Advocacy

As nurses, we are supposed to be advocating for our patients everyday and should be considering how to promote health and well being. This in some way makes me think of nursing, considering customer satisfaction-if the customer is not satisfied with their service-then they leave, taking their business elsewhere. Really, though I certainly am not an advocate of for-profit health care, I think we should always be considering how we increase 'customer satisfaction' I read a letter to the editor of the Canadian Nursing Association magazine, by a nursing student who believed that by referring to patients as clients that we are stepping towards acceptance of the for-profit system and eroding public health care. This was not something that I had ever thought of. I actually think of client as being perhaps, a more empowering term than patient. But I have no idea why I would even think this-other than from working with people with disabilities, we tried to discourage any kind of labelling-rather than seeing people as patients, residents or even clients, see people as people!

So, it is interesting that sometimes, nurses start to resent patients, and start seeing them as not deserving of our care and seeing them as 'drains on the system.' And if we consider a customer satisfaction kind of approach-the issue with hospital care is that people don't have a choice, especially people requiring psychiatric care, who don't have money and have been an oppressed group. Again, I am not in no way advocating a for-profit system, or a 2 tier system in any way. But I do wonder if we consider how we should be viewing our patients, clients, system users, whatever you want to call it. I don't think that we need a competing system-ie HMO, to address these issues, but I do think we need to consider the satisfaction people receive out of this system. Instead of believing that people should be happy with whatever care they get, shouldn't we be thinking of how to improve our care delivery?

I see also, when nurses start to see themselves as victims of patients! I think this might happen more in psychiatry, where we can be dealing sometimes (though much less than people think) with aggressive people. And in some cases, nurses may be on the receiving end of a violent patient, resulting in injuries, which certainly meets the standard of being a victim. I think though, it is important to consider that as noted by CRNBC, that as a nurse, we have more power, and must always be considering how that impacts our care.

This is a challenge sometimes in psychiatry. We deal with a disempowered group, as nurses we hold much more power. It is only relatively recently that mental illness has begun to be seen as illnesses that are blameless. Or rather, as a society, we have just recently started to see mental illness as perhaps not the person's fault-sometimes. Health care still sees people with mental illness as less worthy of care than someone with a physical problem. And nurses working in psychiatry often perpetuate that idea-'oh, I'm not a real nurse, I work in psychiatry' I hate that! Give your head a shake! If you don't see yourself as a real nurse, leave, and let nurses who see themselves and their patients as deserving of real nursing care provide advocacy and care to patients who are entitled to professional, supportive nursing interventions!