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Copyright © 2008 Thomson Delmar Learning
Chapter 12Chapter 12
Power
Copyright © 2008 Thomson Delmar Learning
2
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
Copyright © 2008 Thomson Delmar Learning
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ObjectivesObjectives
Apply an understanding of power to help nurses improve their effectiveness
Analyze how new nurses can increase their power
Copyright © 2008 Thomson Delmar Learning
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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
Copyright © 2008 Thomson Delmar Learning
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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
Copyright © 2008 Thomson Delmar Learning
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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
Copyright © 2008 Thomson Delmar Learning
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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
Copyright © 2008 Thomson Delmar Learning
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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
Copyright © 2008 Thomson Delmar Learning
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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
Copyright © 2008 Thomson Delmar Learning
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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
Copyright © 2008 Thomson Delmar Learning
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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
Copyright © 2008 Thomson Delmar Learning
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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
Copyright © 2008 Thomson Delmar Learning
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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
Copyright © 2008 Thomson Delmar Learning
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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
Copyright © 2008 Thomson Delmar Learning
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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
Copyright © 2008 Thomson Delmar Learning
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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
Copyright © 2008 Thomson Delmar Learning
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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
Copyright © 2008 Thomson Delmar Learning
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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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A Framework for A Framework for Becoming EmpoweredBecoming Empowered
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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A Framework for A Framework for Becoming EmpoweredBecoming Empowered
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
Copyright © 2008 Thomson Delmar Learning
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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