Nursing Advocacy: the Case of Ms Good

Introduction

Advocacy is the main value of professional nursing and is situated within or belonging solely to the practice of nursing. Advocacy is a process that is on the process as opposed to a single isolated event. Clients with chronic illnesses and their families often need a collection of facts from which conclusions may be drawn, apprehension, and adequate intervention to help them redevelop their lives, acculturate their losses, and adapt or conform themselves to the new or different conditions brought about by their illness. As a moral concept, advocacy requires the nurse to speak up for the client’s rights and choices, to assist the client to clarify their decisions, and to protect the client’s privacy and autonomy in decision making (Hamric, 2000).

Four main issues in the case of Ms. Good are

Non-compliant patient

Ms. Good is admitted to our unit. Her history shows that she was being treated for cervical cancer outpatient at the clinic but she missed her last two appointments.

When a patient misses an appointment or does not take medication as prescribed, it is tempting for the nurse to say, “My patient is non-compliant”, thereby placing the blame for a failed course of action on the patient. However, nurses should delete the word non-compliant from their vocabulary. Rather, they should look to the underlying cause of why the patient did not (or more likely, could not) complete a prescribed course of treatment.

Service denial

She was originally being treated by her long-time physician but was told she could no longer be treated at that office because her insurance had been terminated.

If a patient is denied a benefit, one needs to be able to tell the patient and appeal this decision so long as 60 days have not elapsed from the time of the notice of denial.

As a nurse, I would start by looking at the notice, what exactly is the reason for the denial? And check on the reasons as to why the denials like the time of notice whether it was on the short term if she was covered under NYS insurance laws. Consequently, if the patient has had a long-term disability, most insurance companies will deny it. My duty as a nurse’s assistant will be to assist in obtaining Documents critical to all the above. A successful appeal of an insurance company denial depends on documentation and a medically sound appeal (Larkin, 2004).

My role is to:

  1. Know the appeal process- there are only 45 days from the denial to appeal
  2. Make sure the physician supplies the documentation. Often the nurse gathers the information and the physician signs the forms.

Unlawful termination

They have since fired her because she missed so much work for her treatments and has not worked since last year.

Such a patient needs to go through the process of adapting well in the face of diversity, trauma, tragedy, or even significant sources of stress such as family and relationship problems, or workplace and financial stressors. As a nursing advocate, I will try and introduce a newly developed family resilience framework that encourages a shift from a focus on family deficits to family challenges, emphasizing growth from adversity towards hope and strengthening family bonds.

Advocacy

Ms. Good is still legally married to the father of her two children and had gotten her health insurance through him.

The nurse-client relationship has long served as a foundation for understanding the nature of nursing. Central to advocacy are therapeutic relationships in which the client’s wishes are articulated. The purpose of the nurse-client relationship is to maintain and restore control to clients and embodies mutuality reciprocity, and moral decision making. However, in such a scenario whereby my client is still legally married to the father of her two children, as an advocate, I will speak on behalf of my client who is not able to speak for herself and articulates her needs to those in power. As an advocate for my client I will protect my client’s rights and restore autonomy and self-control, or a health care professional who forms the link between the client’s personal values and goals and biomedical intervention, and to make sure that the valid insurance policy is used to assist where possible (Malik, 1997)

Reference List

Hamric, A, B. (2000). A definition of advanced nursing practice. In A.B. Hamric, J.A Spross, & C.M Hanson (Eds.), Advanced nursing practice: An integrative approach, (2nd ed., p 53-73). Phidelphia: W.B. Saunders.

Larkin, J, H. (2004).Justice implications of a proposed Medicare prescription drug benefit. Social Work, 49 (3).

Malik, M. (1997).Advocacy in nursing- a review of the literature. J. Adv. Nursing, 25, 130-138.