Ethical advocacy based on caring: A model for neonatal and paediatric nurses


A/Prof. Kaye Spence, Clinical Nurse Consultant, Grace Centre for Newborn Care, The Children's Hospital at Westmead, Locked Bag 4001, Westmead, 2145, Australia. Fax: 02-98452251; email:


Advocacy has been identified as an ideal in nursing practice. National codes (Australian Nursing and Midwifery Council) and professional standards (Australian College of Neonatal Nurses) state that nurses are to respect their patients' autonomous choices and act as their advocates. This responsibility includes acting as advocates for the needs and welfare of patients, for the profession of nursing and for the interests of colleagues in nursing. However, ambiguous interpretations of the concept of patient advocacy continue to pose a number of problems for nurses in practice and in particular neonatal practice. Neonatal nurses often perceive themselves primarily as advocates for the rights of helpless and vulnerable infants in their care. Advocacy is underpinned by caring, which is a significant feature in the delivery of quality care for each baby and child. This advocacy may be expressed at the bedside, in committee meetings, in agency discussions or in the public arena.