Are you "just a nurse"?

AORN Journal,  Feb, 2008  by Suzanne C. Beyea

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BEING A PATIENT ADVOCATE

Recently, a nurse in the postanesthesia care unit (PACU) was caring for a patient with an inordinate amount of pain after surgery. She did not know what was wrong with the patient, but she knew that the patient's level of pain was not typical of recovery from this type of procedure. She contacted the surgeon, who prescribed more pain medication.

The nurse consulted with the charge nurse and then called the surgeon again, asking him to come and examine the patient. The surgeon stated, "I'm busy and will be there by the time the patient is transferred to the inpatient unit." The nurse firmly insisted that the surgeon come to see the patient; the surgeon came to the PACU and determined that the patient had an active intra-abdominal hemorrhage and indeed needed immediate surgery. That single act of nurse advocacy and assertion saved the patient's life. This would not have occurred if the clinical environment did not support open communication or if the nurse lacked skills of assertion and advocacy.

Learning how to be assertive is crucial to serving as a patient advocate. Each nurse needs to develop his or her skills to become an effective communicator. Leonard et al (4) suggested that health care teams should develop effective and appropriate assertion techniques through education and training. They also recommended the use of structured communication, briefings, and the SBAR technique--a technique in which clinicians clearly communicate the situation, background, assessment, and recommendation--as potential strategies to develop a culture that supports teamwork and communication.

These skills and techniques are essential to members of the health care team in their efforts to participate in effective, nonhierarchical communications. Of greatest importance is a commitment to patient care, excellence, and never being "just a nurse" when providing care. Every nurse should be proud to be a nurse, committed to patient safety and excellence in his or her role. If you have ever felt like you are "just a nurse," take action to learn more about assertion and advocacy. Remember, as a nurse, each of us plays an essential role in advocating for patients and protecting them from harm.

Editor's note: If there are additional patient safety goals that readers would like to recommend for this series, please share them with the column's author by sending an e-mail to AORN at PSFcolumn@aorn.org.

REFERENCES

(1.) Petersen C, ed. Perioperative Nursing Data Set. Rev 2nd ed. Denver, CO: AORN, Inc; 2007.

(2.) American Nurses Association. Code of Ethics for Nurses With Interpretive Statements. Washington, DC: American Nurses Association; 2001.

(3.) Perioperative Standards and Recommended Practices. Denver, CO: AORN, Inc; 2008.

(4.) Leonard MS, Graham S, Taggart B. The human factor: effective teamwork and communication in patient strategy. In: Leonard MS, Frankel A, Simmonds T, Vega KB, eds. Achieving Safe and Reliable Healthcare: Strategies and Solutions. Chicago, IL: Health Administration Press; 2004:37-64.