We also observed lack of advocating among nurses this

and hinders tracking of clinical care decisions and care goals.”
We also observed lack of advocating among nurses. This same lady was being given oral
painkillers that were having no effect on her. She was tachycardiac due to pain since last night
and no doctor came to round. The nurse could have advocated for intravenous painkillers and for
doctor's round. According to Davoodvand, Abbaszadeh and Ahmedi (2017), “ nurses, more than

Malpractice among nursing staf
anyone else, are in contact with patients and their problems therefore, they can provide justice
for the patients better than anyone else. Nurses are the first advocates of patients” ...
Patient-nurse communication was very unsatisfying. During patient’s round, we came to know
that ten out of thirteen patients didn’t know about “risk for fall” band. Moreover, a client who
was recently diagnosed as diabetic, complained about the diabetic diet given to him because of
the communication gap between nurse and patient. Lack of communication, advocacy and wrong
documentation highlights the negligency of staff. Though patients were not harmed, but these
practices depict carelessness, and this could harm patient any time. This is why we chose this
topic because patient is our first priority.
As a leader, one should always determine the causes of the problem before coming to solution.
“ A study conducted by Khani et al. ( 2016 ) revealed that fatigue, large number of patients, high
volume of nursing actions, lack of continuous monitoring and evaluation were important factors
affecting nursing records in hospitals.”( Mutshatshi et al,2018). According to Lunardi, Barlem,
Ramos, Silveira and piexak (2016), “The main barriers to patient advocacy in the field of nursing
include lack of time, work overload, difficulties communicating with patients or healthcare staff,
lack of knowledge, powerlessness, fear of taking risks, lack of autonomy and lack of power to
make decisions.”
Leadership is in the core values of this profession and bedside nurses act as a leader themselves
when involved in patient’s care. That’s an informal leadership but an important aspect of nursing.