Chapter12

Copyright © 2008 Thomson Delmar Learning

Chapter 12Chapter 12

Power


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Objectives Objectives

Upon completion of this chapter, the reader should be able to: Define power, and describe it at the personal, professional, and organizational levels

Describe each of the following sources of power, and analyze its relative strength for an entry level nurse: coercion, reward, legitimate, expert, referent, information, and connection


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ObjectivesObjectives

Apply an understanding of power to help nurses improve their effectiveness

Analyze how new nurses can increase their power


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Definitions of PowerDefinitions of Power

The ability to create, get, and/or use resources to achieve one’s goals

Power can be defined at various levels Personal, cultural, professional, or organizational

Power at the personal level is closely linked to how an individual perceives power, how others perceive the individual, and the extent to which an individual can influence events


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Levels of PowerLevels of Power

Personal Derives from characteristics of the individual

Professional Conferred on members of the profession by one another and the larger society to which they belong

Organizational One’s position in an organizational hierarchy

Being authorized to function powerfully within an organizational culture


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Power and Power and AccountabilityAccountability

Accountability is considered one of the major hallmarks of the health care professions

Nurses have accountability and direct responsibility for decisions made and actions rendered

Effective nurses see power as positive and view their ability to understand and use power as a significant part of their responsibilities to patients, coworkers, the nursing profession, and themselves


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Sources of PowerSources of Power

Diverse, and vary from one situation to another

A combination of conscious and unconscious factors that allow an individual to influence others to do as the individual wants

Multiple types of power


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Expert PowerExpert Power

Derived from the knowledge and skills a nurse possesses

The less acknowledged that experts are in a group, the less effective their expert powers become

Visible reciprocal acknowledgment of expertise among group members balances power and enhances productivity


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Legitimate PowerLegitimate Power

Power that is derived from a position a nurse holds in a group, and it indicates the nurse’s degree of authority

The more comfortable nurses are with their legitimate power as nurses, the easier it is for them to fulfill their role

Nurses in authority are expected to use what authority they have and may be punished for not doing so


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Referent PowerReferent Power

Power derived from how much others respect and like any individual, group, or organization

Nurses who are identified with respected, trustworthy individuals or groups will benefit from referent power by virtue of such identification


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Reward PowerReward Power

The ability to reward or punish others, as well as to create fear in others to influence them to change their behavior

Also referred to as coercive power Rewards are not likely to permanently change attitudes

Withholding rewards or achieving a goal by instilling fear in others often results in resentment


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Connection PowerConnection Power

The extent to which others are connected with others

Leaders can dramatically increase their influence by understanding that people are attracted to those with power and their associates

Nurses should work to resolve issues at the appropriate level before they take their concerns to a higher level of authority


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Information PowerInformation Power

The ability to influence others with the information they provide to the group

Nurses must share knowledge that is both accurate and useful

Information sharing can improve patient care, increase collegiality, enhance organizational effectiveness, and strengthen one’s professional connections


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Positive Personal Positive Personal Orientation to PowerOrientation to Power

A person’s desire for power takes one of two forms An orientation toward achieving personal gain and self-glorification

An orientation for achieving gain for others or the common good


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EmpowermentEmpowerment

A process of power sharing by involvement in the decision-making process

A process of personal growth and development

Something positive, or highly desirable to be aspired to, advocated for, or attained

Nurses disempower themselves if they see nurses or nursing as powerless


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Power and the MediaPower and the Media

There is a relationship between power and perception

The media can be used to create or change perceptions

The way the media present nursing to the public will empower or disempower nursing

Nurses must work to consistently use the media as effectively as other more powerful occupational groups


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Power DevelopmentPower Development

Understanding power from a variety of perspectives is not just important for nurses professionally, it is important for them personally as well

It allows nurses to gain control of their work and personal lives

Three ways to imagine the future What is possible What is probable What is preferred


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Power and Power and the Limits of the Limits of InformationInformation

To make good decisions, nurses must be able to gather enough information and realistically interpret its value, as well as share and apply information in a safe competent manner

Effective nurses understand time constraints and set priorities to ensure that what is most important receives the most attention


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A Framework for A Framework for Becoming EmpoweredBecoming Empowered

Personal Find a mentor Introduce yourself to powerful people in your personal and professional life

Find and maintain evidenced-based sources of ongoing information

Seek answers to questions Notice who holds power in your personal, professional, and organizational life

Make and evaluate a plan


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Professional Assess patient’s condition using relevant objective measurements

Collaborate with administrators, other nurses, physicians, and other health care workers involved in the care of your patients

Join your professional nursing organization

Collaborate with significant others, friends, and members of the patient’s family


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Organizational Actively monitor and improve patient care quality

Volunteer for committee assignments that will challenge you to learn and experience more than what is expected of you in a staff nurse role

Evaluate your plans Volunteer to be involved with health care at the local, state, and national levels


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Power and Decision Power and Decision MakingMaking

Power and decision making are intricately connected

Emphasis on cost containment in health care has created opportunities for nurses

Nurses’ knowledge allows them to participate in health care and cost-containment discussions, giving them more opportunities for decision making

This, in turn, gives nurses greater power


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The Power of Critical The Power of Critical ThinkingThinking

Critical thinking enables nurses to understand more and to find better information

Effective nurses can take information they have acquired in the past and apply it to their present situation

Power is associated with transforming thought into action

Health & Medicine

Chapter12