1. Patient advocates have their best interest at heart and serve as a voice for others who cannot speak for themselves, such as children, non-verbal, cognitively or mentally impaired, uninformed, and even other intimidated healthcare workers (Gerber, 2018). There are several situations in which nursing advocacy can assist patients within the healthcare environment. For example, an alert adult patient may have differing opinions with their family member regarding advance directives. Sometimes, the family can overstep and want to pursue their choices, disregarding the patient. Situations like this can prompt a nurse to advocate for their patients and talk to the family regarding the patient’s rights. Regarding conflict, attempts to compromise to reach a common goal should be handled with therapeutic communication and show assertiveness, not aggressiveness (Gerber, 2018).

It is difficult to say whether pre-licensure education adequately prepares a nurse to act as a patient advocate because it depends on the individual. People have different personalities and handle situations differently. Nursing school may provide basic knowledge of patient advocacy as a student, but it takes an actual situation to have happened to make this determination. It helps when there is a solid support system in the organization to help nurses be advocates for patients, such as experienced nurses mentoring newer colleagues, doctors collaborating with nurses and respecting their autonomy, and support from their supervisors (Gerber, 2018). Also, there is additional training available for those who would like to be a Board Certified Patient Advocate (BCPA), which helps determine their level of competency and passing the certification will show they have at least the minimum requirements in becoming a health advocate (Patient Advocate Certification Board, 2023).

2. Mason et al. (2015) define advocacy as an act of “pleading the cause of another”. Nurse are obligated to act and represent patients as needed in clinical setting by protecting the patient’s autonomy, voicing patients’ concerns, and fight for justice in the healthcare settings on behalf of the patient (Nsiah et al., 2019). Gadow’s concept of nurses as advocates is that they spend the most time with patients therefore have a special connection which makes them obligated to promote their autonomy (Mason et al., 2015, p. 32).

Some of the situations where nurses assist patients in the healthcare setting through advocacy would be explaining a procedure or making sure patients understands what kind of medication they are taking. Nurses normally provide teaching in a healthcare setting through clarification of treatment plans and procedures, as well as medications ordered by doctors. According to Mason et al. (2015), nurses act as patient advocates by making sure they understand what kind of treatment they are receiving while in the hospital. They further stated that nurses act as translators between the patients and the healthcare team by coordinating the plan of care (p. 30).

Pre-licensure education doesn’t prepare nurses to adequately advocate for the patients because there is no specific course on the topic during nursing school. This means that nursing students don’t get enough information about their future roles as nurse advocates, making it hard for them to adjust in the work environment. According to Mason et al. (2015), lack of education and training is one of the biggest barriers of nurses successfully carrying out their roles as advocates. They also continued that during nursing school training, there are very limited programs that focus on training nurses to become successful patient advocates (p. 34).

3.The etymology of the word “patient” means “one who suffers” (Wikipedia, 2023, para. 2). For this reason, I understand others’ concerns regarding using the word “patient” due to dignity issues. Long-term care facilities use “residents” to identify patients (Wikipedia, 2023, para. 10).

There is no other organization that uses the term “patient” as their consumer other than healthcare. Also, “patient” is predominantly used across the interprofessional healthcare system (American Psychological Association, 2018). Therefore, I am okay with the use of “patient” instead of “client” because it is very distinctive of the individuals that we serve in healthcare (British Medical Journal, 1999). But if my patient takes offense and prefers the term “client,” I am also okay with that. In practice, I use the term interchangeably. Nurses must strive to build rapport with their clients by all means, including their preference on the term they prefer nurses use to address them (Butts, 2016, p. 464).

4. According to the American Nurses Association Code of Ethics for Nurses with Interpretive Statements (2015), the term “patient” is rooted in suffering, indicating an individual undergoing medical treatment; meanwhile, “client” implies an individual who listens or follows another – indicating a more business or consultation relationship. Nurses provide care for both patients and clients, but the ANA has decided to keep utilizing the term “patient” for those who receive nursing care – a broader term for clients, consumers, individuals, or groups (ANA, 2015)

I agree that the term “patient” should be utilized since over the terms “client,” “consumer,” or “customer” since they can imply that the care provided are products to be marketed. In that case, “client” is assuming the role of the buyer, and health care providers are considered sellers. “Client” implies an agency relationship – one in which a professional service is bought (Deber et al., 2005). I believe the term patients refer to those who receive care and whose needs are met; clients indicates a business transaction.

5. There were a few behaviors of the student’s and the teacher for me was not acceptable. First, the students had no clear boundaries or respect for the teacher. Second, the teacher was talking in a monotonous voice that was not engaging and very boring. Third, the teacher was just reading the PowerPoint as if she was not prepared for the content, and there was also lack of student interaction inside the classroom. And finally, the teacher called out the late student in front of everyone which could be embarrassing for the student. There are a few ways to manage those issues. Firstly, the instructor should establish clear expectations for behavior and conduct at the beginning of the course, including implementation of consequences for any violations. Secondly, the teacher should be enthusiastic and she should mind her tone. She should not be monotonous to prevent boredom inside the class. Speaking in a low or unclear voice, speaking too quickly or slowly, or speaking in a flat, monotone voice can make it challenging for students to pay attention and comprehend verbal lectures (Billings & Halstead, 2016). Thirdly, the instructor should be well-prepared and know the content of the subject and also she could encourage open dialogue and active listening in the classroom, allowing students to express their opinions and concerns while fostering a collaborative and inclusive environment. Finally, the instructor should talk to the student in private if the student have done something wrong. Privately discuss observed behaviors with the student to address faculty concerns and allow the student to understand the impact of their behavior on others and the course’s learning outcomes (Billings & Halstead, 2016). The goal is to promote a positive and productive learning environment while proactively addressing any instances of any student misconduct.

6.One of the many issues that was displayed in the video on classroom management was the rude remark given by the student who arrived late to class. Other issues include students being on their phone and at least two students have their headphones on; in addition, another student is juggling crumpled pieces of paper in the middle of the classroom. According to Billings & Halstead (2016), “It is important for the educator to be mindful of the manner used to communicate with a student regarding annoying behaviors; in addition, handling small problems by avoiding an escalation of behaviors is essential” (Billings & Halstead, 2016, p. 232). It is also stated by Billings & Halstead (2016) that, “The key in responding to annoying behaviors is to keep grounded in the learning experience, even though the behavior is annoying to you” (Billings & Halstead, 2016, p. 232). For example, asking why the student was late and concluding that it because of an unexpected accident on the freeway or the student woke up late. Teaching the student that things like this happens but take it as a learning experience and to always account for the unexpected. Billings & Halstead (2016) also stated that behavioral expectations should be clearly outlined and reviewed for the course and inform the students when appropriate, such as on the first day of class or anytime that a disturbance occurs, and for the faculty member to provide positive examples of behavior” (Billings & Halstead, 2016, p. 235).

7.Incivility and bullying can put patient safety at risk by creating a negative and stressful work environment that can lead to decreased communication, teamwork, and collaboration among healthcare providers. Some of the causes of incivility and bullying may include stress, competition, power dynamics, and lack of communication skills. There are three factors that are related to the occurrences of incivility: personal issues, situational issues, as well as communication and relationship issues (Ni Gusti, 2019). Students’ personal issues, such as being self-centered, intolerant, blaming and intimidating others, having a sense of entitlement, and experiencing emotional disturbance, can lead to uncivil behavior (Ni Gusti, 2019). Some certain situations can also cause incivility within students, or faculty. Stress and attitudes of superiority were both a common factory that causes incivility (Ni Gusti, 2019). Communication and relationship issues, labeled differently, were the most common problems reported by academics and student nurses, including verbal and nonverbal communication issues, rude behavior, disrespect for others, and relationship issues such as superiority and feeling belittled (Ni Gusti, 2019).

Some approaches can be made to prevent incivility or bullying. Establishing an environment of open communication and respect is essential to prevent incivility and bullying in both the classroom and clinical settings. It may be necessary to implement training programs that emphasize the development of communication and conflict resolution skills, promote open and honest dialogue, and address to any instances of instances of incivility or bullying immediately. Also, implementing policies and consequences for such conduct can show incivility and bullying are not tolerated.

8. Ineffective teaching is having a mono-tone voice and a powerpoint that students cannot read. The students should be prepared for class and ready to learn. The teacher should assign chapters to be read prior to class. This way students can come to class with opportunities to ask questions. The powerpoint was too small and the teacher was just reading off the powerpoint. This can easily make the student bored and want to do something else rather than focusing on the material. The powerpoint should be a summary of the things the teacher wants to talk about. The teacher should not have an attitude when the student walks in late. The teacher should have acknowledged the student then asked them for a discussion after class. By not informing students of the rules prior to teaching, this made the class get out of control. The teacher could have started the class with an open discussion leading into the powerpoint. Then ask questions throughout the powerpoint to ensure the students are focusing on the material.

When there is bullying in a classroom, it could be a number of things. It should not be tolerated by any student or faculty. Bullying or incivility should be stopped immediately. This can put the student, faculty or even the patients at harm. When this is witnessed, the student or the faculty should report it immediately to upper management. This way, it can be handled effectively. In the clinical environment, any faculty or student who witnesses any type of bullying should immediately report it. In the clinical environment, there is no room for any type of bullying because of the amount of risks that it could put on the patient.

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