Nursing Case Management: A Focus on Advocacy

Nursing Case Management

Nursing case management is becoming more important in overall health care delivery. A nurse case manager must wear many hats and juggle many tasks at once in order to be successful at his or her job. Perhaps one of the most important aspects of being a case manager, however, is acting as a patient advocate. This is such an ingrained part of being a case manager that many nurses act as an advocate without even realizing it by doing things like noticing a prescription medication error. There are many other aspects to the role of the nurse case manager as patient advocate, however. Below we’ll highlight some of them, with an emphasis on how nurses advocate for their patients to receive care and social support.

What is advocating?

There are many different definitions of patient advocating. They may depend on a nurse’s personal philosophy or the setting in which he or she works. In general, advocating means standing up for your patient and your patient’s rights. To advocate properly, a nurse case manager must set his or her personal preferences aside and realize that excellent health care is focused on the patient’s needs instead of the needs of her caregivers.
Advocating may involve speaking up in order to get the best care for your patient, but it also may simply involve being an understanding and accepting caregiver. For example, many patients have personal or religious qualms about giving or receiving blood. Being a patient advocate involves not judging these patients or condemning them for not making the medically “appropriate” choice. Advocacy involves supporting their choice while at the same time educating them about their options.

Advocacy isn’t always comfortable

There are times when advocating can put a nurse at odds with his or her employers. The number of nurses, however, who ignore these difficulties in order to provide their patients with optimum care is staggering. For example, at a hospital in Texas, two nurses came forward to identify a physician who they felt was negligent with patients. They believed this physician put some patients at risk and they told the administrator at their hospital. When the administrator failed to act, they went to the Texas Medical Board with their complaints. They were fired and then charged for misusing official information. Eventually the charges were dropped against one of the nurses and the other was quickly acquitted. Their defenses were paid for by donations raised by the Texas Nurses Association.
Although these two nurses went through an extremely difficult ordeal, they did it because of their drive to act as a patient advocate. This is perhaps the ideal example of working for your patient’s rights as these two ignored potential threats to their own careers in order to get the best care for their patients.

The benefits of advocacy

A nurse may benefit from advocacy as it makes him or her feel better about the job they are doing. Most who enter healthcare professions do so because they are concerned about their fellow human beings. Advocacy truly allows for the expression of that motivation.
The true benefits of the nurse case manager as patient advocate appear as benefits to the patient, however. Nurses are the main system of support for patients, and are responsible for easing their transition through the different levels of treatment in a hospital (such as emergency, surgery, etc.). They are also the ones who provide patients with emotional support and often do the same for the families of those patients. Without the support offered by nurses, many patients would have a frightening, confusing, and overwhelming medical experience.
Many healthcare facilities are beginning to recognize the importance of the patient advocacy. They have begun instituting ways to protect nurse’s from repercussions if they are simply advocating for their patients. There have even been some nurses who have taken their skill for advocating and turned it into a full-time career. Private and public groups, whose primary duty is advocacy, have sprouted up in recent years. These groups help patients navigate through the daunting decisions inherent in a healthcare process.
Advocacy is an often overlooked, but critically important part of nursing. Without it many patients would be lost to navigate a complex healthcare system on their own. Patient advocacy is one of the more selfless acts we see in healthcare, and it’s part of what makes the nursing profession special. To learn more about nursing case management, click here.