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Chapter12

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  • 1. Chapter 12 Power
  • 2. 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
  • 3. Objectives
      • Apply an understanding of power to help nurses improve their effectiveness
      • Analyze how new nurses can increase their power
  • 4. Definitions 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
  • 5. Levels 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
  • 6. Power and Accountability
    • 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
  • 7. Sources 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
  • 8. Expert 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
  • 9. Legitimate 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
  • 10. Referent 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
  • 11. Reward 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
  • 12. Connection 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
  • 13. Information 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
  • 14. Positive Personal Orientation 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
  • 15. Empowerment
    • 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
  • 16. Power 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
  • 17. Power 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
  • 18. Power and the Limits of Information
    • 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
  • 19. A Framework for Becoming 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
  • 20. A Framework for Becoming 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
  • 21. A Framework for Becoming 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
  • 22. 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
  • 23. 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

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