Summary

Nurses play a role in client advocacy, particularly in circumstances where clients are unable to adequately represent themselves, or have the legal designation of diminished responsibility. Nurses should be aware of the civil rights of those with mental illness diagnoses. Empowerment leads to self-reliance, participation in decisions, dignity and respect for us and others, and the knowledge of belonging and contribution to a wider community.

Autonomy and independence are not the same. Autonomy is the ability to make decisions for self. Independence is the ability for self-care. Mental health issues can impair clients from making appropriate decisions and taking care of themselves. Restrictions on autonomy are justified by ethics, law, and welfare in situations where clients are unable, because of impairments, to self-determine or act independently in their best interests. The nursing skill of power sharing can enhance nurse-client relationships and is flexible if there are levels in the client’s self-care ability.

Self-advocacy evolves through empowering and assisting clients to speak for themselves to express needs, concerns, and questions about their condition and their treatment. Self-advocacy is a skill to be acquired and nurses have a significant role in this learning through direct instruction as well as through role modeling.

Client advocacy comes into play as nurses care for clients daily, despite barriers that do exist. Included in advocacy is keeping clients informed of the plan of treatment, mediating for clients with others, being diligent to safeguard clients through assessment for possible abuse, and ensuring clients know the value placed on them through the care, compassion, and support. Nurses place importance on championing the role of social justice in ensuring all clients receive the same level of care. Barriers to client advocacy include nursing fear, lack of organizational cooperation and materials, bureaucracy, and limited client financial resources.