# Evaluating the Integration of Professional Nurse and Midwifery Advocacy Roles Within a Large Healthcare Organization: Assessing Service Utilization and Benefits—A Cross-Sectional Survey

## TL;DR

This study evaluates how nursing and midwifery staff in a large healthcare organization use and benefit from professional advocate roles, finding low awareness but high interest in future use.

## Contribution

The study provides new insights into the underutilized professional advocate role in healthcare, highlighting barriers and opportunities for improving staff well-being and retention.

## Key findings

- Most participants were unaware of the professional advocate role, but nearly all expressed interest in using it in the future.
- Midwives had greater familiarity with the role compared to nurses, who showed higher interest in repeated use.
- Participants valued the role for emotional support, advocacy, and career development, but faced barriers like time constraints and confidentiality concerns.

## Abstract

To assess nursing and midwifery staff's awareness, use, and perceived benefits of the professional advocate (PA) role in clinical practice.

Nursing and midwifery staff face growing challenges, including heavy workloads, burnout, and staff shortages. In response to rising attrition and dissatisfaction, the professional nurse advocate and professional midwifery advocate roles were introduced to provide professional support, improve working conditions, and enhance staff well-being. However, there is limited evidence on their effectiveness, particularly regarding staff retention and well-being.

This evaluation employed a mixed-methods approach across four phases. This paper focuses on Phase 2, which involved a cross-sectional, self-report survey of 407 nursing and midwifery staff. Participants completed a self-administered questionnaire between October 2023 and January 2024.

The study highlights significant gaps in awareness and access to PA services, with 64.9% of participants unaware of the role and 80.6% reporting no prior engagement. However, 95.3% expressed interest in future use, indicating strong positive attitudes toward the role and its support. Midwives reported greater familiarity with and access to PA services, likely due to longer exposure to the role, while nurses showed higher interest in repeated use. Informal communication channels, such as word-of-mouth, were prevalent, highlighting the need for more formal communication strategies. Participants valued the PA role for its emotional support, advocacy for staff rights, and career development, with confidentiality and accessibility identified as key priorities. Barriers to access included time constraints, concerns about confidentiality, and the need for greater organizational support. The PA role was perceived as empowering, positively influencing staff well-being and job satisfaction.

Effective integration of PA services has the potential to empower nursing and midwifery staff, improving well-being and retention. Addressing access barriers and enhancing service delivery are essential to maximizing the impact of PA services in supporting staff well-being and professional growth.