Patient advocacy is central to nursing practice; acting as a patient advocate in the perioperative environment requires the care of patients that are highly vulnerable and unable to speak up for themselves, in a busy and often highly pressurised environment involving multiple professional groups providing care simultaneously.
This can present particular challenges for nurses, particularly those unfamiliar with the expectations of being a patient advocate.
Patient advocacy is especially important during surgery when patients are under anesthesia, leaving them vulnerable and unable to make decisions for themselves. However, the operating room is a dynamic environment that can create additional stress for the perioperative nurse.
The complexity of the perioperative environment frequently places the responsibility of patient advocacy on perioperative nurses, who face unique ethical and moral situations when caring for patients undergoing surgical procedures.
By acting as an advocate, nurses perceived a potential for risk to the nurse-physician relationship and questioned whether advocacy would create a power struggle with other members of the health care team.
Nurses also felt the need for additional education and training to advocate confidently in potential conflict situations. Nurses need to have a sound professional identity and a high level of self-confidence and self-esteem to advocate in potentially risky situations such as operating theatre.
By creating a culture of safety in the operating room through education, confidence building, and support from colleagues, these perceived challenges can be mitigated.
According to the Association of Perioperative Registered Nurses (2016), a culture of safety provides an environment where all team members can discuss errors, process improvements, and system issues openly without fear of reprisal.
A few of the ways this can be achieved are through open and honest communication, having staff members that are helpful, supportive and trust each other, and an environment that is patient-outcomes driven.
With a culture of safety in mind, here are some ways nurses can be strong advocates for patients undergoing surgery:
Always Do A Thorough Surgical Timeout According To Hospital Policy
According to the Joint Commission, there are approximately 40 to 60 wrong-site surgeries per week (The Joint Commission Center for Transforming Healthcare, 2020).
Wrong-site surgeries are preventable, and doing a thorough time out can help decrease this occurrence.
No matter how they are rushed, distracted, or the surgeon does not want to participate, ensuring all team members to involve, and do a time-out for every patient, every time is certainly mandatory for every perioperative nurse.
Speak Up For Patients
Whether it is a concern about positioning, or if believe there was a break in sterile technique, it is important to be the voice for patients. Perioperative nurses should follow their gut and speak up if they think something is wrong.
Voicing concerns will maintain patient safety, and they should be taken seriously by the surgical team. The leadership team should help build a strong safety culture.
A quick response from colleagues to any concerns instils trust and confidence in the organization and creates a sense of responsibility to remain vigilant about voicing concerns.
Care For Patients As They Would Care For Own Family Members
This one relates to the golden rule of treating others as they would like to be treated.
If nurses can keep this in the forefront of their minds, they can come from a genuine place and provide more empathetic care.
Communication Is Key
Where there is a breakdown in communication, there is a breakdown in patient safety. Clear and concise communication involving all members of the surgical team improves patient outcomes.
Effective team communication involves adequate planning and preparation for each surgical case through interdisciplinary discussion (World Health Organization, 2009).
Patients trust perioperative nurses and their expertise to keep them safe during a very vulnerable experience. Being a strong patient advocate can be complicated, and perioperative nurses will continue to be challenged in this complex environment.
Promoting a culture of safety and following best practices allows nurses to achieve the best possible outcomes for their patients. Our impact as patient advocates is immense, and this important role must be honored.
Remember, our advocacy could save a life.
Kalivani Poongawanam is programme leader, Post Basic Perioperative Nursing, Nursing Department, Sunway University.
- This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.
