Empowerment as an alternative to traditional patient advocacy roles

Abstract

There has long been acceptance within healthcare that one of the roles that nurses fulfil is to do with patient advocacy. This has historically been positioned as part of the philosophical and inherent requirements of the nursing profession at large and is supported through shared conceptualisations of the nursing profession. Such conceptualisations are communicated to nursing professionals by way of first their education, and second their professional codes, guidelines and standards for practice. The focus on advocacy is further embedded within patient-centred care frameworks and concepts of the nurse–patient therapeutic relationship. Nurses have also been considered ideally placed to undertake the work of patient advocacy due to the 24/7 nature and intimacy of the care provided. What this means is that nurses are under the impression that that they must be an advocate for their patients through their nursing practice. However, for a fundamental concept of nursing, advocacy is poorly defined, and practices commonly associated with advocacy are undercut by the professionalisation of nursing and other constraints. In addition, nursing standards and frameworks of care are being actively reframed around ideas of empowerment which do not necessarily fit well with those of advocacy. This article thus suggests that it is time to recognise that the work of advocacy is no longer representative of what nurses (can) do in practice, and to explicitly reorient conceptualisations of nurse practice around empowerment. This article will further analyse what this may look like in practice.