Communication Strategies and Challenges

Introduction

During advocacy for patients, the nurses require to avoid creating and discrimination towards the patients. The nurses are required to control their emotions and self-belief so that they remain above unequal thoughts and actions to deliver care with compassion and respect, dignity, worth, uniqueness towards all individuals and unrestricted care by considering social and economic status of patients (Vitale et al. 2019). In this assignment, the concept of advocacy in care is to be discussed. Moreover, the way communication strategies support or act as barrier in advocacy is to be informed in relation to the case scenario.

Concept of Advocacy

In Health and Social care, the Advocacy is referred to supportive action towards any vulnerable or disadvantaged individual to ensure that their human rights are being effectively upheld in the care support (Kalaitzidis and Jewell, 2020). The NMC mentions that advocacy in care is essential for the patients as it helps to preserve human dignity and ensure showcasing of value to the service users (NMC, 2018). This is because during advocacy the nurses try to identify the specific needs and demands of the vulnerable people and accordingly develop actions to provide care that meet the cultural and social needs along with respect human rights of the individuals to ensure their safe care (Davoodvand et al. 2016). The advocacy in healthcare is important as it helps individuals feel freedom from suffering. This is because during advocacy the nurses determine the rights present for the patients to take actions against any harm or abuse caused to them better quality life and well-being (Oliveira and Silva, 2018).

According to NMC Code of Conduct, the advocacy can be promoted by nurses for the patients by allowing the service users to have right to decide through information about their care and provide information regarding their own health (NMC, 2018). This is essential to be performed in case of patients who avoid accessing certain treatment so that the patients are able to understand the needs for treatment and can provide informed decision for their support (Pecanac and Schwarze, 2018). The advocacy in care is promoted when the nurses value the needs of the patients over their family members and others. This is because it leads the nurses to stand up for the rights of the patients irrespective of the information suggested by others that may not be approved by the patients in turn protecting the rights of the individual to make care decision (Water et al. 2016).

Case Scenario

In the chosen scenario, it is seen that a pregnant woman is brought to the hospital for regular check-up regarding her health by her husband. The nurses while assessing the patients for vitals notices that she has bruise marks on her hands indicating abuse. However, the husband informs that it is just an accident as she had been clumsy due to pregnancy and has been hurt. The husband was seen to have bilingual understanding of language whereas the woman was speaking in different language other than English. Thus, it was difficult to make direct communication with the patient as her husband was trying to translate the information being mentioned by the nurse (lightshopfilms.co.uk, 2019)

Communication strategies for advocacy

The case scenario informs that face-to-face verbal communication strategy is being used by the nurse to communicate with the pregnant woman. As mentioned by Armuzzi et al. (2019), effective communication establishment is essential between the nurse and patients in advocacy towards the service users. This is because through communication the nurses are able to identify the vulnerability towards the patients and provide effective information to allow the individuals make informed decision regarding their safe care. As argued by Little et al. (2019), lack of meaningful communication between patients and nurses makes the nurses unable to understand key needs of the patients and support their rights. This indicates that hindered communication leads to failure to provide advocacy for patients. In the given scenario, it is seen that through face-to-face communication strategy is being established between the nurse and the pregnant women, yet it acts as barriers towards providing effective advocacy to the patient. This is because the nurse is found to be fluent in English only whereas the pregnant woman is talking in a different language without the ability to effectively understand instructions or reply in English. It is found that her husband is the only individual present in the room to translate the information between the woman and the patients. Thus, without direct meaningful communication with the woman, the nurse is unable to understand her key needs. This, in turn, leads the nurse to face failure in delivering direct information to the woman to make her take appropriate informed decision regarding pregnancy care making the nurse incapable to support the right of the patient.

The face-to-face communication with the pregnant woman by the nurse in the scenario leads her to identify that she had a bruise on her hand. The nurse considers it to be an incident of abuse towards her by the husband but due to lack of privacy in the room, the nurse is unable to determine the exact cause of the incident. This is evident as the husband was already present in the room who was also the only person supporting translation of instruction between the nurse and the woman as the individual was not fluent in English. As commented by Hagan and Medberry (2016), lack of language translator in the healthcare setting leads to hindered communication between the nurse and the patient. This is because the nurses are unable to effectively share and gather information to and from the patients, in turn, making them unable to understand needs of the patient to provide them care to support their rights and dignity to ensure advocacy. In the given case scenario, similar condition is seen where the lack of translator in face-to-face communication led to hindered advocacy towards the patient. This is because the nurse was unable to ask the woman whether or not the bruise is out of abuse or actual incident related by her husband so that she can take effective actions to protect the dignity and rights of the patient to promote advocacy in care. As argued by Kalaitzidis and Jewell (2020), lack of privacy during communication in healthcare leads the patient feel fear of confidentiality. This leads them to avoid sharing potential information for care needs out of fear of abuse. In the case scenario, it is seen that the husband was already present in the room where the pregnant woman was reviewed by the nurse. Thus, the lack of privacy may have led the patient avoid reporting abuse on her to the nurse. It eventually led the nurse unable to support advocacy of care for the patients out of lack of clarified need and demand of the pregnant woman.

Importance of awareness of potential need for advocacy

The advocacy in healthcare by the nurses can contribute to development of familiar and trustful relationship between the nurses and patients when the service users are at risk of abuse or harm. This is because during abuse towards the patients, the advocacy by the nurses helps them to determine the steps to be taken to avoid further abuse towards the patient, in turn, acting to protect patient’s right and dignity (Taylor, 2016). In the given scenario, advocacy of care towards the pregnant woman in protecting her from abuse would lead the nurse to develop better trustful and familiar relationship with the individual. This, in turn, would make the nurse able to more effectively provide care to the patient that is easily accepted by her. As commented by Chung et al. (2017), nurses to promote advocacy require having effective listening and compassionate skill in communication. This is because without detailed understanding of the needs of the care for the patients through active listening the nurse would be unable to determine the rights to be supported and care to be provided to the patient in promoting advocacy for the patient. Moreover, compassion promotes trust towards the nurses making the patients reveal the needs to be advocated for them. In the given case scenario, it is seen that there is hindered compassionate communication and active listening promoted between the nurse and the patient due to lack of understanding of the language spoken by each of them. This led the nurse fail to effectively advocate safe care for the individual.

The advocacy in nursing care can lead nurses to promote dignity in relationship between them and the patient. This is because advocacy leads the nurses to support rights of the patients in all condition making them feel valued and respected in turn assuring dignified relationship to be framed (Cohen and Marshall, 2017). The dignified relationship through advocacy is ensured when the nurses maintain a calm attitude and takes initiative to deliver care information to the patients so that they can make informed decision for their healthcare intervention. This is because calm and constrained attitude leads the nurses to show patience in care for the service users along with delivery of care education to make informed decision leads the patients feel valued by the nurses to support their rights (John et al. 2019). In the given scenario, the advocacy in care could promote dignified relationship to be formed between the nurse and the pregnant woman. In order to execute it, the nurse requires to personally provide information to the service user regarding the actions available to be taken by her to avoid further abuse so that the individual can make informed decision and feel valued in care out of respect towards her opinion.

Conclusion

The above discussion informs that advocacy in care is protecting rights of vulnerable individuals in care. This is essential to protect dignity, ensure value, deliver equal care and others to the patient. In the chosen scenario, the face-to-face communication leads to hindered advocacy in care as there was no privacy in communication and lack of translator led the nurses unable to personally communicate with the patient to help her make informed decision regarding her care.

References

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Chung, M.S., Lim, K.C. and Ko, J., 2017. Human rights sensitivity, advocacy attitudes, and advocacy interventions for mentally disabled people in psychiatric nurses and nursing students. The Journal of Korean Academic Society of Nursing Education, 23(3), pp.309-318.

Cohen, B.E. and Marshall, S.G., 2017. Does public health advocacy seek to redress health inequities? A scoping review. Health & social care in the community, 25(2), pp.309-328.

Davoodvand, S., Abbaszadeh, A. and Ahmadi, F., 2016. Patient advocacy from the clinical nurses' viewpoint: a qualitative study. Journal of medical ethics and history of medicine, 9.pp.20-34.

Hagan, T.L. and Medberry, E., 2016. Patient education vs. patient experiences of self-advocacy: changing the discourse to support cancer survivors. Journal of Cancer Education, 31(2), pp.375-381.

John, R., Marques, M. and Marchand, V., 2019. The Canadian Nursing Students' Association and its Advocacy for a Culturally Competent Entry-to-Practice Exam. Nursing Leadership (Toronto, Ont.), 32(4), pp.92-96.

Kalaitzidis, E. and Jewell, P., 2020. The concept of advocacy in nursing: a critical analysis. The health care manager, 39(2), pp.77-84.

Kalaitzidis, E. and Jewell, P., 2020. The concept of advocacy in nursing: a critical analysis. The health care manager, 39(2), pp.77-84.

Little, J., Ortega, M., Powell, M. and Hamm, M., 2019. ASHP statement on advocacy as a professional obligation. American Journal of Health-System Pharmacy, 76(4), pp.251-253.

Oliveira, M.A.D.C. and Silva, T.M.R.D., 2018. Health advocacy in nursing: contribution to the reorientation of the Brazilian healthcare model. Revista brasileira de enfermagem, 71, pp.700-703.

Pecanac, K.E. and Schwarze, M.L., 2018. Conflict in the intensive care unit: Nursing advocacy and surgical agency. Nursing ethics, 25(1), pp.69-79.

Taylor, M.R., 2016. Impact of advocacy initiatives on nurses' motivation to sustain momentum in public policy advocacy. Journal of professional nursing, 32(3), pp.235-245.

Vitale, E., Germini, F., Massaro, M. and Fortunato, R., 2019. How patients and nurses defined advocacy in nursing? A review of the literature. Journal of Health, Medicine, and Nursing, 63, pp.64-69.

Water, T., Ford, K., Spence, D. and Rasmussen, S., 2016. Patient advocacy by nurses–past, present and future. Contemporary Nurse, 52(6), pp.696-709.

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