Ed's letter: Nurse's duty to advocate for others, but don’t forget yourself

1 June 2014

The word ‘advocate’ is sprinkled across both New Zealand nursing’s Code of Conduct and Code of Ethics.

“Advocate for, and assist, health consumers to access the appropriate level of health care,” says Standard 3.7 of the Nursing Council Code of Conduct and “nurses should be willing to advocate for appropriate health care for the communities within which they practise” says NZNO’s Code of Ethics.

I realised that this issue is stuffed with calls for nursing to advocate and ensure best care for those who are vulnerable or lack a voice.

First, we have a call to improve the physical health of those with chronic mental illness who die too early, too often – with medication side-effects, stigma, and socio-economic deprivation all playing a part.

Next, we look to lung cancer and how the combination of late diagnosis and the “shame” of being a smoking-related disease means lobbyists for our biggest cancer killer are fewer and less visible than their “pink ribbon” counterparts.

Then lastly there is the need to advocate for the vulnerable elderly who are increasingly dying in an under-resourced residential aged care sector stretched thin attempting to give both quality care for the living and quality palliative care for the dying.

But any call for nurses to be willing and ready to advocate for others’ health has to be balanced with the need for nurses to advocate to protect their own professional wellbeing – so they have the capacity to be health advocates for society’s most vulnerable. Research reported on p.15 unsurprisingly found high burnout in aged care nurses and health care assistants but also found the more burnt out they were, the less ready they were to engage in palliative care training.

A recent New Zealand Medical Journal article found 93 per cent of hospital workers had experienced verbal anger from a patient in the last year, 65 per cent physical aggression, and 38 per cent had been physically assaulted. It prompts emergency department nurse practitioner Michael Geraghty (p.19) to ask what employers and professional organisations will do to protect their staff? Because nurses need protection and advocacy, too.

Fiona Cassie