Advocate, Who Needs an Advocate?

We live in a fast-paced, internet-driven world where most feel confident to navigate situations just by looking up how. We go to our friends, coworkers, or family for help and suggestions. For the most part, we can find information on any topic, from how to build a house to how to treat an illness.

Now picture this: you are alone, with no family left or near; you are not savvy with the internet; you don’t drive much or at all; your income is limited. But you have just been told you have a disease which will require treatment, medications, office visits, scans, and more.

At your appointment, the team shares all the medical findings and what you need to do next. Alone, you nod your head in agreement because you don’t want to appear as lost and confused you are. You do not need to be an older individual to fit into this scenario.

You suddenly have multiple appointments and a plethora of medication information to read. Some medical centers have social workers, financial consultants, and pharmacy specialists to help—but not all. Some patients may be too proud or do not know how to reach out on their own. You leave your visit scared, confused, wondering how you will pay for all of this, wondering how you will navigate this new normal.

In most cases, nurses are on the front line of interaction with patients. We are usually the first to meet them and make a connection. Many times, a person will share with the nurse fears and questions that they do not share with the doctor. I have had patients tell me, “I don’t want the doctor to think badly of me.” Nurses often have an intuitive sense of what patients are thinking or feeling, sometimes even through firsthand knowledge if they have experienced a similar illness.

As an oncology nurse for many years, I have sadly seen this quite often. Our population is living longer, and modern treatments are making some cancers more like chronic illnesses. In that, though, comes the struggle of feeling isolated and bewildered. Some populations face socioeconomic barriers to health and may feel less confident in their ability to steer through the details.

I have known some to forgo medications or treatments they need because of finances, transportation, and fear or lack of understanding of the medication. On the other hand, I have seen patients use the little money they have to pay for those things, leaving them without enough to live on.Neither is a good option, and neither benefits the patient. The medical world tries to help patients maneuver through this but can only do so much. Multiple appointments, scans, and labs are all scheduled, sometimes without considering the person attached to those appointments, especially if they have concurrent comorbidities and multiple providers.

Enter an advocate. What is an advocate? This is someone who speaks or writes in support of a person. A family member or trusted friend is usually the best to advocate, but not every patient has that option. Advocates are passionate about helping others and willing to take the time to know and develop a relationship with the person they are assisting. They are not afraid to ask questions, confront confusing or conflicting information, or learn what resources are available to any person they advocate for. They should be concise, articulate and respectful to the patient and those they speak with.

An advocate is not the same as a health care proxy who is assigned to speak for a patient on their advanced directives. Advocates are helpers and cannot make medical decisions for someone unless they are assigned to.

As nurses, we innately have a desire to help others; otherwise,we would be in another, not-so-difficult but not-so-rewarding profession. How special it is for a patient with a new diagnosis to have a professional that will care, listen, direct and guide. Often the nurse is the one they make connection with and trust. Nurses may have more consistent interactions with them. We can make sure they have the best resources available, such as printed materials or the most helpful sites to visit on the internet, to navigate new waters.

Anyone can be an advocate for another person, and it can be in any area of need and comfort for both parties. The challenge is allowing yourself to be invested in another person’s life and being willing to use your time, talents, and skills for their benefit. The challenge is giving patients the comfort to share their story and struggle with someone else. Nursing is one of the greatest callings, where we can use our knowledge, compassion, and personal experience to come along side those placed in our path.

As the 1935 version of Florence Nightengale’s Pledge states, nurses are “missioners of health”:a powerful statement and a reminder of our vocation.