Ombudsman: A New Role for Advanced Practice Nurses in Psychiatric‐Mental Health Nursing

TOPIC. The role of ombudsman for advanced practice nurses in psychiatric mental health nursing. PURPOSE. To describe the role of ombudsman and its fit with nursing as seen in the Price Spratlen Ombudsing Model. SOURCE. The author's own experiences as both an advanced practice nurse and an ombudsman. CONCLUSION. Because of downsizing, reorganization, and a general trend toward mutual distrust in large organizations, being an ombudsman has been named one of the "25 hottest careers." Advanced practice nurses in psychiatric mental health nursing, by virtue of their knowledge of interpersonal, preventive, and systems theories, are in a unique position to fill this role. Key words: Advanced practice psychiatric nurse, conflict resolution, ombudsman Over the past five years, profound changes have taken place in the structure of large organizations, including those employing advanced practice nurses in psychiatric-mental health (PMH) nursing. These changes include downsizing, reorganization, and, in many cases, elimination of middle managers. As a result a chasm exists between staff and upper administration. With fewer middle managers, a channel for resolving problems, conflicts, and disputes is missing. A second result is mutual distrust within organizations between staff and administration. From this perspective, it is easy to see why being an ombudsman has been named one of the "25 hottest careers" (Anzelowitz & Siegal, 1992). Advanced practice nurses in PMH nursing, especially those who have worked in liaison nursing, are uniquely qualified to use their expertise as ombudsmen. For the past 15 years, I have served as Ombudsman for Sexual Harassment and, since 1988, also as the University Ombudsman. My client groups include students, staff, faculty, parents, alumni, visitors, and vendors. In my work I have drawn upon knowledge and experiences gained in traditional nursing employment settings such as hospitals, clinics, and other treatment centers. In addition, I have integrated my expertise in community mental health and urban planning to conceptualize a model of delivery that reflects the needs of clients, the values and goals of the university, and my own commitment to holistic and humane service. The Concept of Ombudsman The concept of ombudsman originated in 1809, when Sweden appointed an ombudsman to address public complaints against government actions. The use of an ombudsman in government then spread to Finland (1919), Denmark (1954), New Zealand (1962), and Great Britain (1966). While the United States never adopted a national ombudsman, several states created their own ombudsman role (Webster, 1989), Hawaii being the first (Rowland, 1970). Beginning in 1966, academic institutions began appointing ombudsmen to accommodate the needs of students. In 1968 and 1969, nearly 30 campuses began ombudsmen services (Rowland, 1970). The university where I practice was among the first 10 institutions of higher education to establish an ombudsman's office. The office does not replace existing university governance or appeal procedures. The purpose of the office is to improve communications regarding university operations and to enable members of the university community to protect their rights and have their concerns responded to efficiently and effectively. Anderson (1969) identified five essential characteristics of an ombudsman, including being: (1) independent, (2) impartial, (3) an expert in government; (4) universally accessible, and (5) empowered to recommend and publicize. I have modified these characteristics and extended them for use in my role as an academic ombudsman. The Concept of Professional Nursing In nursing's social policy statement, the American Nurses Association (ANA, 1995) defines nursing as the diagnosis and treatment of human responses to actual or potential health problems. …