Advocacy in nursing--perceptions of practising nurses.

This paper reports on a qualitative study which examined the interpretation of patient advocacy by practising nurses. Focus group interviews, which allowed respondents to recount and share their particular 'stories' of patient advocacy, were used to collect data. Results indicate that a triadic model of advocacy predominated which involved the nurse in a conflict/potential conflict situation. The patient's requests, the patient's fear, the patient's vulnerability or threats to the patient's human rights provoked an advocacy response in the perceptive nurse. The nurse was sustained in the role through patient recognition, the nurse-patient relationship, emotional strength, moral justification and knowledge/expertise legitimacy. The nurse used direct and indirect means to protect the patient against incompetent/inappropriate practice and/or represent patient/family choice, the advocacy activity resulting in positive or negative outcomes. In conclusion it is argued that if the triadic conflict model of advocacy outlined by this research is to be sustained by practising nurses, the potential risks involved should be recognized. Professionalization of the role may be the only way forward if the ethical code (United Kingdom Central Council, 1992) continues to make patient advocacy a mandatory activity for the professional nurse.