"Weaponized Advocacy"

[Brent Duff]

Throughout my nursing career, I've noticed a phenomenon I call "weaponized advocacy".

Weaponized advocacy happens when someone uses the noble idea of patient advocacy as a mask for self-promotion, sabotage, or shaming colleagues. Instead of improving patient care, it erodes trust, poisons teamwork, and creates a toxic environment.

Imagine a nurse, Becky, caring for a patient who is complaining of pain. At that moment, pain medication is contraindicated because the patient's vital signs are unstable. Giving it could cause serious harm. Becky is appropriately focused on stabilizing the patient first so that the medication can later be given safely.

Then another nurse, Janet, enters the room after seeing the call light. When the patient mentions their pain, Janet tells them they are entitled to pain medication and suggests that Becky is acting inappropriately by "allowing" them to suffer. To the patient, it now appears that Becky is neglecting their needs, while Janet positions herself as the hero.

In reality, Becky is protecting her patient's safety. Janet, missing key information and motivated by self-interest, undermines her colleague to elevate herself. This kind of behavior damages reputations, erodes patient trust, and undermines teamwork. The result is a fractured care environment where the nurse doing the right thing looks like the antagonist, while the one acting with selfish motives appears to be the advocate.

Weaponized advocacy is not about protecting patients—it is about advancing oneself by tearing others down. It thrives on undermining colleagues in front of patients and families, creating the illusion of superior advocacy while actually destabilizing care. Healthcare is a team effort. Yes, true neglect must be called out and corrected. But this is something different. This is advocacy with dark motives, dressed up to look virtuous, while in reality it sabotages both caregivers and patients.

If you have been in healthcare long enough, you will likely witness weaponized advocacy. And when you do, you'll recognize that it has nothing to do with patient safety and everything to do with someone trying to stand taller by standing on someone else.

Note: I have a great team of coworkers in my unit. So don't try to read into this. We have a great team that is free of this toxic behavior. 
I was just thinking about this and felt the need to talk about it, because I've seen it happen to outstanding nurses and have experienced it myself no matter what hospital.

Has this ever happened to you?