Nursing and Healthcare policies response

You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per response.) All replies must be constructive and use literature where possible.

Respond to each post in APA 7 format with at least 150 words. Use at least one reference per discussion response that was published within the last 5 years. References must be from a reputable source such a medical journal, book, .edu, .gov websites. Search topic followed by NCBI 2016 for best results.

Discussion Post 1

Advocating for patients is at the foundation of efficient and effective nursing care. Although the act of advocating is multidimensional, I believe as part of excellent care, a nurse is always advocating for their patient(s) by way of the care being given or verbally standing up for the specific care they’re needing. I believe the foundation of successful advocating is precise, clear communication, based on the common goal of providing the best possible and most efficient care possible to all patients in our care as a department and an individual nurse.

The responsibility of patient care is shared by everyone involved with the patient and their specific needs to assist their recovery. The patient’s needs can be very taxing, or there is a change in condition, and the physician or Advanced Registered Nurse Practitioner hasn’t made rounds. As that patient’s nurse, I’m actively assessing my patient, evaluating what I can do to correct the change in condition before contacting anyone. If my efforts aren’t enough, I will reach out to the caregivers involved for us to develop a plan of care based on the medical changes being noted.

My advocating may consist of pain management. If there is an order available and I’m able to administer medication, I will do so. I will contact the provider for the appropriate medication or communicate my patient’s condition(s) if need be. Sometimes the advocating is for both the patient and myself as the nurse. For instance, as their nurse, I have advocated a patient who is combative or disoriented and is removing wires, IVs, foley catheters, blood pressure cuffs, O2 sensors, or BIPAP/CPAP masks for a sitter or restraints, patients who didn’t like their diet, provider, or medications they were administered, and for patients who were not satisfied with their questions being answered before a procedure.

The key to advocating is simply caring. However, getting the cooperation required for excellent advocacy requires everyone involved to have a shared interest in the well-being and mission of resolving our patient’s needs. That may necessitate a referral to a specialist. For example, as a home health nurse, I’ve stepped in with diabetic patients with uncontrolled blood sugars that their primary care providers could not manage and recommended a local Endocrinologist, which proved to be exponentially beneficial to the patients.

I’ve recently learned that advocating isn’t simply about patient care. It is for the nurse’s well-being as well. With nursing shortages, increased COVID 19 cases, increased stress levels, workloads, and a dim light down a long dark tunnel, nurses need to make their needs known for their survival. The very definition of advocate: “a person who publicly supports or recommends a particular cause or policy” (Oxford languages and Google – English), implies we should be speaking on behalf of others. There are times when speaking on behalf of others, the advocate is also included in that scenario.

One morning we arrived to work, we found that three of our nurses had been floated from our floor the “Heart and Vascular Center” to the COVID 19 wing of our hospital, with nurses from the COVID 19/ICU wing being sent to our floor. This created a very hostile moment for the nurses involved. This would have met the Stubborn term of conflict: “Conflict has become complex, challenging, and resistant to resolution. The stakes feel high and there may be significant emotion attached to the issues and to the ways they are being addressed. However, when handled well, resolution may be reached” (Mason et al., 2016).

This absurd decision was met with extreme resistance that even the higher-ups were brought in to assist with some resolution. The nurses tasked to work the COVID 19 have pre-existing conditions that precluded them from being in contact with COVID 19 patients. The person who developed the schedule wasn’t concerned with those facts and demanded the schedule be followed as written and delivered. The stand-off lasted for three hours; the conclusion was a split; two of the nurses went to the COVID 19 wing, with one remaining on the cardiac wing. This conflict ended because the nurses involved are committed to caring for patients. Advocating in healthcare is becoming a tool that is more than just for the patient. Nurses have to advocate for themselves. I took a stand with those nurses against management.

Patient advocacy is essential to patient outcomes. Patients and family members are aware of genuinely standing in their corners and working to improve their situations. Advocacy isn’t a new concept but has proven to be a potent nursing tool: “Patient advocacy in nursing is a relatively modern idea, but its first movements originated in Florence Nightingale’s era. It is of such importance that it has entered the moral codes of nursing institutions. The need for justice is among the basic human needs and nurses, more than anyone else, are in contact with patients and their problems; therefore, they can provide justice for the patients better than anyone else. Nurses are the first advocates of patients and are the link between the patient and the health care system. Patient advocacy is one of the extremely important roles of the nurses” (Davoodvand et al., 2016).

The idea of nurses advocating for patients cannot be over-emphasized. Davoodvand et al. (2016) revealed: “that nurses are able to empower vulnerable patients, delivering them from discomforts, unnecessary treatment, as well as protecting them from actions of incompetent healthcare professionals through advocacy.” He also stated that ineffective and in-efficient advocating for patients leads to decreased patient satisfaction and patient outcomes. It has been my experience that advocating is a paramount tool to quality care, job satisfaction, and patient outcomes. Advocating for patients is a nurse by nurse decision. It is a heartfelt way or method to meet our patient’s needs and perform our duties as nurses at a higher level of care.

References:

Davoodvand, S., Abbaszadeh, A., & Ahmadi, F. (2016, June 11). Patient advocacy from the clinical nurses’ viewpoint: A qualitative study. Journal of medical ethics and history of medicine. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4958925/.

Mason, D. J., Gardner, D. B., Outlan, F. H., & O’grady, E. T. (2016). Policy & politics in nursing and health care (7th ed.). Elsevier.

Oxford languages and Google – English. Oxford Languages. (n.d.). https://languages.oup.com/google-dictionary-en/.

Discussion Post 2

Advocacy is the cornerstone of the nursing profession. It can take form in many ways: The nurse can advocate for his/her patients, which they do every day in their practice.

What often comes to mind when one speaks of nurse advocacy is the professional nurse playing the role of supporter to the patients he/she is taking care of. But what is less talked about in terms of advocacy in the nursing profession is nurses supporting and advocating for other nurses. This discussion will address both instances of the roles of advocacy for patients and other nurses.

As discussed in previous posts, the nurse as a profession is highly regarded. According to the Gallup poll, we are rated the most honest and ethical of all professions (Reinhart, 2021)

. This ranking has been strengthened due to the role that nurses played in the fight against COVID-19 (Trusted profession, 2021)

Nurses in most positions are responsible for admissions, which often entails orienting the patient and their families to the facility, the unit, rules of the unit and meeting clear goals and expectations throughout their stay. Nurses spend quite some time educating their patients on a variety of things such as medications, treatment plans, procedures and after care. There are many times where the professional nurse must be the spokesperson for his or her patients in order for the patient to have an outcome that is best for them. Oftentimes nurses are in positions that require them to be liasons between upper level practitioners and the patients. There are times that mid-level practitioners must also serve as advocates. The reason is simply because nurses are at the frontline of many health care settings. There have been numerous times in my nursing career in several nursing settings that I have had to advocate for patients under my care, particularly those patients who did not have a strong command of the English language. I have had to support my Spanish-speaking patient and communicate to the physician that the patient was not in agreement with the doctor’s proposed recommendations. Achieving the desired outcome that my patient expected was rewarding for both the patient and myself.

Nurses in management positions who care about his/her staff many times advocate for their subordinates. As a former Director of Nursing in a correctional facility, I often had to assert myself, defend the nurses that I supervised and represent their interests, often at a personal cost. I knew for sure that my nurses worked very hard, many times with limited resources. However, the nursing department was always scrutinized when an occurrence would happen. Security would insist that I reprimand specific nurses who were present during events. I would listen to security’s concerns and respectfully disagree with their insistence that I punish my nurses. I was very careful not to disrespect security leadership, but I would stand up for my nurses and quote policy and highlight the fact that the nurses did indeed follow protocol. After the meeting, I remember feeling some tension, but that would always dissipate after a few days. The nurses appreciated the fact that I would stand up for them.

REFERENCES:

Nurses are the “Most Trusted Profession” for 19 years in a row. Johns Hopkins Nursing Magazine. (2021, January 22). https://magazine.nursing.jhu.edu/2021/01/nurses-are-the-most-trusted-profession-for-18-years-in-a-row/.

Reinhart, R. J. (2021, August 13). Nurses continue to Rate highest in Honesty, Ethics. Gallup.com. https://news.gallup.com/poll/274673/nurses-continue-rate-highest-honesty-ethics.aspx.

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