Patients often report feeling lost in the medical system, like they're just a number. They may become angry or confused because no one seems to be listening to them. They often find that even by doing everything the doctors tell them, they are still not getting better. Patients find themselves facing a serious diagnosis, not understanding what is really happening and wondering if they've been told all of their treatment options. They wonder why they need so many medications.
In response, a program partnered with the University of Arizona College of Nursing in Tucson and endorsed by the American Holistic Nurses Association is preparing experienced registered nurses to be Independent RN Patient Advocates (iRNPA).
Created in 2002, RN Patient Advocates, PLLC, facilitates the contribution clinical RNs can make to improving healthcare in the U.S. - patient by patient - by following their passion for advocacy. The comprehensive, clinically based education program embraces the full range of medical treatment modalities, including integrative and functional medical paradigms, along with traditional Western medicine. There are now iRNPAs in 25 states.
An iRNPA works with patients in varying levels of need, from wellness education to the ICU. They may specialize in one area, such as oncology or neurology, or opt to work as generalists. There are iRNPAs in nearly every clinical specialty and a majority of them hold advanced degrees. The RNPA National Network [www.patientadvocates.com] hosts member profiles and offers an abundance of online resources for members.
The iRNPA Role
The iRNPA connects the dots in the healthcare continuum. We ensure every physician knows what every other is doing, because faulty communication causes medical errors. We advocate on clients' behalf with doctors and hospitals, asking those questions they do not know how to ask, which also helps to prevent medical errors.
We teach clients about their conditions individually and provide group education through our Community Health Literacy program. Understanding the pathophysiology of their condition better prepares the client to be proactively involved in their care and ensures a greater compliance with treatment plans. The iRNPA analyzes clients' medical records to create the MEDiKEY, a synoptic chronology of their history based on a forensic study of medical records and ensure physicians have all of the critical data on hand. Physicians are very appreciative of this tool. We also help to ensure an accurate diagnosis, researching all useful testing and preventing unnecessary repetition of procedures.
The iRNPA researches all treatments, teaching clients and families along the way to enable them to make the best healthcare choices as they progress through the healthcare maze. We weed out potential problems, such as adverse interactions with other meds, with foods or with supplements. We also teach clients which medications block specific nutrients, which may contribute to a worsening condition.
The iRNPA does not diagnose, prescribe or do hands-on patient care. We work collaboratively with all members of the healthcare team as an advocate of patients, not an adversary to clinicians. We partner with physicians to help provide our clients optimal care across the continuum.
Practice & Policy
Patients typically find an iRNPA through direct contact following a community health presentation, after visiting the RN Patient Advocacy Network website and referrals from previous clients. The services provided by iRNPAs are not covered by insurance policies, which typically are limited to conventional medical approaches. Hospitals or primary care physicians may refer patients but the iRNPA and their services remain entirely patient centered.
There is not at this time any credential or certification for RN Patient Advocacy; it's too new. The RN Patient Advocacy Learning Intensive offers a certificate of completion.
Healthcare reform supports the role of the iRNPA by providing reimbursement for care coordination, which is part of our Advocacy Process©. Our partner in education, the UA College of Nursing, is designing a certification program for RN Care Coordinators. That curriculum is incorporated almost entirely into the RN Patient Advocate Learning Intensive.
No clinical specialty is necessarily more helpful than another for iRNPAs. What matters most is depth of knowledge of the entire healthcare continuum. Other qualifications include an active RN license, a commitment to being a lifelong learner, good teaching and communication skills, an ability to work autonomously and use critical thinking skills to problem solve, a penchant for conducting research online and a desire to be a nursing pioneer.
Karen Mercereau is founder of RN Patient Advocates, PLLC, and developer of the RNPA National Network and Advocacy Process© for the iRNPA. Learn more at www.patientadvocates.com.