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The Role of the Nurse as Advocate in Ethically Difficult Care Situations With Dying Patients

McSteen, Kerstin MS, APRN, BC; Peden-McAlpine, Cynthia PhD, APRN, BC

Journal of Hospice & Palliative Nursing: September-October 2006 - Volume 8 - Issue 5 - p 259-269

The concept of advocacy in nursing is broadly defined, and the actual practice of advocacy in nursing varies from nurse to nurse. It is imperative for the profession of nursing to understand and apply the concept of nursing advocacy in the intimate, interpersonal nature of nurse-patient relationships. The purpose of this qualitative study was to identify and illustrate the key activities of expert nurses who act as patient advocates in ethically difficult care situations involving dying patients. A hermeneutic phenomenological approach was used in this study because it is in the narratives of nurses who have experienced ethically difficult care situations with dying patients that the meaning of advocacy can be discovered. For nurses to act as strong advocates for dying patients means that they are guides, liaisons, and supporters during this experience.

Kerstin McSteen, MS, APRN, BC, is Clinical Nurse Specialist of Palliative Care, Abbott Northwestern Hospital, Minneapolis, MN.

Cynthia Peden-McAlpine, PhD, APRN, BC, is Associate Professor, School of Nursing, University of Minnesota, Minneapolis, MN.

Address correspondence to Kerstin McSteen, MS, APRN, BC, Abbott Northwestern Hospital, Mail Route 14201, 800 East 28th Street, Minneapolis, MN 55407 (e-mail:

© 2006 The Hospice and Palliative Nurses Association