Chapter 6 - Advocacy

end of life decisions, technological advances, access to health, transitions in health care

4 common areas requiring nurse patient advocacy

advocacy

helping others grow and self-actualize; protecting and defending what one believes in for both self and others; informing other of their rights and being sure they have sufficient information on which to base their decisions

safe, conducive, professional, personal, subordinates

in workplace advocacy, the manager works to see that the work environment is both ____________ and _____________ to _______________ and ______________ growth for _______________

external whistleblowing

Involves reporting OUTSIDE the organization such as the media or an elected official; E.g. A health care provider reports inflated practices of documentation and coding that result in elevated cost reimbursement to the media; When an employee discovers organizational misconduct and chooses to bring it to the attention of law enforcement agencies and/or the media.

subordinate advocacy

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

internal whistleblowing

Occurs WITHIN an organization, reporting up the chain of command; This occurs when an employee discovers organizational misconduct and brings it to the attention of a company official, who then follows established procedures to address the misconduct within the organization.

patient protection and affordable care act

a new patient's bill of rights was established to give new patient protections in dealing with insurance companies including elimination of annual and lifetime coverage limits, provided for choice fo physician from a plan's network, allowed children to get health insurance in spite of existing medical conditions, allowed children to stay on parent's policy until age 26, and more

political action committees

groups that attempt to persuade legislators to vote in a particular way; nursing lobbyists in out nation's capital are influencing legislation on quality of care, access to care issues, patient and health worker safety, health-care restructuring, direct reimbursement for advances practice nurses, and funding for nurse education

state level, federal level

advocacy participation can occur on the _____________ such as the CT Nurses Association, or the ________________ such as the ANA, Academy of Medical Surgical nurses

individual

an entry point for user engagement in the health care system - the aim is to increase the skills, knowledge, and understanding of patients and families about what to expect when receiving care

community

an entry point for user engagement in the health care system - the emphasis is to expand the focus beyond the hospital setting and find opportunities to improve overall community health

health care team

an entry point for user engagement in the health care system - the focus is to promote shared understanding of expectations among patients and providers when seeking care

organization

an entry point for user engagement in the health care system - the objective is to encourage partnerships and integrate the patient and family perspective into all aspects of hospital operations

individual, health care team, organization, community

entry points for user engagement in the health care system - 4

controlling patient choices, assisting patient choices, paternalism, autonomy

it is important for the patient advocate to be able to differentiate between ______________________________ and in _____________________________. nurses must be careful not to use ___________________ at the cost of patient _____________________

whistleblowers

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

group

legislators and policy makers are ore willing to deal with nurses in a ___________ rather than as individuals, so join gin and actively supportive professional organizations allow nurses to have a greater voice in health care and professional issues

media, trust

nurses have great potential to educate the public and influence policy though the _____________ as a result of the public's high __________ in nurses and because the public wants to hear about health-care issues from a nursing perspective

helping others make informed decisions, acting as an intermediary in the environment, directly intervening on behalf of others

nurses may act as advocates by - 3

caring, autonomy, respect, empowerment

nursing values central to advocacy emphasize - 4

18, capacity, terminal disease, 6 months

right to die laws apply only to: - patients who are at least ______ y/o - with the __________________ to make medical decisions - with a _________________ expected to result in death within ___________

theory, fact, disloyal

speaking out as a whistleblower is often honored more in __________ than in _________. whistleblowers may be considered _____________ or experience repercussions for their actions, even if it was done for the best intentions

work hours, schedules, staffing, wages, decision-making

subordinates should be able to have the expectation that their - - ________________ and _______________ will be reasonable - _______________ ratios will be adequate to support safe patient care - _____________ will be fair and equitable - nurses will be allowed participation in organizational _____________________

Patient's Bill of Rights

summary of a patient's rights regarding fair treatment and appropriate information INCLUDED THREE KEY GOALS - To help patients feel more confident in the US health care system - to stress the importance of a strong relationship between patients and their health care providers - to stress the key role patients play in staying healthy by laying out rights and responsibilities for all patients and health-care providers

scope and standards of practice, code of ethics

the ANA establishes two things -

take appropriate action, speak up, advocate

the RN is expected to ______________________________________________ regarding instances of illegal, unethical, and inappropriate behavior that can endanger or jeopardize the best interests of the health-care consumer or situation, __________________________ when appropriate to question health-care practice when necessary for safety and quality improvement, and ___________________ for equitable health-care consumer care

workplace advocacy

the manager works to see that the work environment is both safe and conducive to professional and personal growth for subordinates

legally binding

while states have passed patient's bill of rights, they are not _____________________ but re used to guide professional practice

internal, external

whistleblowing should not be considered the first solution to ethically troubling behavior. it should only be considered after other prescribed avenues of solving problems have been attempted. employees should typically use __________ whistleblowing and going up the chain of command in reporting concerns, as opposed to ___________ whistleblowing