The emergency department (ED) is an entry point to the hospital facility. There are vulnerable patient groups including domestic violence victims, elderly neglect and children that attend the ED requiring advocates to speak and stand in for them [1], [2]. There have been many explanations of patient advocacy. However, many authors agree that it involves the process of representing and defending the patient’s rights, moralities and welfares against unethical and illegal acts [3], [4], [5]. Although much is not known about ED nurses experiences of patient advocacy, ED nurses in a prior study posits that advocacy underpins the care provided to ED patient [6]. They advocate for better policy regulations, renegotiate unsafe and untimely care and provide adequate timely care to patient [6], [7], [8], [9], [10].

Patient advocacy at the ED is stressful and cumbersome as result of increasing patient to nurse ratio and high patient turnovers and unfavorable policies [8], [9], [10]. Yet, in USA and Canada, studies shown that the practice of advocacy in the ED promote positive care outcomes and patient satisfaction [11]. Patient advocacy is considered an integral part of nursing.

Earlier studies (Ware et al., 2011; Vargas et al., 2019) described factors that influence nurses in exercising advocacy for patients both positively and negatively [12], [13]. Nurses’ personal beliefs and experiences, desire to protect the safety of patients and view of advocacy as a professional responsibility have been reported as some of their motivating factors. However, advocating for patients has not been without challenges. Some of the challenges include limited autonomy, reprisals from institutions, fear of mistakes and job losses [14], [15], [16].

Globally, studies on advocacy in the healthcare literature have mainly focused on professional nurses and have been conducted in the Middle East (Iran), North (United States of America) and South (Brazil) America [12], [13], [14], [15], [16]. Very little is also known about ED nurses’ experiences of advocacy. Further considering the nuances in cultural backgrounds and the different health care systems which can change the profile and autonomy of participants, the previous findings may not be applicable in the emergency setting [17], [18]. In view of the unique and complex nature of the emergency department (ED), the current sought to explore the experiences and factors that influence patient advocacy among nurses in a resource-constrained ED.

Specifically, the objectives were as follows:

To explore emergency nurses’ experiences of patient advocacy.

To describe the factors that motivates ED nurses to practice patient advocacy

To describe the factors that challenges ED nurses during the practice of patient advocacy