Advocacy in Nursing: Resources for Nurse Practitioners

As frontline, patient-facing health care professionals, nurses play a vital role in advocating for patients. Advocacy can range from guiding patients in navigating a complex health care system and translating medical terms to helping them make informed decisions about their health. Nurses also can push for policies inside health care settings that improve patient outcomes.

Advocacy in nursing also can involve promoting ideas and policies that benefit colleagues and the nursing profession. For example, a nurse can advocate for a safe, healthy work environment for health care professionals in hospitals.

Nursing advocacy isn’t limited to hospitals. Nurses willing to work directly with policymakers at the local, state, and federal levels can take political action for their communities. They can support initiatives to reduce health inequities, malnutrition, and domestic violence.

This guide highlights the importance of nurses supporting their patients and fellow nurses and standing up for professional nursing standards.

What Is Advocacy Work in Nursing?

Advocating for patient health is inherent in nursing roles. In essence, all nurses are patient advocates. Nursing: Scope and Standards of Practice, Fourth Edition describes the new advocacy standard — of individuals, families, groups, and communities —as a measure of performance in nursing. The American Nurses Association (ANA) describes Nursing: Scope and Standards of Practice, Fourth Edition, as a guide that provides “authoritative statements of the actions and behaviors that all registered nurses are expected to competently perform, regardless of role, population, specialty, and setting.”

An example highlighting the importance of patient advocacy includes a patient case of passive acceptance. None of the nurses providing care acted on abnormal but mild signs of a health anomaly with a patient that was present over many shifts. This describes a case of passive acceptance. A nurse could have advocated for the patient to begin an investigation into the cause of the anomaly to provide better care for the patient.

In defining what advocacy in nursing is and explaining who benefits from it, it is important to highlight three components of nursing advocacy:

Nurse Advocacy for Patients

Nurse advocacy for patients can be informal, but some individuals serve in formal nurse advocacy roles. Nurses serving in these distinct positions have the clinical background of a typical nurse. Still, their primary focus is on defending patients’ rights, ensuring that patients receive high-quality care, serving as liaisons between patients and physicians, listening to patients’ concerns and grievances, connecting patients with resources, and helping patients and families deal with insurance companies.

Nurse Advocacy for the Nursing Profession

In health care organizations, employees can complete surveys to share important information about workplace improvements. Organizational leaders and human resources departments largely drive these employee surveys, rather than nurses working at patients’ bedsides. Nurse advocates can employ other strategies, such as forums or town halls, to focus more on the issues that nurses face daily, both inside and outside hospitals. These issues can include safe and fair working conditions, adequate pay and compensation, and inclusion in policy and practice decision-making.

Nurse Advocacy for the Community

Some nurse advocates represent voices in their communities. They focus on ensuring the well-being of their communities by promoting an equitable, well-functioning health care infrastructure. Nurse advocates can use their expertise to inform and educate people about wellness and lend a hand in building a healthy, robust community.

Resources

The following links provide examples of advocacy work in the nursing field:

• 10 Nurse Advocacies and Campaigns You Need to Know, Nurselabs: Highlights of nurse advocacy groups and campaigns.
• Nursing Advocacy Beyond the Bedside, Wolters Kluwer: Examples for nurses about advocating for patients, the profession, and themselves.
• Patient Advocacy: 5 Ways to Advocate for Your Patients, Onward Healthcare: Strategies for nurses to promote advocacy.
• Registered Nurses’ Description of Patient Advocacy in the Clinical Setting, Wiley Online Library: An investigation of patient advocacy and its positive impact on delivering quality patient care.

How Does Advocacy in Nursing Benefit Patients?

Every nurse must adhere to ANA’s Code of Ethics for Nurses, which highlights the importance of respecting, honoring, protecting, and providing safe environments for patients. The ability to mediate, educate, and communicate with patients is critical for nurses. All of these elements are foundational to nurse advocacy, which provides a myriad of benefits to patients.

How does advocacy in nursing benefit patients? Nurses can use the following strategies to help advocate for patients:

• Treating patients with respect. When communicating with patients, it is important to have an open dialogue. By respecting them, including and not talking down to them, nurses help build trust.
• Honoring patients’ wishes. It is a nurse’s job to help patients get better. However, nurses must also abide by a patient’s wish regarding health care choices.
• Protecting patients’ rights. As an ethical principle, patients have a right to fair treatment. Nurses help ensure that their patients receive equal care and fair treatment, regardless of race, ethnicity, gender, language, religion, etc.
• Keeping patients safe. Nurses ensure that patients receive the right doses of doctor-prescribed medicines and that room environments are secure.
• Mediating conversations between patients and physicians. Patients may not have a clear understanding of what physicians are saying. Physicians also sometimes need help understanding patient concerns, due to time factors, language/cultural barriers, or other circumstances. Nurses serve as the go-betweens to ensure clinical accuracy and help address patient needs.
• Educating patients about disease treatment and prevention, and healthy lifestyles. With their clinical knowledge and experience treating patients with all types of conditions, nurses can help patients understand the importance of choosing healthy habits for better health, including taking medicine as directed and having a healthy diet.
• Communicating with patients’ families and the health care team. A nurse should understand the concerns of both patients and their families and relay those concerns to members of the patients’ health care team. In interdisciplinary health care settings, it also is important to coordinate care with team members, which helps reduce patient stress and lead to better outcomes.
• Advocating for health policy changes. Nurses are the health care practitioners who patients interact with most, and as such, they can understand what patients need and deserve. This may mean challenging higher authorities to implement policies that help patients.

Nurses tend to advocate for patients before themselves. However, nurses should find opportunities to advocate for themselves by participating in nursing mentorships, which can help them acquire critical skills.

Nurses are ideal spokespeople for their field. They can advocate for the nursing profession by joining committees that influence policy and practice and by becoming active in professional nursing associations, such as the American Hospital Association, which has published its 2021 AHA Advocacy Agenda. The American Nurses Association (ANA) is another example of a nursing association that nurses can join.

Resources

The following resources include research, data, examples, and other information about how nursing advocacy benefits patients and why it’s important in health care: 

• Patient Advocacy in Nursing: A Concept Analysis, SAGE Journals: A research-based analysis of patient advocacy in nursing.
• The New Nurse Advocacy Standard: What Nurses Need to Know, American Mobile: What does ANA’s new Nursing: Scope and Standards of Practice, Fourth Edition, mean for nurse advocacy. Learn more about the new standard in this resource.
• Nurse Advocacy: Adopting a Health in All Policies Approach, American Nurses Association: A discussion of the benefits of nurse advocacy for achieving health equity, particularly in relation to poor and disadvantaged populations.
• Nursing Advocacy, National Center for Biotechnology Information: A highlight of the importance of nursing self-advocacy and an investigation of the ways to promote it.

What Roles Do Nurse Lobbyists Play in Advocating for the Profession?

Professional lobbyists do various policy-related tasks, such as meeting with members of Congress or helping draft legislation. They receive payments from special interest groups, corporate clients, or others. Lobbyists must register with the federal government to do their job.

In the nursing field are a group of professionals known as nurse lobbyists, or health policy Analysts/lobbyists. These professionals promote advocacy in nursing on a large scale by combining their knowledge of health, health care, and the nursing profession with their policymaking, legislative, and communication skills to influence decisions from officials and lawmakers in local, state, and federal governments.

Policy Advocacy

Nursing associations and other health care organizations employ lobbyists who communicate professional concerns, provide relevant data, and represent community concerns to lawmakers. Such policy advocacy helps shape health care legislation. Political and social issues that nurse lobbyists advocate for include:

• The nursing shortage. Nurse lobbyists can help legislators understand the nursing shortage, including its implications on the health outcomes of patients.
• Ensuring adequate nurse staffing. For all nurses to deliver safe, quality care, the health care setting must have proper nursing staff.
• Inequities in the provision of health care. Nurses are mindful of how health inequity affects groups — ethnic minorities, immigrants, and low-income individuals, for example — from receiving the care they deserve. Legislators need help to understand how it impacts nurses and the general population.
• Prevention of gun violence. Guns can have detrimental health effects on people. In the case of domestic violence or youth violence, the effects can spill over into health care settings, affecting nurses and patient outcomes.
• Health care workplace health and safety. Nurses can face insults or even violence from uncooperative patients and their families. To ensure health outcomes for every patient, nurses must feel safe in their work setting.
• Environmental health. Patients with all types of infectious diseases receive hospital care. Improving health care settings through building upgrades and modernization can help create healthier environments.

Resources

The following resources highlight how nurse lobbyists can affect legislation and policy by promoting the nursing profession and the patients’ rights to quality health care:

• Nurses as Self-Styled Lobbyists and Advocates, Ausmed: Explanation of nurse lobbying or advocacy and steps that nurses can take.
• Nurses: How to Advocate for Federal Policy Change, Campaign for Action: Advice for nurses and professional nursing organizations interested in expanding their efforts.
• Policy & Advocacy News, American Academy of Nursing: Examples of how the American Academy of Nursing serves the public and the nursing profession through nursing advocacy.
• Federal Issues, American Nurses Association: A summary of how ANA advances the nursing profession and improves health and health care through advocacy.

Advocacy as the First Line of Defense for Nurses and Their Patients

Through their clinical and nursing training, nurses can help improve outcomes at patients’ bedsides. The nursing profession has an increasing need for effective advocacy. Advocacy in nursing represents the interests of patients and promotes their health. After all, nurses have a professional and ethical duty to care for the patients in their care.

Nurse advocacy is also about letting decision-makers know what nurses need to succeed in their roles and about helping communities prosper. By joining nursing associations and participating in advocacy activities, nurses have a positive impact on the lives of patients. They can also serve families, peers, and communities in a greater capacity.