Workplace Advocacy

Introduction

In a profession where others' health and well-being are priority, there leaves room for neglect of those who are delegated to care for these people. As a professional nurse, there are many obstacles that arise and affect the care provided to a patient, as well as the livelihood of the nurse. The current deteriorating and unsafe staffing conditions in hospitals and other institutions prompts workplace advocacy as the universally appropriate concept for maintaining professional nursing practice. The Arkansas Nurses Association and the Louisiana State Nurses Association define workplace advocacy as a planned, organized system of services and resources designed to support the professional nurse in the workplace (White Paper on Workplace Advocacy, 1997). It provides nurses with the knowledge and skills to use a range of strategies to ensure their voice and involvement in nursing practice and workplace decisions. "The ethical norms of the profession, Standards of Clinical Nursing Practice, and nurse practice acts validate the nurse's professional obligation to provide quality care and protect clients and families" as stated by the Arkansas Nurses Association and the Louisiana State Nurses Association in the White Paper on Workplace Advocacy (1997).

Workplace Advocacy educates and empowers nurses to help make changes in the workplace that will enhance the quality of their work environment (White Paper on Workplace Advocacy, 1997). It is intended to facilitate strategies for employers, nurses, and healthcare providers to work collectively toward safe, quality, cost-effective client care. According to the Center for American Nurses (2006), in order to confront these issues, nurses must have a clear vision of their responsibilities in the workplace and the personal, professional, and legal information to ensure the well-being of themselves and their patients. Workplace issues are of great concern to the professional nurse due to the direct impact on the quality care and safety of a patient.

History

The American Nurses Association warrants that workplace advocacy is its central mission. In 2000, ANA's House of Delegates established the Commission on Workplace Advocacy (Center for American Nurses, 2006). This commission consisted of nine members who were delegated to establish an effective workplace advocacy program. The resultant program was the Center for American Nurses. This professional association, incorporated in August 2003, states that its vision is "to be recognized as the voice of workforce advocacy for professional nurses by contributing to the creation of healthy workplaces that value and respect the contributions of nurses."

In an effort to promote workplace advocacy aims, nurses adopted the concept of collective bargaining. Catalano (2006) defines collective bargaining as the uniting of employees for the purpose of increasing their ability to influence their employer and to improve working conditions. This concept allows nurses to organize unions, which become their voice. Prior to the adoption of the collective bargaining concept in the health-care setting, there were alternative solutions. During the years following World War II, ANA had not yet engaged in collective bargaining and this presented a tremendous problem. Due to the poor working conditions and inadequate pay, there was a resultant shortage in the number of nurses available (Budd, Patton, & Warino, 2004). According to Budd (2004), at the 1946 ANA Convention, an economic and general welfare program was implemented. The program set guidelines for the State Nurses Associations (SNAs) to promote economic security and engage in collective bargaining (Budd, 2004). In 1965, mass resignations of nurses at an Ohio hospital were the negotiating factors for nurses faced with issues that dealt with staffing, scheduling, decision-making, wages, and benefits (Budd, 2004). After thirteen days of negotiating, the nurses returned to work. Events of this nature identify the importance of programs that address the concerns of the professional nurse.

Review of Literature

From Bedside to Boardroom-Nursing Shared Governance, an article written by Robert G. Hess, discusses shared governance involvement with the nursing shortage that healthcare facilities are now facing. Hess focused on the purpose of shared governance, which is to give registered nurses control over their practice. This will help ensure nurse involvement in the workplace. In expressing his struggle, Hess clearly defines shared governance with the order of structures and processes involved within each organization (Hess, 2004). However, he does agree with its purpose that nursing shared governance helps with every situation a nurse may encounter in the healthcare setting. The following article further evaluates workplace advocacy in a way that relates to shared governance.

In an article entitled, Common Denominators: Shared Governance and Workplace Advocacy-Strategies for Nurses to Gain Control over Their Practice, Green, and Jordan explore the concepts of shared governance and workplace advocacy. According to Green (2004), organizations implementing shared governance concentrate on having a partnership between the organization and the employees. Shared governance concentrates on the micro level, which is the internal aspect of workplace policies (Green, 2004). In contrast to shared governance, workplace advocacy focuses on both micro and macro levels, which are external. These external policies consist of local, state, or federal policies (Green, 2004). Some of the variables that both shared governance and workplace advocacy share are accountability, empowerment, conflict resolution, and patient advocacy. Workplace advocacy approaches accountability and empowerment at the macro level, whereas it approaches conflict resolution at both micro and macro levels. With that being stated, workplace advocacy and shared governance work in conjunction to enhance the working conditions for nurses and the quality of care for their patients. It is very important that nurses are able to have a voice within the institution and outside of the institution when the policies directly affect the professional nurse.

In another article titled Ethics and Collective Bargaining: Calls to Action, the author, William, discusses goals and values of nursing practice. The directives outline the nurse's responsibilities of caring, advocating, and being faithful to those who entrust their health to them (William, 2004). In order aid in organizing the topics, William discusses The Joy of Triumph Dissolves with Time, which allows registered nurses to comment on their experiences and views related to collective bargaining and strikes. However, the participating