133). This informal power is quite significant when it comes to patient decisions and as such doctors need to appreciate and understand this power nurses wield.
Due to the unique information nurses have about patients, nurses have considerable decision-making responsibilities concerning patients. For this reason, many medical schools have implemented programs, in their curriculum, to teach medical student how important it is to listen to the advice of their nurses. Innovative universities like the University of Kentucky Medical Center actually encouraged their residents to develop a collaborative partnerships with the nurses with which they worked. Paynton (2009) notes that outcomes of patient care improve when collaboration increases and the role of nurses is valued. However, regretfully, this collaboration does not always take place.
Although there is a shift in trends towards more collaboration between doctors and nurses, giving nurses more formal power in advocating for patients, the narratives collected by Paynton (2009) revealed that nurses still must continue to use informal power strategies when working within formal constraints, in order to achieve desired patient outcomes. The medical profession is still perceived to have a monopoly regarding central patient care tasks, including diagnosis and therapeutic measures. Time and again, courts reiterate this formal power structure, calling medical and not nursing evidence to the stand (Goodman, 2003). Participants in Paynton's study expressed that they still felt obligated to follow the formal power structure of healthcare organizations and physicians, when it came to implementing patient care. The primary exception to this following of the formal power structure manifested itself when the nurses felt that the physicians' and/or healthcare organizations' decisions regarding patient care were inappropriate. When this occurred, the nurses surveyed employed significant informal power, as a means of advocating what they felt was appropriate patient care. All six of the nurses surveyed in Paynton's study felt that their role as patient advocate was most important duty.
Advocacy and Uncertainty in Nursing Students:
Although it's clear that nurses have a duty to act as a patient advocate, the conflicting power structures couple with the ambiguous nature of the definition of the concept of advocacy has often led to confusion regarding the role of advocacy and...
Keatley (2008) quotes a BSN student, "Sometimes patients are helpless or unsure in certain situations and I believe this is where we as nurses server as their advocates with our knowledge, close contact with their situations and link to ... The team" (p 20). This student appears to have an understanding similar to the varied definitions discussed earlier. However, Keatley quotes another student describing advocacy by stating, "I try to show respect for others by understanding that people have a right to make their own decisions. My role (as) a nurse is to respect these choices and help them, when needed, to honor their decisions" (p. 20). This student demonstrates a different understanding of the components of the concept of advocacy. Until the nursing profession has a unified definition of advocacy there is likely to continuing uncertainty in nursing students, regarding the concept.
Although patient advocacy is a critical role for professional nursing, there is still work to be done in defining the concept and facilitating nurses ability to be patient advocates. Patient advocacy has evolved to counter the personal and institutional vulnerabilities that patients face, which are often exacerbated by specialized patients, such as victims of crimes. To ensure nurses are able to be advocates, they must be empowered, yet often have to rely on an informal power structure to fulfill this important role. Yet, until the concept is clearly defined, the role of advocacy and professional nursing will continue to have elements of confusion.
Goodman, B. (Nov 2003). Ms. B and legal competence: Examining the role of nurses in difficult ethico-legal decision-making. Nursing in Critical Care, 8(2). Retrieved April 22, 2009, from CINAHL Plus.
Keatley, V. (2008). Identifying and Articulating the Characteristics of Nursing Agency: BSN Students' Perspective. Self-Care, Dependent-Care & Nursing, 16(2). Retrieved April 22, 2009, from CINAHL Plus.
Lawson, L. (2008). Person-centered forensic nursing. Journal of Forensic Nursing, 4(3). Retrieved April 22, 2009, from CINAHL Plus.
McCarthy, V. & Freeman, L. (Fall-Winter 2008). A multidisciplinary concept analysis of empowerment: Implications for nursing. Journal of Theory Construction & Testing, 12(2). Retrieved April 22, 2009, from CINAHL Plus.
Negarandeh, R., Oskouie, F., Ahmadi, F., & Nikravesh, M. (Jul 2008). The meaning of patient advocacy for Iranian nurses. Nursing Ethics, 15(4). Retrieved April 22, 2009, from CINAHL Plus.
Paynton, S. (2009). The informal power of nurses for promoting patient care. Online Journal of Issues in…
Roles of Professional Nursing Associations Conduct a web search of at least two professional nurses' associations and describe how each organization defines its respective role at local, state, and national levels. Identify the organization and its website. What are some examples on the website demonstrating that the organization addresses policy and politics? The website for the American Nurses Association (ANA) can be found at www.nursingworld.org, and by reviewing the wealth of content provided
Role Development for Advanced Nursing AS HIGH-QUALITY CARE PROVIDERS Researcher -- an ANA-Masters-prepared nurse or Advanced Practice Nurse continues to increase and expand knowledge for her own practice and to contribute to the body of knowledge of her field (CNHS, 2011; Cooke et al., 2008). She applies appropriate communication technologies in transferring her continuous learning to others in the field and related ones. She also initiates the exploration of new knowledge by
Professional Counseling The relevance of counseling as a helping profession cannot be overstated. This is more so the case taking into consideration the role counseling plays towards the facilitation of the development of not only an individual but also a family or even a group. Counseling as a Distinct Profession: The History and Philosophy of the Profession Marini and Stebnicki (2008) point out that although counseling as a term made its first appearance
Professional Association Professional Organization for Nursing In the past, a number of individuals inside every society started delivering care and nutrition for all those who had been struggling to look after themselves. Because these people became 'care specialists,' they started to express to other individuals the procedures that helped them and also to train other individuals as apprentices who would probably at some point continue their function. The advancement of contemporary nursing
Professional Nursing Associations: Rationale A professional association refers to "an organization of practitioners who judge one another as professionally competent and who have banded together to perform social functions which they cannot perform in their separate capacities as individuals" (Merton, as cited in Matthews, 2012). Nursing has, over time, developed to professional status and is at present characterized by numerous national professional associations. Whether or not these associations add value to
All these dimensions conclude on one problem which a CMHC could interpret the best through his experience, intelligence and practice. LOCAL, STATE, and NATIONAL PUBLIC POLICIES POTENTIALLY AFFECT the QUALITY and ACCESSIBILITY of CLINICAL MENTAL HEALTH SERVICES. Mental Health parity is considered as an evolution in an American Politics. States took over federal policies and fought hard to implement mental health insurance along with general health insurance. (Harris, 2006) Parity Law