Tuesday, September 6, 2011

A Nurse or an Advocate?

Is a Nurse an Advocate?
Working with a small group of nurses who would soon become patient’s advocates was an eye opening experience. For years nurses have called themselves the patient’s advocate, but in actuality, they are the patient’s nurse.  They may offer medical care, information, comfort and advice but that’s what a nurse does.  An advocate is the person who makes sure all that happens – correctly and in a timely manner.   I learned, at this recent training session that many nurses have been taught at a very early age to be respectful of the doctor.  When in the hospital, some nurses won’t speak up to the doctor when something doesn’t seem right.  This confirms why I have heard many times over the years that nurses are the ones who tell the family when a patient died or was injured because of the care received. 
Nurses will always say that they are the patient’s advocate.  And, in many ways that’s true.  But the nurse can’t possibly stay at the patient’s bedside or pay attention to only one patient as an actual advocate will do.  Nurses are often shuffling the responsibility of more than one patient, sometimes as many as ten, and that itself is a good opportunity for an error.
If you can bring an advocate, better that they are trained, but they should have only one patient and should be an extension of your care and be able to stand up to any doctor on your behalf.

Monday, September 5, 2011

The Advocate's Training

The Advocate's Role in Communication

I just read on a website that is offering patient advocate training that the participant will learn, among other things for the fee of $795.00 to “Interpret medical jargon, diagnosis and treatment to the patient and family when appropriate”.
In the advocacy training offered by PULSE of NY we dispute the role of the advocate to ‘interpret” medical information to the patient.  If the patient or family does not understand the information being given, the advocate’s role is to make sure the patient does – by having the doctor or other medical professional repeat it, or rephrase the information.
Another area, that this advocate will be trained in for this fee is “Explain various diagnostic tests, treatments and medications”.  This too is dangerous water for an advocate to be wading in. 
A patient’s advocate should not be interpreting or translating for the healthcare provider, they should be the bridge connecting the relationship and strengthening it.  Another professional, such as an advocate willing to take over for the doctor or medical professional can become complicated and there is danger of giving or getting misinformation.  An advocate should never tell the patient “I will explain it to you”.  They should absolutely be encouraging the medical professional to help the patient understand.    In the healthcare system there are people who have roles to help the patient and family understand the appropriate services, and their rights.  The advocate’s role should be to make sure they are doing their job.  Not doing their job for them.
The pharmacist, nurse or physician can answer questions about medication, the advocate should not.  Making sure the patient is getting the proper and agreed upon medication is the role of the advocate.  The advocate should not be getting information without the patient’s approval, nor can they speak for the patient if there is not written consent.  Too often a nurse at the bedside will assume that the advocate knows the patients history.  They may not and the advocate needs to know early on what their role will be to protect themselves and the patient what their role is not.
To sign up for the PULSE Patient Safety Advocate course go to PULSE of NY Family Centered Patient Advocacy Training.