Advocacy and Communication Strategies in Nursing Essay

Introduction

Among nurses and midwives’ duties, there is one that relates to the responsibility of speaking on behalf of patients. The NMC has created a set of videos intending to promote advocacy for patient’s health, specifically to ensure that healthcare professionals report abuse and other types of mistreatment of vulnerable patients. These films support the standards that NMC outlines in its Code of Conduct for Nurses (The code of conduct, no date; NMC, 2015). This paper will review healthcare advocacy using relevant theories and address potential communication strategies.

Advocacy

NMC’s code of ethics outlines the standards of work that each nurse or midwife practising in the United Kingdom must adhere to daily. The NMC’s (2015, p. 6) first standard is as follows: nurses must ‘treat people as individuals and uphold their dignity. In the NMC’s first scenario, the man’s dignity is compromised since he continuously asks to give him glasses, and all nurses ignore his requests. Hence, the first scene shows that the standards set out by NMC are not met in some care facilities.

The importance of being aware of the need for advocacy within relationships in health care is linked to the patients not always communicating their needs clearly and effectively (Barr and Gates, 2029; Jackson, Gettings and Metcalfe, 2018). Hence, nurses have to recognise these issues and address them since they spend a lot of time caring for patients and communicating with them, which allows them to assess the latter’s needs (Nsiah, Siakwa and Ninnoni, 2019; Prestia and Dyess, 2020).

Regis College (no date) defines an advocate as an individual who speaks on behalf of the vulnerable people, whose voices and opinions may be lost due to bureaucracy or other issues. Consequently, a nurse advocate is a professional who observes and listens to ensure that all patients’ needs are met, including psychological. Nursing advocacy is not a novel concept, and it is integral to the job position. As part of the third principle by NMC (2015, p. 7), nurses have to assess patients’ physiological and psychological needs and ‘act as an advocate for the vulnerable, challenging poor practise and discriminatory attitudes and behaviour relating to their care’.

As becomes evident from the NMC film, there is still an issue with nurses failing to fulfil their advocacy role. In a discussion article by Nursing Times, Smith and Lee (2017) argue that nurses are often afraid to advocate for their patients since it requires them to challenge others. For example, in the NMC’s first scenario, one of the nurses would have to confront the others about ignoring his request to ensure that he receives his glasses now and will be heard in the future. This confrontation can lead to conflict and stress, which humans naturally tend to avoid. As a result, nurses, who often work with and support vulnerable populations, such as older adults or disabled individuals, often fail to fulfil their role as advocates.

Evidently, to be advocates, nurses have to possess not only excellent knowledge of medicine but also leadership qualities. Regis College (no date) outlines leadership, communication, decision-making skills and negotiation capabilities as a necessity to support nurse advocacy. These skills are necessary because they allow nurses to follow through with identifying the problem, voicing it and collaborating with other teams to resolve it.

Advocacy may relate to the day to day work of nurses, such as helping an elderly patient find his glasses, or it may concern systematic problems within the healthcare continuum. According to Regis College (no date), nurses can advocate within their medical facility, legal system or families. Hence, a nurse can raise the question of understaffing the elderly care facilities, which leads to neglect and improper care to advocate for policy changes to ensure that the issue faced by the older man can be avoided in the future.

Communication Strategies

Communication and advocacy are linked since without being able to listen and voice the advocacy issue effectively, and a nurse will be unable to resolve a problem (Abbasinia, Ahmadi and Kazemnejad, 2020). A range of communication strategies can enable the development of therapeutic relationships and help support the values and attitudes of patients. Active negation and advocacy on behalf of people to ensure equal access to care and support are possible if a nurse can effectively understand how the environment and the sender-receiver relationship affects the therapeutic relationship (Communication theory and its applications in nursing and healthcare, no date).

There are several theories of communication applicable to the nursing profession. One of them is Peplau’s Interpersonal Relationships Theory, which takes into account the environment, attitudes and beliefs shaped by a person’s culture as the factors that influence the nurse-client relationship (Blaszko Helming et al., 2021; Thomas, 2019). Hence, according to this approach, nurses should understand the complex factors that impact their communication with a patient. For example, in the NMC film, the patient is an older man who states that he does not want to burden anyone (If you don’t do something… NMC, 2017). However, his basic needs are overlooked since he repeatedly asks for glasses and does not receive them.

Following Peplau’s theory, one can assume that nurses in this care facility overlook the fact that older adults are burdened by negative feelings and do not want to trouble others, which may prompt them to overlook some of their needs or not state them clearly. Peplau developed three nurse-client communication stages: orientation, identification, exploitation and resolution (Brown et al.; Thomas, 2019; Sundqvist, 2018). If the nurses assessed the man’s needs during the orientation phase, mainly because he has bad eyesight and needs glasses to perform his daily activities, it would be easier for them to understand his needs during the identification and subsequent phases. Therefore, Peplau’s theory is one example of how communication and advocacy are linked because, without adequate identification of needs, nurses may fail to advocate for their patients.

NMC Safeguarding Film

NMC’s film under review is about using three scenarios that healthcare professionals may face in their practice. The first scenario is about an older adult placed in a care facility who faces neglect from the staff (If you don’t do something… NMC, 2017). The communication strategy used by NMC in its Safeguarding film is negative because this approach helps support the urgency of the advocacy problem and show the distress the patient feels if his needs are unmet (Bola-Arotiowa, 2020; Peate, 2019). The main messaged is ‘If you don’t do something, who will?’, which aims to encouraged people to report cases of abuse and mistreatment.

The NMC’s film is an example of a negative communication strategy, and it shows the negative effect that neglect and mistreatment have on an elderly patient. This video shows a patient in distress, and the goal is to show the nurses, who are the target audience, the negative effect that neglect has on the individuals in care facilities. Hence, the negative communication strategy is justified here because the mental health consequences of neglect are severe, and it is vital for NMC to highlight this problem. If a positive communication strategy was chosen, the NMC could show a happy elderly patient in a care facility, who communicates with the staff and receives adequate care, but the message of this campaign ‘If you don’t do something, who will?’ would be perceived as less serious (If you don’t do something… NMC, 2017).

Conclusion

In summary, this paper assesses the importance of nurse advocacy and communication strategies using a case study scenario by NMC. In the first part of the video by NMC, a man in an elderly care facility asks for glasses, but nurses ignore his needs. From an advocacy viewpoint, this is a severe violation of the NMC’s standards of practice, which require nurses to assess and advocate for their patient’s needs, both physiological and psychological. This video is an example of a negative communication strategy, which is used to emphasise the message of the campaign. Hence, the NMC’s scenario supports advocacy by showing a common issue in an elderly care facility and emphasising the distress that the patient feels. Moreover, this film shows the importance of the potential need to be aware of advocacy issues as patients do not always explain or justify their needs. Peplau’s theory of communication offers four steps of communication and can be used to develop a therapeutic relationship, values and attitudes.

Reference list

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Nsiah, C., Siakwa, M. and Ninnoni, J. (2019) Registered Nurses’ description of patient advocacy in the clinical setting’, Nursing Open, 6(3), pp. 1124-1132.

Nursing & Midwifery Council (NMC) (2015) The Code. Web.

Peate, I. (2019) Fundamentals of assessment and care planning for nurses. New Jersey, USA: John Wiley & Sons.

Prestia, A. and Dyess, S. (2020) ‘Losing sight: the importance of nurse leaders’ maintaining patient and staff advocacy’, Nurse Leader, 18(4), pp. 329-332.

Regis College (no date) ‘Helping hands, helping voices: examples of patient advocacy in nursing.’Regis College Blog. Web.

Smith, L. and Lee. M. (2017) ‘Patient advocacy: breaking down barriers and challenging decisions’. Nursing Times, Web.

Sundqvist, A. et al. (2018) ‘Protective nursing advocacy: translation and psychometric evaluation of an instrument and a descriptive study of Swedish registered nurse anesthetists’ beliefs and actions’, Journal of PeriAnesthesia Nursing, 33(1), pp. 58-68.

Thomas, A. (2019) Communicate. Care. Cure. (3rd edn.). Gurgaon, India: Walters Kluwer Health.