How do you get it through nurses heads that we MUST be patient advocates?

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Sigh.......any suggestions?

Specializes in Med-Surg, Geriatric, Behavioral Health.

Vicky RN, I am so glad we have you, an active nurse educator with us and on the board.

Your posts are very timely and helpful.

Wolfy

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Specializes in Gerontological, cardiac, med-surg, peds.
Vicky RN, I am so glad we have you, an active nurse educator with us and on the board.

Your posts are very timely and helpful.

Wolfy

Thank you very much :) And I feel the same way about your postings.

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I am not in management. I am a nurse of over 22 years. I just see newer nurses almost afraid of "standing up" to doctors for example. I do not mean being disrespectful. I mean speaking up when they know they are right. Do people see us as being a "*****" ? I try to be assertive rather than aggresive.

I 100% agree about teaching through example!

Some are never going to be able to "stand up" to docs.It's just not in their personalities. Some experienced nurses cannot, either. You either have it or you don't, sad to say..........

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Some are never going to be able to "stand up" to docs.It's just not in their personalities. Some experienced nurses cannot, either. You either have it or you don't, sad to say..........

i find it interesting that you're the first poster to mention this.

advocacy was drilled into our nsg curriculum when i went to school.

but i think the bottom line is either you have the personality to assert/advocate for your patients, or you don't.

and i've worked with too many nurses that don't advocate, just keep their heads buried in the sand.

part of it is learned, part of it is personality and i think part of it is inherent; meaning that it's something that doesn't have to be taught- that you understand that you are there for your patients and to protect them to the best of your ability.

you can teach someone until you're blue in the face.

but ultimately it's up to the person on whether they will utilize what they've been taught.

leslie

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yes, I agree...You either have it or you don't. Its basically placing your patient before yourself. Telling a patient you will do all you can to help them, and then acting on it.

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If you don't have it to begin with, I am proof that you can learn to put on the act. :) I learned by example from someone who is very good at being a patient advocate and whenever I have to, I just pretend I am that nurse. Works like a charm.

Now if I can just learn to be that assertive when I'm dating...

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Specializes in Med-Surg.

Vicky, I agree with Wolfy, excellent post. (I might have to save this thread because your post might be a good topic for a future paper. hmmmm..............)

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Specializes in Med-Surg.

Chris, you bring up an interesting point. Patient advocacy for a patient outside of your assignment. We had a trauma patient admitted with ortho injuries. About an hour after admission they noticed he had no pain medicine ordered. The nurse said "I can't call dr. so and so because he'll yell at me, that he doesn't give drunk patients pain medicine....". Me of course, not being able to keep my two cents out of it "the etoh has wear off sooner or later and he's in pain, you have to address that...." Nurse "but I'll get yelled at...." Me...."so??????". She did call, but it the doc never called back after an hour.

Conincidentally, the Supervisor, who is an RN, comes by and says "try not to bother Dr. so and so tonight unless you absolutely have to, he's had a busy night in trauma and is in a bad mood." Me..."I never, call an MD unless I absolutely have to, but I will call if my patient needs it...for instance so and so patient is in pain and waiting....". We ened up calling the ortho doc in consult at 3am and getting the patient pain medicine which by then he was crying in pain.

I'm so frustrated by night nurses who don't want to bother a doc because they are afraid to get yelled at, or the supervisor having the nerve to say don't bother him he's in a bad mood. What the heck is that about?

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Specializes in PICU, Nurse Educator, Clinical Research.
I agree. There is a big difference between being assertive in a respectful way, and being a witch or a jerk to get your point across. Some nurses and doctors believe that being assertive means being aggressive or abrasive. Talking to someone in a respectful manner does not make a person "weak", it conveys a message that "I am willing to work with you to make sure we meet in the middle and that the patient best interests are # 1 "...

the charge nurse I worked with today said to our attending, 'well, here at hospital x, we get our points accross by yelling'. I'd like to say he was kidding, but he's barked orders at everyone on the unit. he prides himself on being a patient advocate, but most of his patients are afraid of him because he's *so* abrasive.

the old adage about catching more flies with honey than with vinegar is true here, as it is in most places.

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Sigh.......any suggestions?

I must say I have gotten into hot water many many times in my nursing life and it was always worth it in the end to be a patient advocate. I can sleep well knowing I did the right thing, opened my mouth and stood up for what I knew was right even if it got me fired and it did. I say you can never go wrong if you speak for your patient to protect or defend from harm. In this day and age of terrible lack of caring and greed with hospitals turned into businesses instead of what they were meant to be. I feel it is very important to advocate and make it a part of your documentation to "seal the deal'. I have used this to get better care more than once....call a doctor for orders and get hung up on or given a bad order---what do you do? Call back and tell the doctor you are writing his words and actions in the chart. It did not win me any popularity contests but it worked to get the patient care needed. It is used everyday in my documentation as a Case Manager for elderly and disabled who have problems voicing needs in the complicated systems of Medicare and Medicaid. Getting the medications they need is always a challenge in limited programs that will pay for some brand names, the rest in generics with rules for prior authorization that are even difficult for nurses to unravel. Shoot, I had trouble getting a med paid for myself and had to advocate for me. The "doubletalk" I got from a pharmacy tech made my blood pressure go up. I feel sorry for anyone trying to get healthcare these days.

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Thank you one and all for your opinions. Thank you Vicky for the references!

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Lesson

Arrogant world famous MD violates patient human rights.

Unit boss and 5 of 6 nurses sign written statements of regarding unethical behavior of MD.

Hospital greivance committee cuts world famous MD hospital privileges.

Unit boss pressured out of job.

4 nurses no longer employed at that unit after 6 months

MD privileges returned

test question

was it worth it.

answer...no

moral

patient advocacy is myth created by nurses who wish they were doctors but were unable or unwilling to pay the price for the power.

we were right and the hospital agreed but we are the unemployed ones.

so just follow your orders and keep your opinions to yourself....that is our role.

if you want to be more than that then go to medical school and earn the power.

as far as waking up a mad doctor for pain meds...that not patient advocacy thats just nursing.

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