Chapter 6: Patient, Subordinate, Workplace, and Professional Advocacy

Question 1

Principles of Advocacy #1

What does it involve?

Answer 1

Involves helping others to grow and self-actualize

Question 2

Principles of Advocacy #1

How is it defined?

Answer 2

Defined as protecting and defending what one believes in for both self and others

Question 3

Principles of Advocacy #1

What are the actions of an advocate?

Answer 3

The actions of an advocate are to inform others of their rights and to be sure they have adequate information on which to base their decisions

Question 4

Principles of Advocacy #2

Who are nurses advocating for?

Answer 4

Nurses must advocate for themselves, clients, subordinates, and their profession.

Question 5

Principles of Advocacy #2

What are nurses ‘balancing’ as advocates?

Answer 5

Balance the need to advocate for several different individuals, groups, and organizations

Question 6

How Nurses Can Act as Advocates?

Answer 6

The nurse advocate informs others of their rights and makes certain they have sufficient information to make decisions.

Question 7

How Nurses Can Act as Advocates:

What do nurse advocates help others with?

Answer 7

Helping others make informed decisions

Question 8

How Nurses Can Act as Advocates:

What do nurse advocates act as in the environment?

Answer 8

Acting as intermediaries in the environment

Question 9

How Nurses Can Act as Advocates:

What else do nurse advocates do?

Answer 9

Directly intervening on behalf of others

Question 10

How Nurses Can Act as Advocates:

What else do nurse advocates advocate for?

Answer 10

Advocating for social justice

Question 11

Controlling Patient Choices Versus Assisting Patient Choices

What is important for the patient advocate to differentiate between?

Answer 11

It is important for the patient advocate to be able to differentiate between controlling patient choices (domination and dependence) and assisting patient choices (allowing freedom).

Question 12

Being a client of the health-care system increase the need for advocacy due to:

Answer 12

Decreased independence

Loss of physical freedom

Interference with the ability to make choices autonomously

Increased vulnerability due to impaired communication

Question 13

Common Areas Requiring Nurse–Patient Advocacy #1

Answer 13

End-of-life decisions

Aging populations

Technological advances

Access to health care

Provider–patient
conflicts

Withholding of information

Insurance authorization

Health-care reimbursement

Transitions in health care

Question 14

Common Areas Requiring Nurse–Patient Advocacy #2

Answer 14

*Provider-patient conflicts regarding expectations and desired outcomes

*Withholding of information or blatant lying to patients

*Insurance authorizations, denials, and delays in coverage

*Medical errors

*Patient information disclosure (privacy and confidentiality)

*Patient grievance and appeals processes

*Respect for patient dignity

*Inadequate consents

*Incompetent health care providers

*Complex social problems including AIDs, teenage pregnancy, violence, and poverty

Question 15

Common Areas Requiring Nurse–Patient Advocacy #3

What can be used to guide professional practice?

Answer 15

Since the 1960s, some advocacy groups, professional associations, and states have passed Bills of Rights for patients. Although not legally binding, they can be used to guide professional practice.

Question 16

Patient Rights #1

1998?

Answer 16

1998 Patient’s Bill of Rights (=Consumer Bill of Rights and Responsibilities)

Question 17

Patient Rights #1

1998 Patient’s Bill of Rights (=Consumer Bill of Rights and Responsibilities)

What does it help with?

Answer 17

Helps patients feel comfortable in the US health- care system

Question 18

Patient Rights #1

1998 Patient’s Bill of Rights (=Consumer Bill of Rights and Responsibilities)

What does it stress?

Answer 18

Stresses strong patient–provider relationship

Stresses key role patients play in staying healthy

Question 19

Patient Rights #1

2010?

Answer 19

2010 Affordable Care Act:

Question 20

Patient Rights #1

2010 Affordable Care Act:

Answer 20

Gives patients protection in dealing with insurance companies

Question 21

Patient Rights #1

The provisions of the Patient’s Bill of Rights are threefold:

Answer 21

(a)to help patients feel more confident in the US health-care system,

(b) to stress the importance of a strong relationship between patients and their health-care providers, and

(c) to stress the key role patients play in staying healthy by laying out rights and responsibilities for all patients and health-care providers.

Question 22

Patient Rights #2

What does the philosophy of person- and family centered care suggest?

Answer 22

The philosophy of person- and family-centered care suggests that care should be organized first and foremost around the needs of patients and family members.

Question 23

Patient Rights #2

What is a key factor in advocating for clients and families in the healthcare system?

Answer 23

Engagement has been identified as a key factor in advocating for clients and families when they are in the health-care system

Question 24

Patient Rights #2

The philosophy of person- and family-centered care, what does this do for the patient experience?

Answer 24

Thus, this approach to care humanizes, personalizes, and demystifies the patient experience.

Question 25

Patient Rights #2

The National Right to Die Movement;
Who does this apply to?

Answer 25

Typically, right to die laws apply only to patients who are at least 18 years old, with the capacity to make medical decisions, with a terminal disease expected to result in death within 6 months.

Question 26

Subordinate Advocacy

What should nurse administrators advocate for?

Answer 26

Nurse administrators should advocate for other health-care providers (including subordinates) as well as patients, especially when this is related to health and safety.

Question 27

Subordinate Advocacy

What is an example of a nurse manager doing subordinate advocacy for nurses on the floor?

Answer 27

Subordinate Advocacy by a nurse manager for nurses working on the floor, example: creating workable schedules, and including nurses in the decision-making process

Question 28

Workplace Advocacy

When does workplace advocacy occur?

Answer 28

Workplace advocacy occurs when the manager assures the work environment is both safe and conducive to professional and personal growth for subordinates.

Question 29

Workplace Advocacy

What is an example of workplace advocacy?

Answer 29

example: preventing violence, promoting safety

Question 30

Internal Versus External Whistleblowing #1

What is Internal Whistleblowing?

Answer 30

Internal whistleblowing occurs within an organization, reporting up the chain of command.

Question 30

Internal Versus External Whistleblowing #1

What is external whistleblowing?

Answer 30

External whistleblowing involves reporting outside the organization, such as to the media or an elected official.

Question 31

Internal Versus External Whistleblowing #1

What is important for nurses to consider before taking action?

Answer 31

Before taking action, it is important for the nurse to consider the possible ramifications, which could be serious.

This must precede efforts such as hiring a lawyer or contacting the media.

Question 32

Internal Versus External Whistleblowing #1

Depending on the circumstances, what could be done before whistleblowing?

Answer 32

Depending on the circumstances, it may be inadvisable to dialogue with the manager before whistleblowing

Question 33

Internal Versus External Whistleblowing #2

What must nurses do before they can have a major impact on political and legislative outcomes

Answer 33

Nurses must exert their collective influence and make their concerns known to policy makers before they can have a major impact on political and legislative outcomes.

Question 34

Internal Versus External Whistleblowing #2

What must leader-managers be willing to do for whistleblowers?

Answer 34

Leader-managers must be willing to advocate for whistleblowers who speak out about organizational practices that they believe may be harmful or inappropriate.

Question 35

Writing a Letter to a Legislator #1

What kind of letter should you write?
How should you be? How long should the letter be?

Answer 35

Write a personal letter.

Be formal but polite.

The letter should be one page.

Question 36

Writing a Letter to a Legislator #1

How should you address the legislator?

Answer 36

Address the legislator by title.

Question 37

Writing a Letter to a Legislator #1

What should be done early in the letter?

Answer 37

Establish your credibility early in the letter as both a constituent and as a health-care expert.

Question 38

Writing a Letter to a Legislator #1

How are emails viewed?

Answer 38

E-mails are easy to ignore and are less effective than personalized letters

Question 39

Writing a Letter to a Legislator #1

How should you refer to the bill?
What should you state?
What should you offer?

Answer 39

Refer to a specific bill by number.

State your position on the issue.

Offer your assistance as a resource person for additional information.

Question 40

Writing a Letter to a Legislator #1

How should you sign the letter?

Answer 40

Sign the letter, including your name and contact information.

Question 41

Writing a Letter to a Legislator #1

What should you do about legislators who are undecided on an issue?

Answer 41

Be persistent and write repeatedly to legislators who are undecided on an issue.

Question 42

Nurses and the Media

Many nurses avoid media exposure why??

Answer 42

Many nurses avoid media exposure because they believe they lack the expertise or because they lack self-confidence.

Question 43

Nurses and the Media

What should nurses do when it comes to media?

Answer 43

However, nurses should take every opportunity to appear in newspapers and on radio and television.

The public needs and wants to hear from nurses.

Get media training to increase both your skill and self confidence.

Question 44

Nurses and the Media

What do nurses have the potential to do?

Answer 44

Nurses have great potential to educate the public and influence policy through the media as a result of the public’s high trust in nurses and because the public wants to hear about health care issues from a nursing perspective.

Question 45

Tips for Interacting with the Media

Answer 45

1. Limit your key points to two or three and frame them as bullet points.
2. Avoid technical or academic jargon.
3. Introducing statistics that support the key points.
4. Repeating key points several times during the interview.
5. Providing background material related to the key points.