Patient Advocacy in Nursing

Patient Advocacy in Nursing
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  • In room #1, we have a 74 y/o female. Doctors believe that she is suffering from a UTI. She voids on herself, which is not helping. She is a little confused, due to the bacterial infection.
  • Ok, I will ask the doctor to create orders for a urinary catheter. Thank you!
  • I agree that she needs a catheter in place. I will create orders. 
  • Ok! I will go explain the process to the patient...
  • I wish that you would change your mind, but I have to respect your decision. 
  • I understand the procedure, but I do NOT want it done!
  • This is a story of patient advocacy. It is based on a situation that I encountered during one of my clinicals. Here, we see report given during shift change. The nurse finds that the patient is able to understand and answer questions appropriately.
  • The patient is confused. Put in the catheter. She needs it!
  • The doctor has verbally ordered for the nurse to put in the urinary catheter. The charge nurse is also present. The nurse then goes to explain the process to the patient. 
  • The patient voices that she understands the orders for a catheter. However, she is refusing to let the nurse put it in. The nurse listens to the patient and obeys her wishes. 
  • Sorry! I will NOT put the catheter in against the patient's wishes. I am an advocate for her decisions.
  • When the nurse tells the charge nurse that the patient is refusing, the charge tells her to put it in anyway against the patient's wishes. This upsets the nurse, who has an important role of acting as patient advocate.
  • The nurse is very upset. She knows that the patient needs the catheter to help prevent further infection. However, the patient is refusing. The nurse remembers that patient advocate is a very important role in her position. As the patient advocate, "it is important for you to support and at times defend your patient's decisions" (Potter, Perry, Stockert & Hall, 2017, pg. 37).
  • The nurse refuses to obey the charge nurse's orders. The patient distinctly expressed that she did not want a catheter. The nurse's role as patient advocate means that she needs to act on behalf of the patient. The nurse just needs to keep the patient clean and dry and hopes that the antibiotics will heal the UTI. 
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