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WHAT is patient advocacy? Is it a nurse running down the hall to grab a physician who was unaware of a family in need of information? Is it the nurse in every family telling Aunt Mary which gastroenterologist that she should or should not go to? Is it the CNO implementing a patient safety program? Is it the hospital's board of directors endorsing a zero-tolerance policy for disruptive physician behavior? All of these examples tie in some way to the role of a patient advocate in its broadest definition. However, these examples, often referred to as exemplary acts, suggest the need for the role of the nurse as patient advocate to be framed as a formal expectation, not an act "above and beyond the call of duty." Like any performance expectation, the knowledge, skills, tools, and environment to fulfill a particular expectation must be present for a professional to succeed.
Historical Perspective Se Conceptual Discourse
What is patient advocacy from a philosophical or ethical perspective? In the nursing literature, Maggie Mallik and others discuss the evolution of the concept of patient advocacy (Mallik, 1997a, 1997b, 1998; Mallik & Rafferty, 2000). They offer philosophical and conceptual ways to consider the role and wrestle with the ethical and professional implications for the role. Interestingly, Mallik noted that the formal role of nurses as patient advocates did not appear in the United States nursing literature until the 1970s. While there is no reason to doubt her bibliometric analysis, Florence Nightingale seemed quite clear on her role has patient advocate, nearly to a paternalistic extreme, in Notes on Nursing. Her rigid approach to managing the care and environment for patients certainly implied an underlying fervor, the likes of patient advocacy.
The philosophical debate around the role of nurses as patient advocates continues in the literature. While the term patient advocacy is considered a buzzword by many, the need can also be described as a commitment to uncompromised professional practice. Mallik described the roots and use of the word forms of advocate. The Latin meaning is "to call," while the legal use of the word is "to plead" or "to counsel." Counseling or educating is certainly a commonly described nursing role in the definition of patient advocate. Mallik also draws...