Breaking Barriers to Advocacy as a Core Professional Responsibility in Nursing: The Nursing Advocacy Activation Model

Nursing advocacy has emerged as a foundational pillar of modern nursing practice, reflecting the profession's ethical commitment to protecting patient rights, promoting health equity, and shaping health policy. Despite its significance, advocacy remains inconsistently practiced due to barriers at the individual, interpersonal, and systemic levels. This article synthesizes current literature to analyze the evolution, conceptual foundations, challenges, and impact of advocacy as a core professional responsibility in nursing. Findings reveal that while advocacy is strongly supported by ethical codes and professional frameworks, its practical implementation is often hindered by bureaucratic structures, fear of retaliation, limited institutional support, communication barriers, and workload pressures. Strategies such as enhanced education, policy empowerment, organizational culture reform, and interprofessional collaboration are essential to strengthen advocacy in clinical and policy settings. There is a need for a renewed commitment to empowering nurses to advocate in this increasingly complex health-care environment. Future studies should emphasize sustainable advocacy frameworks that enhance nurses' and midwives' influence on health-care system transformation.