Patient advocacy and the nurse: is there a conflict of interest?

The role of patient advocate has been mandated by law in some states, supported by the American Nurses Association and by nursing theorists. Guidelines have been published to assist the nurse as she pursues the role of patient advocate and to help her decide when she should pursue the role and when she should delegate the advocacy position. Two case studies have been presented to examine the possible conflicts arising between the rights of the patient and the duties of the nurse to society as a whole. Smith, in the final paragraph of her story concludes that: As practicing professionals in any society, we not only have a responsibility to know what we need to know to practice, but also a responsibility to act as advocates for those who cannot speak for themselves. As professionals, we carry a commitment and responsibility to all people in the community in which we practice (p. 625). The situation today, however, continues to present the nurse as patient advocate with an assigned responsibility but without the designated authority to fulfill that responsibility. There is a conflict of interest between the duty to act as the client's advocate and the rights of the nurse to practice nursing in a manner that protects the interests of the nurse, the nursing profession, and the employing institution. Autonomy for the nurse acting as patient advocate remains a theory.