Advocacy has been defined as the process of assisting the cause of, speaking or writing in support of, and interceding on behalf of a person or group. (2012) Segens Medical Dictionary Advocacy, according to Segens Medical Dictionary 2012, gives knowledge and serves as a tool to provide self-empowerment for patients’ health and social care, as well as assisting patients in obtaining essential resources.

What Is Advocacy? Concept, Evolution And Barriers Of Advocacy

Advocacy has been defined as the process of assisting the cause of, speaking or writing in support of, and interceding on behalf of a person or group. (2012) Segens Medical Dictionary Advocacy, according to Segens Medical Dictionary 2012, gives knowledge and serves as a tool to provide self-empowerment for patients’ health and social care, as well as assisting patients in obtaining essential resources.

Advocacy’s Evolution

Advocacy is the active support of a cause, and so advocacy may be defined as standing up and speaking up for a moral good, sharing your worries about disadvantaged or vulnerable people, and partnering with individuals or groups who require assistance by exploiting their preferences and rights (Influence through advocacy: Raising awareness, advancing change, 2020).

There has been uncertainty and controversy regarding what the precise definition of advocacy is, owing to a lack of universal agreement that stems from the recent and contentious history of advocacy in the social health care sector, as well as the role of those who work in the sectors as advocates (Advocacy Skills for Health and Social Care Professionals, 2020 Neil Bateman).

According to Negarandeh et al., 2020, advocacy has been a topic of great debate in the nursing profession over the last two decades, and this critical function has been embraced by nurses despite the fact that it is often limited in practice. Patient or nursing advocacy is one of the increased practices that nursing organizations throughout the world have highlighted. This method is a relatively recent concept, yet its origins can be traced back to Florence Nightingale’s time (Shirmohammad Davoodvand, 2020).

Florence Nightingale fought for better hospital conditions for Crimean War victims, as well as greater education for nurses. She advocated for better health care for the sick and vulnerable by influencing government, policymakers, physicians, and donors (influence through advocacy: Raising awareness, advancing change, 2020). Nurses are the major advocates for patients, acting as a link between the patient and the health care system; thus, patient advocacy is seen as one of the most crucial duties of nurses (Shirmohammad Davoodvand, 2020).

Nursing qualities like as problem solving, communication, influence, and teamwork are required to be a successful advocate who promotes a cause or interest on one’s own or on behalf of another (Advocating for Nurses and Nursing, 2020).

Advocacy is important in protecting vulnerable people who have been discriminated against, speaking up for people who are unable to speak for themselves, empowering people by helping them express their own needs and make informed decisions, enabling people to access information, understand their options, and express their views, wishes, and feelings, and finally actively supporting people to make informed choices. (2020)

Shirmohammad Davoodvand, 2020) stated that there are patients or clients who are vulnerable and have suffered varying degrees of harm, and thus there are numerous opportunities for nursing in enforcing patient advocacy, making the nursing profession the most dependable profession in terms of patient advocacy.

According to Voiceability, advocacy plays a crucial role in avoiding abuse by educating individuals about their rights and empowering them to advocate for them. Advocacy is thus critical in detecting and reporting abuse, and those who advocate for people provide a trusted point of contact to divulge allegations of abuse, and thus their presence in hospitals and care homes, as well as their understanding of norms and training, aids in dealing with allegations or observations of abuse.

Advocacy communication

Nurses are community champions as well as communicators and team coordinators, therefore communication skills for nurses are essential. Sibya (2018)

 

Sibiya (2018) defines communication as the exchange of information between people through sending and receiving, which can be accomplished through speaking, writing, or any other medium. According to Sibiya (2018), clear communication allows information to be communicated successfully between people, and communication skills are crucial for nurses to be successful. Furthermore, nurses deal with people from diverse educational, cultural, and socioeconomic backgrounds, and this interaction must be done in an effective, caring, and professional manner, especially when interacting with patients and their families.

According to kourkouta and Papathanasiou 2020, three core abilities are required in communication: communication without words or nonverbal communication, which is a continual process reflected by facial expressions, gestures, postures, and physical barriers such as distance from the speaker. Also, listening is a communication skill that requires concentration of attention and the use of all senses for perception of verbal and nonverbal messages produced by the patient. Finally, personal relations is another foundational skill in communication that is evident by kindness, compassion, and care. Nurses can thus develop good personal relations, which gives nurses the ability to ask questions with kindness and provide information.

Language, psychological, emotional, physical, and cultural barriers, among others, can all obstruct communication, resulting in misunderstanding and failure (Barriers of Communication: Types of Barriers to Effective Communication 2020).

Nurses and nursing staff are at the forefront of communication, so they assess, record, and report on treatment and care; they handle information sensitively and confidentially; they deal with complaints effectively; and they have a duty to report anything that concerns them (Principles of nursing practice). 2020, Royal College of Nursing)

According to the Nursing and Midwifery Council (NMC 2018), nurses must be able to recognize when a person is at risk or need further care and protection, and they must take reasonable action to protect them from abuse. Also, they must employ a variety of communication skills and approaches, including verbal, nonverbal, and written communication, to acquire, interpret, and document their knowledge and understanding of people’s needs, as well as use technology to support person-centered care and improve quality and safety.

According to the Nursing and Midwifery Council (2018), nurses must consider different ways people communicate as well as the ability to recognize and respond effectively when a person finds it difficult to communicate, as well as when language interpretation or other forms of communication support are required and how to obtain the support.

 

Identification Practitioners, such as nurses, can identify and intervene in domestic violence by recognizing the indicators of abuse and providing support and referral for protection as needed. (Domestic Abuse: A Resource for Health Professionals, 2017)

In the scenario in video 2, the nurse was able to recognize certain signs of abuse, such as marks on the patient’s arms, how anxious, afraid, and hesitant she was, and the partner not allowing the patient to speak for herself, all of which are signs of abuse.

 

Responding to Domestic Abuse: A Resource for Health Professionals, 2017 by the Department of Health There are symptoms that can alert health providers that a patient is experiencing domestic violence. Some of them are subtle, so professionals must be on the lookout for them and respond correctly. Some victims may give hints in their contacts with medical personnel, and their actions may also be telling. As a result, the health practitioner must listen, persist, and inquire about the indicators and clues.

Advocacy roadblock

Scenario 2 in the Video A detailed examination of the scene in scenario two reveals some of the fundamental concerns and challenges that nurses face on the job. The nurse encountered two advocacy barriers: language and the presence of a spouse who acted as a communication barrier for successful advocacy being employed by the nurse to protect the patient who may be harmed by her partner.

In my opinion, the nurse should have asked the husband to wait outside so that she could examine the lady further regarding the bruises on her arm and possibly other parts of her body. That would also have given her the opportunity to alert another member of staff to investigate the situation and arrange for an interpreter to provide effective and clear communication between the patient and the nurse.

Beynon et al, 2012 conducted a study on the barriers that healthcare professionals, such as nurses, face when asking about intimate partner violence. Language barriers were commonly described by nurses, and in the second scenario, the nurse was unable to communicate with the lady because she did not speak English and the partner was speaking on her behalf. Partner presence was also seen as a barrier because abusive partners have a tendency to scream.

The patient is subservient or frightened to talk in front of the partner or spouse and always attends appointments unnecessarily The spouse or partner is forceful, dominating, or too attentive, speaking for the patient or refusing to leave the room (, Responding to Domestic Abuse: A Resource for Health Professionals, 2017)

People who insist on accompanying their partners to appointments or speaking for them may appear to be caring and protective, and this may be plausible; however, controlling their partners’ access to the nurse, as depicted in the second scenario, is part of the abuse, and this supports the need for advocacy. Domestic Abuse: A Resource for Health Professionals, 2017.

Because intimate partner violence is common, victims frequently cannot or do not advocate for themselves. As a result, it is up to nurses to be aware of these issues, be familiar with any risk factors, patterns of injury associated with intimate partner violence, and understand how and to whom intimate partner violence should be reported.(2020)

Solution

Healthcare providers, like as nurses, can assist by screening for domestic violence, documenting abuse in the patient medical record, protecting evidence, offering medical advice, referrals, and safety planning, and demonstrating understanding and compassion (Domestic Violence , Sexual violence , intimate partner Violence 20)

Only discuss domestic abuse with a patient when you are alone with them in private; otherwise, ask the escort to wait elsewhere.

Privacy- Only discuss domestic abuse with a patient when you are alone with them in private; otherwise, ask the escort to wait elsewhere.

Using a translator Never utilize a victim’s relative or acquaintance as an interpreter. Always utilize a professional interpreter who has been trained in domestic violence or an advocate from a local specialised domestic abuse service. The interpreter must be the victim’s gender and must sign a confidentiality agreement. Look at your patient and speak to them directly, not to the interpreter.

They require employees to follow up on private conversations, document details of observed and reported behaviors, sentiments, and injuries, and support them in acting in accordance with their organization’s procedures and local pathways (, Responding to Domestic Abuse: A Resource for Health Professionals, 2017)

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