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  1. 1. Chapter 12 Power
  2. 2. Objectives <ul><li>Upon completion of this chapter, the reader should be able to: </li></ul><ul><ul><li>Define power, and describe it at the personal, professional, and organizational levels </li></ul></ul><ul><ul><li>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 </li></ul></ul>
  3. 3. Objectives <ul><ul><li>Apply an understanding of power to help nurses improve their effectiveness </li></ul></ul><ul><ul><li>Analyze how new nurses can increase their power </li></ul></ul>
  4. 4. Definitions of Power <ul><li>The ability to create, get, and/or use resources to achieve one’s goals  </li></ul><ul><li>Power can be defined at various levels </li></ul><ul><ul><li>Personal, cultural, professional, or organizational </li></ul></ul><ul><li>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 </li></ul>
  5. 5. Levels of Power <ul><li>Personal </li></ul><ul><ul><li>Derives from characteristics of the individual </li></ul></ul><ul><li>Professional </li></ul><ul><ul><li>Conferred on members of the profession by one another and the larger society to which they belong </li></ul></ul><ul><li>Organizational </li></ul><ul><ul><li>One’s position in an organizational hierarchy </li></ul></ul><ul><ul><li>Being authorized to function powerfully within an organizational culture </li></ul></ul>
  6. 6. Power and Accountability <ul><li>Accountability is considered one of the major hallmarks of the health care professions </li></ul><ul><li>Nurses have accountability and direct responsibility for decisions made and actions rendered </li></ul><ul><li>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 </li></ul>
  7. 7. Sources of Power <ul><li>Diverse, and vary from one situation to another </li></ul><ul><li>A combination of conscious and unconscious factors that allow an individual to influence others to do as the individual wants </li></ul><ul><li>Multiple types of power </li></ul>
  8. 8. Expert Power <ul><li>Derived from the knowledge and skills a nurse possesses </li></ul><ul><li>The less acknowledged that experts are in a group, the less effective their expert powers become </li></ul><ul><li>Visible reciprocal acknowledgment of expertise among group members balances power and enhances productivity </li></ul>
  9. 9. Legitimate Power <ul><li>Power that is derived from a position a nurse holds in a group, and it indicates the nurse’s degree of authority </li></ul><ul><li>The more comfortable nurses are with their legitimate power as nurses, the easier it is for them to fulfill their role </li></ul><ul><li>Nurses in authority are expected to use what authority they have and may be punished for not doing so </li></ul>
  10. 10. Referent Power <ul><li>Power derived from how much others respect and like any individual, group, or organization </li></ul><ul><li>Nurses who are identified with respected, trustworthy individuals or groups will benefit from referent power by virtue of such identification </li></ul>
  11. 11. Reward Power <ul><li>The ability to reward or punish others, as well as to create fear in others to influence them to change their behavior </li></ul><ul><li>Also referred to as coercive power </li></ul><ul><li>Rewards are not likely to permanently change attitudes </li></ul><ul><li>Withholding rewards or achieving a goal by instilling fear in others often results in resentment </li></ul>
  12. 12. Connection Power <ul><li>The extent to which others are connected with others </li></ul><ul><li>Leaders can dramatically increase their influence by understanding that people are attracted to those with power and their associates </li></ul><ul><li>Nurses should work to resolve issues at the appropriate level before they take their concerns to a higher level of authority </li></ul>
  13. 13. Information Power <ul><li>The ability to influence others with the information they provide to the group </li></ul><ul><li>Nurses must share knowledge that is both accurate and useful </li></ul><ul><li>Information sharing can improve patient care, increase collegiality, enhance organizational effectiveness, and strengthen one’s professional connections </li></ul>
  14. 14. Positive Personal Orientation to Power <ul><li>A person’s desire for power takes one of two forms </li></ul><ul><ul><li>An orientation toward achieving personal gain and self-glorification </li></ul></ul><ul><ul><li>An orientation for achieving gain for others or the common good </li></ul></ul>
  15. 15. Empowerment <ul><li>A process of power sharing by involvement in the decision-making process </li></ul><ul><li>A process of personal growth and development </li></ul><ul><li>Something positive, or highly desirable to be aspired to, advocated for, or attained </li></ul><ul><li>Nurses disempower themselves if they see nurses or nursing as powerless </li></ul>
  16. 16. Power and the Media <ul><li>There is a relationship between power and perception </li></ul><ul><li>The media can be used to create or change perceptions </li></ul><ul><li>The way the media present nursing to the public will empower or disempower nursing </li></ul><ul><li>Nurses must work to consistently use the media as effectively as other more powerful occupational groups </li></ul>
  17. 17. Power Development <ul><li>Understanding power from a variety of perspectives is not just important for nurses professionally, it is important for them personally as well </li></ul><ul><li>It allows nurses to gain control of their work and personal lives </li></ul><ul><li>Three ways to imagine the future </li></ul><ul><ul><li>What is possible </li></ul></ul><ul><ul><li>What is probable </li></ul></ul><ul><ul><li>What is preferred </li></ul></ul>
  18. 18. Power and the Limits of Information <ul><li>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 </li></ul><ul><li>Effective nurses understand time constraints and set priorities to ensure that what is most important receives the most attention </li></ul>
  19. 19. A Framework for Becoming Empowered <ul><li>Personal </li></ul><ul><ul><li>Find a mentor </li></ul></ul><ul><ul><li>Introduce yourself to powerful people in your personal and professional life </li></ul></ul><ul><ul><li>Find and maintain evidenced-based sources of ongoing information </li></ul></ul><ul><ul><li>Seek answers to questions </li></ul></ul><ul><ul><li>Notice who holds power in your personal, professional, and organizational life </li></ul></ul><ul><ul><li>Make and evaluate a plan </li></ul></ul>
  20. 20. A Framework for Becoming Empowered <ul><li>Professional </li></ul><ul><ul><li>Assess patient’s condition using relevant objective measurements </li></ul></ul><ul><ul><li>Collaborate with administrators, other nurses, physicians, and other health care workers involved in the care of your patients </li></ul></ul><ul><ul><li>Join your professional nursing organization </li></ul></ul><ul><ul><li>Collaborate with significant others, friends, and members of the patient’s family </li></ul></ul>
  21. 21. A Framework for Becoming Empowered <ul><li>Organizational </li></ul><ul><ul><li>Actively monitor and improve patient care quality </li></ul></ul><ul><ul><li>Volunteer for committee assignments that will challenge you to learn and experience more than what is expected of you in a staff nurse role </li></ul></ul><ul><ul><li>Evaluate your plans </li></ul></ul><ul><ul><li>Volunteer to be involved with health care at the local, state, and national levels </li></ul></ul>
  22. 22. Power and Decision Making <ul><li>Power and decision making are intricately connected </li></ul><ul><li>Emphasis on cost containment in health care has created opportunities for nurses </li></ul><ul><li>Nurses’ knowledge allows them to participate in health care and cost-containment discussions, giving them more opportunities for decision making </li></ul><ul><li>This, in turn, gives nurses greater power </li></ul>
  23. 23. The Power of Critical Thinking <ul><li>Critical thinking enables nurses to understand more and to find better information </li></ul><ul><li>Effective nurses can take information they have acquired in the past and apply it to their present situation </li></ul><ul><li>Power is associated with transforming thought into action </li></ul>
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