[lady_chrome1]

Hello there:

I am a final semester nursing student who is to graduate in April. I have to give a speech this Friday for the ALPNA convention about what it means for the LPN to be a patient advocate.
We just touched over the subject of being a patient advocate but did not really go into depth of how to be and what exactly it means. I know that it is going to mean something different for every nurse out there.
Can I get input from all the nurses about this subject so that I can have some ideas of how to make this speech great?

Thanks
Lola Gifford

[Jules A]

Hi Lola,
To me being a patient advocate is such a basic nursing duty, whether someone is a RN or LPN, that I would probably just add a couple of personal instances where you found something that your client needed extra assistance with and describe how you went that extra mile to ensure the best care for them. Good luck! Jules

[Apollosn]

I think "nurse" and "advocate" go together like peanut butter and jelly (without any allergies, of course :P). You can have one without the other, but they sure do best together!

[june2009]

I guess I'm a little late with this response but I just wanted to add my two cents. I am an LPN and I have found that my biggest passion as far as advocacy goes in in the elderly. I have worked LTC and LTAC my entire career and have found the the elderly are really screwed in this country.
I live near Pittsburgh, PA, where pretty much the only place an LPN can get hired is in LTC. Since, in my area, a huge percentage of elderly long-term-care residents are dependent on LPNs to speak for them when they cannot.
I believe the elderly to be very undermedicated for pain. I'm sorry but when you have an 80 year old woman with rheumationd arthritis so bad that she has deformitie of her hands and other parts of her body, tylenol arthritis just isn't going to cut it. They are frequently not allowed to die with the dignity and comfort that they have stated in a living will that they wish to die with. I have seen feeding tubes and ventilators on people who have living wills stating that they do not want anything to prolong their life when they are in a terminal state. Sometimes, the elderly just decide that it is their time to die. They will stop eating, drinking, and taking their meds. their activity level decreases and they become more withdrawn. So, after it is decided that the cause is not physiological, the person gets a lovely feeding tube and lives on for another 5 years or however long. It is the LPNs job (and RNs too) to show the MD and patient's family the living will and to say "this is not what the patient wants.
When death is approacing, it is the job of the nurse to ask the doc for a morphine gtt or whatever comfort measures are used at your facility.
Also, I can't tell you how many patients I've seen hospitalized because they could not afford their medications, and cannot afford to eat the right kinds of foods. They are frequently elderly patients, living on a fixed income of social security, and who have a limit to the amount of money medicare/security blue will pay towards their copays. It is the nurses job to say to the physician "hey, this abilify (or whatever) is $400 for a 30 day supply. we need to give this patient some samples or can you prescribe something else that is less expensive.
Please, I'm not trying to start a debate or anything, I just want you to know that LPNs in my area are the ones who work with the elderly the most (in nursing homes and doctors offices). But all nurses everywhere need to advocate for all their patients. I'm sure these issues happen with all different age groups and populations, I was just citing a few of my own personal experiences. Thanks for taking the time to listen.

Michelle

[CITCAT]

You are the lady with the lamp,the one who comforts the downhearted,disenfanchised,the one who is the protector of the innocents,the ones who cannot speak for themselves,the sentinel of the elderly,the guardian angel of hope to the hopeless,The archangel of the challenge to those under your charge to do good.The mediator between angry guiltridden imperfect humans, You are the still voice in the day or night You are the lady with the lamp

[pagandeva2000]

Advocating for your patients means to inform the team of your findings and your thoughts, allowing them dignity, checking for their safety in all domains that you are responsible for. Checking medication dosages, comfort, safety in transferring and reporting your observations through the proper channels are some.

I also believe that you should continue to read journals and updates to improve your practice. It is very important to be up to date with new information to share with others. Knowing the disease processes, cardinal signs and more subtle signs as well, because you cannot advocate if you do not comprehend. Keep your practice safe and develop your standards, in spite of the madness. It takes time...I am still learning, myself.