7/24/2019 Nursing Empowerment

1/3

Power and Empowerment in Nursing: Looking Backward to Inform theFuture

Abstract

There are compelling reasons to empower nurses. Powerless nurses are ineffective nurses. Powerless nurses

are less satisfied with their jobs and more susceptible to burnout and depersonalization. This article willbegin with an examination of the concept of power; move on to a historical review of nurses power over

nursing practice; describe the kinds of power over nursing care needed for nurses to make their optimum

contribution; and conclude with a discussion on the current state of nursing empowerment related to nursing

care. Empowerment for nurses ma consist of three components! a workplace that has the re"uisite

structures to promote empowerment; a pschological belief in ones abilit to be empowered; and

acknowledgement that there is power in the relationships and caring that nurses provide. # more thorough

understanding of these three components ma help nurses to become empowered and use their power for

better patient care.

The Concept of Power

Power is a widel used concept in both the phsical and social sciences$ and as a result$ there are mandefinitions. %n the phsical sciences power refers to the amount of energ transferred per unit of time.

Electricians work to provide and restore this tpe of power as a matter of course. &athematicians have a

different notion of power in mind when the talk about a numeral to the second 'or third( power.

)ociologists describe power as the abilit to impose ones will upon others$ and savv researchers conduct

power analses before the begin their experiments

)everal definitions of power have been used in nursing. Power has been defined as having control$ influence$

or domination over something or someone '*handler$ +,,-(. #nother definition views power as the abilit

to get things done$ to mobilize resources$ to get and use whatever it is that a person needs for the goals he

or she is attempting to meet '/anter$ +,,0$ p. +11(. 2or 3enner$ power includes caring practices b nurses

which are used to empower patients '3enner$ -44+(. Power ma also be viewed as a positive$ infinite force

that helps to establish the possibilit that people can free themselves from oppression '5les$ +,,,(.

)ome researchers have described tpes of power$ such as legal$ coercive$ remunerative$ normative$ and

expert power '*onger 6 /anungo$ +,77(. 8f particular interest to nursing is the concept of expert power$

which has been defined as the abilit to influence others through the possession of knowledge or skills that

are useful to others '/ubsch$ +,,1$ p. +,7(. 3enner '-44+( has described "ualities of power associated

with caring provided b nurses such as transformative and healing power. Transformative and healing power

contribute to the power of caring$ which is central to the profession of nursing '3enner$ -44+(.

Power is necessar to be able to influence an individual or group. 9urses need power to be able to influence

patients$ phsicians$ and other health care professionals$ as well as each other. Powerless nurses are

ineffective nurses$ and the conse"uences of nurses lack of power has onl recentl come to light 'Page$

-44:(. Powerless nurses are less satisfied with their jobs '&anojlovich 6 aschinger$ -44-($ and more

susceptible to burnout and depersonalization 'eiter 6 aschinger$ -441(. ack of nursing power ma alsocontribute to poorer patient outcomes '&anojlovich 6

7/24/2019 Nursing Empowerment

2/3

/anter '+,,0( maintains that power is ac"uired through the process of empowerment. )he views

empowerment as arising from social structures in the workplace that enable emploees to be satisfied and

more effective on the job '/anter$ +,,0(. *handler argues that empowerment arises from relationships and

not merel from the parceling out control$ authorit$ and influence '*handler$ +,,-(. Empowerment has

been conceptualized from man different perspectives '/uokkanen 6 /atajisto$ -440(. Empowerment ma

be either an individual or a group attribute '5les$ +,,,(. %t ma arise from the work environment '/anter$

+,,0( or from within ones own psche '*onger 6 /anungo$ +,77( and ma be viewed as either a process oran outcome '>ibson$ +,,+(.

The concept of empowerment emerged in the late +,14s and earl +,?4s as a result of the self=help and

political awareness movements '5les$ +,,,(. #lthough power has been discussed in nursing literature since

the +,?4s '/alisch$ +,?7($ *handler '+,71( was among the first to describe the process of empowerment in

nursing. *handler '+,,-( also distinguished between power and empowerment$ noting that empowerment

enables one to act$ whereas power connotes having control$ influence$ or domination.

8ngoing research on empowerment in nursing has demonstrated that empowered nurses are highl

motivated and are able to motivate and empower others b sharing the sources of power 'aschinger 6

@avens$ +,,1$ p. -7(. Empowered nurses experience less burnout 'aschinger$ 2inegan$ )hamian$ 6 Ailk$

-440( and less job strain 'aschinger$ 2inegan$ 6 )hamian$ -44+(. #lternativel$ disempowerment$ or the

inabilit to act$ creates feelings of frustration and failure in staff nurses$ even though the ma still be

accountable 'aschinger 6 @avens$ +,,1(.

@istoricall access to and the content of nursing education has not been full under the control of nurses

'5afael$ +,,1(. 8ther groups continue to exert control over nurses professional lives$ as exemplified b the

increasing use of unlicensed health care personnel and the medical lobb opposing nurse practitioners as

primar health care providers '5afael(.%t is small wonder that nursing remains powerless relative to other

professions.

7/24/2019 Nursing Empowerment

3/3

ma lie in understanding workplace sources of power$ expanding the view of empowerment to include the

notion of empowerment as a motivational construct$ and finall making more explicit growth fostering

relationships which also contribute to power.

Conclusion

%n conclusion$ nurses power ma arise from three components! a workplace that has the re"uisite

structures that promote empowerment; a pschological belief in ones abilit to be empowered; and

acknowledgement that there is power in the relationships and caring that nurses provide. 9ursing research

has been able to demonstrate the relationship between the first two components and empowerment; et

there remains a need for research to examine the power that exists in relationships. 9ursing research from a

relational theor perspective ma help make nurses power more explicit and more visible$ moving our

understanding of power in nursing further than has previousl been possible. # more thorough

understanding of these three components ma help nurses to become empowered and use their power for

their practice and for better patient care.