SPN NEWS Column Editor: Jeannie Rodriguez RN, MSN, C-PNP/PC
Pediatric Nurses as Advocates Yvonne M. Sterling PhD, RN, AE-C* SPN Child Advocacy Committee
Patient advocacy has been an essential role in nursing for many years, but since the 1980s, it has become more of a priority of the profession (Hanks, 2008). An advocate is one who pleads the cause of another and provides a voice for those who are not heard, making sure that important issues are addressed (Mason, Leavitt, & Chaffee, 2012; Sullivan, 2004). Pediatric nurses do this every day when they advocate for family and child needs to be prioritized over hospital routines or school bureaucracies. Intrinsic factors that influence the nurse's advocacy role include one's self-concept and personal values and beliefs. Extrinsic factors are composed of the nurse's work setting and environment, which includes the nurse's relationships with nursing colleagues and other health care professionals. These relationships can have a strong impact on the nurse's advocacy actions (Hanks, 2010). The nurse's advocacy actions can have positive and negative consequences. Advocacy experiences can be rewarding, but can also be frustrating and involve risk. Advocacy is commonly associated with the concept of social justice, which involves activities that address social inequities among individuals and groups. In light of this perspective, there is significant disparity among children in terms of their utilization and access to healthcare. Alarming numbers of children face and endure social conditions and determinants (e.g., poverty, racism, inadequate housing, and lack of resources) that adversely impact their health status and outcomes. Riley and Beal (2010) describe nurses' social justice advocacy actions as one component of service to the public. These researchers found that nurses were involved in various social advocacy activities, including participating in disaster relief efforts, voter registration, and lobbying legislators and public interests groups. Every pediatric nurse can be an advocate if that nurse has the passion for and concern about the well-being of children ⁎ Corresponding author: Yvonne M. Sterling PhD, RN, AE-C. E-mail address: [email protected]
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and has the knowledge and skills to promote the most optimal outcomes for children. Pediatric nurses advocate for children and their families from diverse backgrounds in various ways and in multiple settings as they provide evidenced based care and education to meet their needs. For example, Lauver (2012) provided an overview of the problems associated with natural gas drilling in her state and its effect on the environment and children. Lauver suggested that pediatric nurses should serve as environmental advocates and recommended that pediatric nurses have educational preparation and relevant resources to support this role. May and Bigham (2012) described how a nurse advocated for a child who was to be sent to another facility that would further traumatize his homeless family after the EF4 tornado in Alabama. “Being that I am not afraid to speak my mind and consider myself a strong patient advocate, I looked at him (the physician) and said, oh no, you are not sending him to Children's!” (p. 392). After considering the nurse's strong position, the physician agreed and the child was not transferred. The SPN Child Advocacy Committee is committed to fostering the development of the advocacy role of pediatric nurses through education and support of SPN members. The committee has revised the Advocacy Tool Kit, which provides current information about advocacy. This includes information on key health care policy issues including child health insurance and the Affordable Care Act, selected advocacy, policy, child welfare and family related organizations, and how to communicate with legislators, including sample letters and relevant references. It is hoped that this toolkit can be used to initiate, facilitate, or support your advocacy activities. The toolkit is a work in progress. The updated version will be posted soon on the SPN Web site, www.pedsnurses.org. We welcome your comments and recommendations. We also invite you to submit your advocacy stories to the Child Advocacy Committee for posting in the toolkit. It should describe how you advocated for children/families in your work setting or community.
References Hanks, R. (2010). The medical–surgical nurse perspective of advocate role. Nursing Forum, 45, 98–107. Hanks, R. (2008). The lived experience of nursing advocacy: A descriptive pilot study. Nursing Ethics, 15, 468–477. Lauver, L. (2012). Environmental health advocacy: An overview of natural gas drilling in northeast Pennsylvania and implications for pediatric nursing. Journal of Pediatric Nursing, 27, 383–389.
SPN News Mason, D. J., Leavitt, J. K., & Chaffee, M. W. (2012). A framework for action in policy and politics. In D. J. Mason, J. K. Leavitt, & M. W. Chaffee (Eds.), Policy and politics in nursing and healthcare (6th ed.). St. Louis: Elsevier. May, O., & Bigham, A. (2012). After the storm: Personal experiences following an EF4 tornado. Journal of Pediatric Nursing, 27, 390–393. Riley, J., & Beal, J. (2010). Public service: Experienced nurses' views on social and civic responsibility. Nursing Outlook, 58, 142–147. Sullivan, E. J. (2004). Becoming influential: A guide for nurses. Upper Saddle River, NJ: Pearson Education, Inc.