A Reflective Patient Advocacy (RPA) Paper as Scholarly Closure to the BSN Clinical Experience

Background: Patient advocacy is a crucial nursing responsibility. Within today’s complex, scientific-based, and highly technological healthcare environment, advocacy is often needed for patients with a poor prognosis,... [ view full abstract ]

Background: Patient advocacy is a crucial nursing responsibility. Within today’s complex, scientific-based, and highly technological healthcare environment, advocacy is often needed for patients with a poor prognosis, multiple co-morbidities and/or marginalized socio-economic backgrounds.

Aim/Objective: To promote the transition from classroom to professional practice as a Registered Nurse (RN), graduating BSN students were required to complete a written RPA paper.

Description: A RPA template was developed/provided to guide students, as well as to guide faculty review/grading of the paper. Graduating BSN students (n = 79) completing their final medical-surgical clinical practicum were required to complete a RPA paper describing a patient advocacy dilemma that occurred during their clinical practice. Foci included background of the concern, affected individuals, advocacy attempts, student motivation and intervention(s), and self-reflection of the impact of the dilemma on the student. In addition to review/grading, faculty conducted a thematic analysis of RPA papers.

Impact: The RPA papers were rich with tales of advocacy opportunities and student motivation to act as a patient advocate. Each student wrote of using their learned nursing knowledge in identifying/verifying a patient concern and justifying advocacy. At times, the patient situation was unethical in nature. The depth of detail regarding student motivation for patient advocacy, and the dilemma’s impact on the student was inspiring and far exceeded faculty expectations. Similar themes were noted among the RPA papers, such as students finding their “voice” to advocate for a patient despite their “limited” student nurse status. A large majority of students commented on feeling empowered after realizing that their advocacy actions were necessary, acknowledged, and appreciated by patients, family members, faculty, and staff.

Conclusion/Implications: The RPA paper provided opportunities for enhanced student critical thinking, patient advocacy, and moral reasoning prior to entry into professional practice as a Registered Nurse (RN).