The legal duty of nurses to advocate for patients vs. their duty to cooperate with law enforcement

The legal duty of nurses to advocate for patients vs. their duty to cooperate with law enforcement

Nurses are expected to provide their professional services within the confines of the law as per the American Nurses Association (ANA). In this regard, nurses have a legal duty to advocate for their patients while still cooperating fully with law enforcement. However, it is a widely accepted fact that the professional standards of the nursing profession can change with the changing dynamics an evolving professional environment. Furthermore, the conditions or specific clinical circumstances have an effect on the application of nursing standards at any particular time. It is therefore important for all practicing nurses to be aware of the scope of practice and standards that guide their excellence in the nursing practice by recognizing the legal implications of certain standards and definitions of their scope of practice (Cole et al., 2014).

Nursing as a profession is subject to certain legal aspects which have a significant impact on the way in which care is delivered by the nurses to their patients. Such legal concerns have an effect on the professional environment in which nurse’s practice and it determines how information is kept and stored within the clinical setting. In the long run, nursing care and nurses, in general, are judged based on definitions that exist in law for standard care offered by nurses. The written standards of nursing care and the legal definitions are available as tools used in determining how nursing care is delivered to patients and the quality of the care. It is worth noting that the legal definitions of nursing standard care are not guidelines or policies which are set by institutions or individuals. Rather, they are a representation of the collective professional knowledge of what the average nurse is required to do and they set minimum criteria for nursing proficiency (Hanks et al., 2017)

State and federal laws also impact the way which nursing as a profession is practiced. One of the most regulated sectors of commerce is healthcare and much of the regulation of the nursing profession arises from federal as well as state laws. Various government-sponsored programs also such as Medicare are also regulatory requirements which are imposed on the nursing profession. Their regulatory requirements are self-imposed in order to conform to the different private and government initiatives. In the nursing profession, there is always a potential for criminal and civil sanctions and liabilities in regards to healthcare.  As a precautionary measure nurses should familiarize themselves with the key regulations and statutes that regard the delivery of care to patients (Smith, 2017).

This essay looks at the legal standards of care for nurses and how it affects nursing practice in regards to the legal duty of nurses to advocate for their patients within the confines of the law. Malpractices in nursing are also examined as well as suggestions on how to minimize the risks of lawsuits for malpractice. Laws that have an impact on the practice of nursing will also be looked at in detail.

Role of nurses in advocating for their patients

Apart from performing various roles in the healthcare of their patients, nurses are also advocates for may act or intercede on their behalf. Nursing as a profession involves a great amount of interpersonal contact with patients which places nurses in the best position to become liaisons between the patients and their families and other healthcare providers. In order to perform this role efficiently, nurses must be versed with all knowledge pertaining all aspects of the patient’s care while maintaining a positive working relationship with other healthcare providers. According to the ANA Code of Ethics included in Provision 3, nurses are required to promote, advocate for and aim to safeguard the safety, health and rights of patients placed under their care (Gazarian et al., 2016).

Nursing advocacy operates on the basis of three core values which are: preservation of patient dignity, freedom from suffering and patient equality. Preserving the dignity of their patients involves the right to treat patients with respect and honor. In most cases, patients and their family members are often frightened, anxious and confused. In such situations, they need an advocate who will help them navigate the healthcare system which is unfamiliar and facilitate cooperation6 with other caregivers. This may be in the form of interpreting test results or decoding instructions from doctors in patients that are understandable to the patients. It is also important for nurses to educate their patients on the need for certain procedures and tests as well as providing physical and emotional support during healthcare procedures. Nurses are in a better position to integrate all areas of patient care and ensure that the patient’s concerns are addressed. Furthermore, nurses should ensure a positive outcome for their patient which should be the goal of their practice. Nurses should respect the ethnic and cultural beliefs of patients and their families. To act as effective advocates, nurses must be in consideration of patient privacy and regard patient information as confidential and privileged. They must adhere to state, organizational and national laws when disclosing or discussing patient healthcare information (Jones and Smith, 2014).

As a way of advocating for the patients, nurses must be willing to offer their patients freedom from suffering.  Nurses should have an innate desire to help their patients overcome physical, psychological or emotional suffering which is the most important aspect of patient care. In some situations, nurses may be required to provide emotional support or simply offer a friendly listening ear to their patients. That calls for great commitment from the nurse to be fully available to the patients and their families (Hanks et al., 2017)

As part of patient advocacy nurses are required to promote patient equality. Due to the evolving healthcare environment in response to changes in funding, advance in technology, the disparities that exist in the delivery and provision of patient care may become more defined. Nurses are therefore required by the ANA Code of ethics practice with due compassion and respect for the dignity uniqueness and worth of every patient. Their practice should not be restricted by consideration of economic or social status, the healthcare problem or personal attributes (Josse‐Eklund et al., 2014).

Legal barriers to the role of advocacy for nurses

There are several barriers to the role of nurses as advocates for their patients. These include physicians, fear and the patient’s families. Newly practicing nurses have reported that absence of proper communication and lack of support and time as barriers to their role in patient advocacy. In the modern patient care setting, nurses have reported differing policies and practices in the care systems the lack of smooth relations with caregivers from multidisciplinary backgrounds as being a major legal obstacle to their role of advocacy (Slatyer et al., 2016).

In most situations, advances in patient rights have greatly disturbed the balance of power and as a result, nurses are placed at a disadvantage in terms of being vulnerable to malpractice suits. Patients, on the other hand, have an upper hand in terms of the law being more protective of their rights. In this regard, nurses find themselves at a crossroad on whether to provide utmost advocacy to their patients and risk being sued for malpractice or laying back and sitting on the fence in terms of patient advocacy. Lack of clear guidelines for nurses in regards to their duties and mandate in patient advocacy has also been cited as major obstacles to the role of nurses in acting as liaisons for their patients (Tobiano et al., 2016).

Recommendations and conclusions

As a way of fostering the role of nursing advocacy in the future, nurses should be equipped with the right tools to play this role in terms of legal frameworks that acknowledge and protect their professional practice. The current situation calls for nurses to be patient advocates but mechanisms to protect the nurses from the legal implications of their divisive role in advocacy are lacking. Practicing nurses are called to do more in terms of playing the liaison role for their patients so as to ensure the best possible health outcomes. This involves putting the interests of their patients and their families first before any personal career ambitions or the fear or legal implications. Governments, health institutions as well as nursing professional bodies should strive to lay down concrete guidelines and policies to enable nursing to know the extent to which they should provide their patients with advocacy and the legal repercussions that may result in the case of malpractice. Nurses should strive to be advocates for their patients but as they do so, they should ensure that they operate within the legal limits in order to avoid malpractice suits.

References

Cole, C., Wellard, S., & Mummery, J. (2014). Problematising autonomy and advocacy in nursing. Nursing ethics, 21(5), 576-582.

Smith, M. A. (2017). The ethics/advocacy connection. Nursing Management, 48(8), 18-23.

Gazarian, P. K., Fernberg, L. M., & Sheehan, K. D. (2016). Effectiveness of narrative pedagogy in developing student nurses’ advocacy role. Nursing ethics, 23(2), 132-141.

Jones, M., & Smith, P. (2014). Population‐Focused Nursing: Advocacy for Vulnerable Populations in an RN‐BSN Program. Public Health Nursing, 31(5), 463-471.

Josse‐Eklund, A., Wilde‐Larsson, B., Petzäll, K., & Sandin‐Bojö, A. K. (2014). Individual and organisational factors influencing registered nurses’ attitudes towards patient advocacy in Swedish community health care of elders. Scandinavian journal of caring sciences, 28(3), 486-495.

Slatyer, S., Coventry, L. L., Twigg, D., & Davis, S. (2016). Professional practice models for nursing: a review of the literature and synthesis of key components. Journal of nursing management, 24(2), 139-150.

Tobiano, G., Bucknall, T., Marshall, A., Guinane, J., & Chaboyer, W. (2015). Nurses’ views of patient participation in nursing care. Journal of advanced nursing, 71(12), 2741-2752.

Hanks, R. G., Starnes‐Ott, K., & Stafford, L. (2017, April). Patient Advocacy at the APRN Level: A Direction for the Future. In Nursing Forum.