Nursing Is There a Limit to One's

Nursing Is there a limit to one's professional obligation to the patient? Is that the same as advocacy? Advocacy can be construed as a professional obligation to the patient, especially when advocacy is framed as an ethical obligation. There are therefore few limits to a nurse's ethical responsibilities to the patients, even though some situations may seem morally ambiguous. Many nursing researchers promote the concept of patient advocacy as "an ethic of practice," one that is an immutable part of the professional responsibilities of the nurse. (Gaylord & Grace, 1995, p. 11).

Are the characteristics of caring relevant to 2010? The characteristics of caring are more relevant in 2011 than they were in 2010 or have ever been before, in part because of increasing patient diversity. Knowledge of the different concepts of health, healing, illness, and the role of the doctor helps make nurses more accountable to patient needs. Viewing the patient as a whole person is crucial. Moreover, the widening schism between persons in power and the powerless makes caring essential to any nursing practice. 3.

Carper states that "caring, as a professional and personal value, is of central importance in providing a normative standard which governs our action and our attitudes toward those for whom we care." Caring is certainly a normative standard; it is almost impossible to envision the nursing practice outside of the framework of caring. Caring may be only one aspect of the nursing profession, but it is most certainly a realistic and relevant normative standard in the profession. 4.

How are caring and advocacy similar and dissimilar? Advocacy is an expression of caring. It is not possible for nurses to act on behalf of patients as an advocate without coming from a position of caring for that patient's rights. However, a nurse who operates within the normative framework of caring may stop short of his or her professional obligations and withhold advocacy -- whether for fear of reprisal or for lack of self-empowerment in the workplace. 5.

Is the discussion on advocacy relevant to 2010? As Hanks (2008) puts it, advocacy is "an essential component of nursing practice" (p. 468). Advocacy is relevant to 2010 as well as 2011 because the practice entails "speaking out and speaking for patients; being compelled to act on unmet needs of patients," (Hanks p. 468). Moreover, family members are increasingly being involved in healthcare decisions. As Beyea (2005) puts it, part of the responsibility of the nurse advocate is to advocate on behalf of the family as well as the patient. 6.

How effective are you and others in advocating for patients? As a nurse leader, I have been highly effective -- even activist -- in my approach to advocating for patients. I have seen too many transgressions on patients' rights to ignore them any longer. Withholding information or belittling patient wishes must cease to be a part of the healthcare practice. 7.

How do you advocate for patients in situations where you feel powerless? Or do you feel that nurses are not powerless but effective in advocating for patients? Nurses are sometimes encouraged to feel powerless in order to maintain spurious organizational hierarchies. However, it is up to the individual nurse leader to encourage the team of nurses to act on behalf of patients without fear of reprisal. Nurses can only be effective at advocacy when their supervisors encourage it. 8. What is your reaction to the discussion on autonomy and advocacy vs.

autonomy and relationships? Patient autonomy is enhanced via the practice of advocacy, when nurses act intelligently.