Professional Nursing Influence: Advocating for Patients, Populations, and Policy

Advocacy is the essence of nursing’s professional commitment to protection of patients from harm, preservation of human rights, and provision of quality patient care across the globe. Theoretical models provide diverse and complex definitions of nursing advocacy from philosophical, spiritual, ethical, and functional perspectives. Functional models describe both micro-social and macro-social attributes of nursing advocacy that reflect the tenets of the nursing profession to advocate for vulnerable patients and, as stated by Florence Nightingale, “to provide a safe and caring environment that promotes patient health and well-being.” Advocacy actions strengthen the nurse-patient dyad and influence quality outcomes, and population health. Nursing advocacy actions ensure the presence of professional nursing in the development of health care policy. To advocate effectively for patients and populations, nurses must embrace attitudes and beliefs that support complex nursing actions consistent with micro- and macro-social attributes of advocacy. These attributes include safeguarding patient autonomy, acting on behalf of patients, and championing social justice for patients and the profession (Bu & Jesewski, 2007; Selander & Crane, 2012). To develop attitudes that ensure the implementation and promotion of advocacy actions, nurse educators and leaders must provide opportunities for nurses to develop and maintain competency in both micro-social and macro-social attributes of advocacy. Micro-social attributes of advocacy serve as the foundational underpinning to a quality nurse-patient dyad in the practice setting and support the application of policy at the bedside. Macro-social attributes of advocacy emphasize the historic roots of nursing to inform and influence local, national and international health policy to address the needs of vulnerable populations and nations. Novice to expert advocacy actions include setting agenda, identifying key stakeholders and allies, translating problems to solutions, and informing policy (Maryland & Gonzalez, 2012; Millstead, 2013). From bedside to community, professional nurses influence and advance the health of populations. Through the development of population-specific, solution-driven policies that expand services provided by nurses, professional nurses influence the global effort of promoting health in individuals and populations.