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Delmar Learning Copyright © 2003 Delmar Learning, a Thomson Learning company Nursing Leadership & Management Patricia Kelly-Heidenthal
Delmar Learning Copyright © 2003 Delmar Learning, a Thomson Learning company Chapter 17 Power
Chapter 17Copyright © 2003 Delmar Learning, a Thomson Learning company3 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.
Chapter 17Copyright © 2003 Delmar Learning, a Thomson Learning company4 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.
Chapter 17Copyright © 2003 Delmar Learning, a Thomson Learning company5 Definitions of Power Power is described as 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, regardless of level, comes from the ability to influence others or affect others’ thinking or behavior.
Chapter 17Copyright © 2003 Delmar Learning, a Thomson Learning company6 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.
Chapter 17Copyright © 2003 Delmar Learning, a Thomson Learning company7 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.
Chapter 17Copyright © 2003 Delmar Learning, a Thomson Learning company8 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
Chapter 17Copyright © 2003 Delmar Learning, a Thomson Learning company9 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
Chapter 17Copyright © 2003 Delmar Learning, a Thomson Learning company10 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.
Chapter 17Copyright © 2003 Delmar Learning, a Thomson Learning company11 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.
Chapter 17Copyright © 2003 Delmar Learning, a Thomson Learning company12 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.
Chapter 17Copyright © 2003 Delmar Learning, a Thomson Learning company13 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.
Chapter 17Copyright © 2003 Delmar Learning, a Thomson Learning company14 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.
Chapter 17Copyright © 2003 Delmar Learning, a Thomson Learning company15 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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