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Working as a family nurse practitioner (FNP) means you may find yourself advocating for very vulnerable people in complex situations. It requires confidence, a good grasp of ethics, and a solid understanding of how to frame your arguments and where to go to get things done.
You will need to take an evidence-based approach throughout and draw on your experience. In the early stages of your career, when you haven’t had time to accumulate much of this, the experience gained during the clinical placements you undertook as part of your initial training will play a vital role. This article looks at how.
The importance of nurse advocates
Most ordinary, untrained people struggle to advocate for themselves within complex bureaucratic systems at the best of times. When they’re in poor health or worried about the health of a loved one and busy providing care, it can feel impossible. It is where nurses come in, working on their behalf to ensure that such difficulties never lead to the sick person missing out on proper care.
Nurses advocate on behalf of individual patients, patient groups who might be facing discrimination, and patient groups whose particular illnesses they feel are not receiving adequate treatment through established protocols. The patient always comes first, and in a family setting, this can sometimes mean advocating against the interests of other family members, so it’s important to have a clear understanding of the cultural and ethical issues involved and to put your focus on evidence-based practice, establishing a clear, rational basis for everything that you do.
Building up your confidence
Whether you’re trying to talk a worried mother into letting you do what’s best for her child when she feels frightened by it or taking on your own bosses over a policy that you feel is having a negative effect on your patients, you need confidence to be an advocate, and that is not something that everyone can summon up automatically.
Working in different environments during your clinical placements can be a big help because it gives you the chance to see how other nurses handle such situations and to understand that it is a normal part of the nursing experience—in speaking up, you are not doing something unreasonable. Basing your approach on evidence-based practice gives you a similar kind of grounding and allows you to check that you are not making mistakes and that your position is sensible.
Understanding the system
In order to drive through change, you first need to understand where the levers of power are. It begins with learning the basic structure of the system within which you work—who is officially responsible for what, all the way up to the top—and extends to the more subtle art of understanding who actually has the most influence. Despite the hierarchical structure of healthcare institutions, a lower-ranking individual with a strong personality who has the ear of those at the top can sometimes be more useful to you than their official position would suggest.
Wide-ranging placement experience will help you develop this sort of awareness. You will also learn about the processes involved in making complaints or suggestions and following them up. You will learn how to frame your arguments and what’s required to make them convincing.
Developing your negotiation skills
Good negotiating skills are essential to many aspects of nursing and something you can never acquire from lessons alone. The right placements will give you the opportunity to develop them in practice, partly through observation and partly through the direct work you do with patients, initially under supervision and without having to handle more complex situations.
You will encounter plenty of those when, in due course, you are working as an FNP, and then your negotiation skills will be essential to successful advocacy. You will find them particularly useful within family units, where gentle persuasion is almost always the most effective approach. By drawing on evidence-based practice and talking family members through their worries in terms that are calm and simple but never patronizing, you will often be able to talk people into agreeing to respect the wishes of a family member whose decisions they were initially reluctant to support.
When you’re making a case to a senior staff member or health board, you will need more than just your own negotiating skills. One of the most powerful approaches you can take involves bringing in other professionals to back up your argument. Experts in the relevant areas are invaluable, but if they’re not available, having a large number of fellow nurses on your side, regardless of their level of experience, can still be persuasive. Either way, you will need to draw on your networks for support.
Clinical placements are an excellent place to start building them. If you’re studying at a place like Carson-Newman University Online, you can expect your fellow students to be moving into some of the highest-paying nursing careers after they graduate, so they will be highly influential. Don’t forget to take the time to get to know established staff members too. You never know who might be able to help you or might know someone who can.
As all this should illustrate, clinical placements are far more than a chore you need to get out of the way before you can graduate. They’re a fantastic opportunity to build up skills, understanding, and contacts that could benefit you tremendously in years to come, especially when it comes to advocacy.
They’re also the first place where you will really get to apply your theoretical learning in practical ways, learning how to use evidence-based practice as the foundation of everything you do. Not only will this benefit you, it will benefit all the families you work with in the future, helping you support them to the best of your ability. You could be the nurse practitioner who solves their problems once and for all.