result of patient advocacy through increases in professional fulfillment, self-confidence and self-respect through the preservation of personal integrity and moral principles (Bu & Jezewski, 2006). \u00a0 Negative consequences can occur when nurses advocate for patients and risks are reported as the advocator being insubordinate; many patient advocators suffer loss of reputation, support system, and self-esteem (Bu & Jezewski, 2006).<\/p>\n
Identification of Examples of Empirical Referent<\/p>\n
Empirical referents are classes or categories of actual phenomena demonstrating the occurrence of the concept, and in many cases the defining attributes and empirical referents will be the same (Walker & Avant, 2011). \u00a0 The concept of patient advocacy, or specific patient advocacy action, is classified under the core attributes listed above, and the empirical referents of this concept analysis are the same. \u00a0 The defining attributes include safeguarding, protecting, representing patients\u2019 rights, best interests, and values within the healthcare<\/p>\n
system (Bu & Jezewski, 2006). \u00a0 Safeguarding patient\u2019s autonomy, acting on behalf of patients, and defending social justice in the delivery of health care are also listed as defining attributes of patient advocacy (Bu & Jezewski, 2006). \u00a0 Patient supporter and patient representative are also included in this analysis to be attributes in the role of nurse patient-advocate (Hank, 2007).<\/p>\n
In conclusion, patient advocacy is an essential part of the professional nursing practice. If the need for advocacy is not appropriately acknowledged and applied, effective healthcare will not be received. \u00a0 The concept analysis of this paper provided clarity, definition, and refinement of the concept of patient advocacy and promotes advocating of patients as a necessary step in the advancement intended for nurses\u2019 professional practice.<\/p>\n
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