Example 1: Advocating for a Patient’s Right to Refuse Treatment

A patient admitted to the emergency room is unconscious and has no known healthcare directives. The family is divided; some want aggressive treatment to save the patient’s life at all costs, while others believe the patient wouldn’t want to be kept alive on machines if there’s no hope of recovery.

Nurse’s Advocacy:

The nurse can advocate for the patient’s rights by:

• Researching state laws: Understanding the legal framework for informed consent and substituted judgment (decisions made by family on behalf of an incapacitated patient) is crucial.
• Facilitating family discussions: The nurse can help the family communicate their wishes and understand their legal options. This might involve mediating discussions or connecting them with social workers or ethics committees.
• Ensuring all options are presented: The nurse can ensure the family is aware of all potential treatment paths, their risks and benefits, and the patient’s prognosis.
• Supporting the family’s decision: Once a decision is made, the nurse can advocate for honoring the family’s wishes, even if it differs from some members’ preferences.

Example 2: Advocating for Increased Staffing Levels

A nurse on a busy medical-surgical unit frequently experiences situations where there are not enough nurses to adequately care for all the patients. This can lead to:

• Safety Risks: With fewer nurses, there’s a higher risk of medication errors, falls, and missed signs of patient deterioration.
• Increased Nurse Burnout: Nurses under constant pressure can experience fatigue, stress, and job dissatisfaction, impacting patient care and potentially leading to higher turnover rates.

Nurse’s Advocacy:

The nurse can advocate for improved staffing by:

• Collecting Data: Documenting incidents related to understaffing, such as missed medication administration or extended wait times, can provide evidence of the problem’s impact.
• Working with Colleagues: Uniting with other nurses to raise concerns strengthens the message and demonstrates the widespread nature of the issue.
• Meeting with Hospital Administration: Presenting data and collaborating with administrators to develop solutions, such as hiring more nurses or adjusting patient-to-nurse ratios.
• Lobbying for Legislative Changes: Nurses can support legislation that mandates safe nurse staffing levels in healthcare facilities.

These are just two examples of how nurses can advocate for their patients and their profession. By being informed, assertive, and working collaboratively, nurses can make a significant difference in healthcare delivery.