EMPOWERMENT AND ADVOCACY

Empowerment and Advocacy

Empowerment and Advocacy

Advocacy

Advocacy is an umbrella term for acting on behalf of another by supporting and pleading that person's cause. The numerous definitions and explanations of advocacy in the nursing literature range from counsellor, 'watchdog' and representative to potential whistle-blower. Advocacy is more than speaking for another. Advocacy involves intervening for 'vulnerable' people who require it. In similar vein Teasdale (1998), explaining that advocacy in healthcare is about power, stated that it involves intervening on behalf of the powerless by manipulating those who have power. In these terms Donahue reminds us that advocacy has existed as long as there has been a need for the powerless to be championed (Donahue, 2004, Pp. 51).

Advocacy and Nursing

Advocacy is about making it possible for patients to exercise their right to freedom and self-determination. In providing support the advocate helps people to express what they want and helps to secure their rights. The role of the nurse therefore is to advocate and to represent patients' interests. In today's health service where there is a requirement to provide a patient-led service, advocacy may be considered a necessary way of ensuring people's voices are heard (Mallik, 2001, Pp. 38).

Advocacy as essential nursing practice

Healthcare reforms are about making services responsive to patients' needs and preferences. This means putting people in control, and will require professionals to be in a position to empower them so that their voices are heard. As members of the healthcare team, nurses have a role to play in advocating for patients. A model of advocacy will be explored to demonstrate advocacy as essential nursing practice.

Characteristics of advocacy

From a concept analysis Baldwin revealed that advocacy has three essential characteristics, summarized as valuing, apprising and interceding:

Valuing encompasses a therapeutic nurse-patient relationship in which patients' freedom and self-determination may be secured.

Apprising promotes and protects patients' rights to be involved in decision making and informed consent.

Interceding involves acting as an intermediary between patients and their family or significant others, also between them and healthcare providers.

Valuing

The advocate is one who maintains the person's sense of individuality and humanity. Gadow contends that the nurse, acting as advocate, helps patients to 'authentically' exercise their freedom of self-determination. This means that the nurse acting as advocate respects the patient as an individual, a real person who has individual needs and preferences and one who can make decisions (Abrams, 2005, Pp. 67).

In valuing the patient as a holistic being, nurses promote dignity. Evidence of valuing will be those activities that show nurses enabling and supporting patients to make decisions, freely and without pressure. They include encouraging patients to make their decision and supporting patient-centred goals and priorities. This aspect is stated by Curtin, who claims that advocacy is 'not-so-simple good nursing practice'. She recognised that it involves creating 'an atmosphere in which something intangible such as human values, respect and compassion can be realised'. Valuing affirms patients' dignity, respect, integrity and self-determination (Donahue, 2004, Pp. 51).

Apprising

Apprising involves informing, advising and ...