Nursing Leadership & Management

1. Nursing Leadership & Management Patricia Kelly-Heidenthal 0-7668-2508-6 Delmar Learning Copyright © 2003 Delmar Learning, a Thomson Learning company

2. Chapter 17 Power Delmar Learning Copyright © 2003 Delmar Learning, a Thomson Learning company

3. Objectives • Upon completion of this chapter, the reader should be able to: • Define the concept of power from more than one perspective. • Identify the various ways power has been described in the literature. • Describe how a nurse’s perception of and orientation to power affects patient care. Copyright © 2003 Delmar Learning, a Thomson Learning company

4. Objectives • Discuss the relationships among empowerment and personal and collective commitment. • Describe the association of connection power and relationships. • Explain why nurses are faced with a paradox within the context of information power. Copyright © 2003 Delmar Learning, a Thomson Learning company

5. Definitions of Power • Poweris described as the ability to create, get, and/or use resources to achieve one’s goals.  • Power can be defined atvarious levels: personal, cultural, professional, or organizational. • Power, regardless of level, comes from the ability to influence others or affect others’ thinking or behavior. Copyright © 2003 Delmar Learning, a Thomson Learning company

6. Power and Accountability • Effective nurses view their ability to understand and use power as a significant part of their responsibilities to patients, their coworkers, the nursing profession, and themselves. • Nurses are accountable, both professionally and legally, for decisions and actions occurring under their supervision. Copyright © 2003 Delmar Learning, a Thomson Learning company

7. Power and Accountability • Accountability without authority to make responsible decisions poses a threat to nurses individually and collectively. • Nurses must understand that power is a means of developing and retaining the authority that must accompany their accountability. Copyright © 2003 Delmar Learning, a Thomson Learning company

8. Sources of Power • Expert power: derived from knowledge and skills • Legitimate power: derived from the position of authority a person holds • Referent (charismatic) power: derived from how much others respect and like a person • Reward power: derived from a person’s ability to bestow rewards on people Copyright © 2003 Delmar Learning, a Thomson Learning company

9. Sources of Power • Coercive power: derived from a person’s ability to punish or threaten others • Connection power: derived from a person’s connection to others with power • Information power: derived from a person’s ability to provide information Copyright © 2003 Delmar Learning, a Thomson Learning company

10. Power and Decision Making • 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. Copyright © 2003 Delmar Learning, a Thomson Learning company

11. Personal Orientation and Motivation in Relation to Power • A person can desire and wield power for personal gain or for the common good. • Nursing has traditionally worked for the common good. • To continue doing so, nursing must exert power and control over its decision-making abilities. • Nurses must examine their personal motivations for seeking and exerting power. • Any one perspective on power is incomplete. Copyright © 2003 Delmar Learning, a Thomson Learning company

12. Empowerment and Disempowerment • Empowerment is the “process by which we facilitate the participation of others in decision making and take action within an environment where there is an equitable distribution of power.” • Nurses can disempower themselves by acting powerless when interacting with other professionals, legislators, or the media. • Nursing can empower itself through a greater presence in the media and in the minds of the public. Copyright © 2003 Delmar Learning, a Thomson Learning company

13. The Power of Relationships • Nurses regularly are afforded special opportunities to form relationships, by entering into a loop of information sharing.  • However, information sharing alone does not create power—it must be accompanied by commitment. • Nursing expresses a commitment to patients, and nurses must articulate and act upon that commitment. Copyright © 2003 Delmar Learning, a Thomson Learning company

14. The Power and Limits of Information • Information alone does not create power, as potentially there is no end to information and information gathering. • Nurses must be able to gather the necessary information for competent decision making and make decisions in an appropriate time frame. • The critical thinking process that nurses use to gather, interpret, share, and apply information is what transforms their information into power. Copyright © 2003 Delmar Learning, a Thomson Learning company

15. The Power of Critical Thinking • 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. Copyright © 2003 Delmar Learning, a Thomson Learning company