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chapter 5 | Organizations, Power, and Empowerment 65 CikguOnline
■ Coercion. The threat of pain or of harm, which Empowering Nurses
may be physical, economic, or psychological
This final section looks at several ways in which
There is power at the bottom of the organizational
nurses, either individually or collectively, can maxi-
ladder as well as at the top. Patients also have
mize their power and increase their feelings of
sources of power (Bradbury-Jones, Sambrook, &
empowerment.
Irvine, 2007). Various groups of people in a health-
Power is the actual or potential actual ability to
care organization have different types of power
“recognize one’s will even against the resistance of
available to them:
others,” according to Max Weber (quoted in
Mondros & Wilson, 1994, p. 5). Empowerment is a
■ Managers are able to reward people with salary
psychological state, a feeling of competence, con-
increases, promotions, and recognition. They can
trol, and entitlement. Given these definitions, it is
also cause economic or psychological pain for the
possible to be powerful and yet not feel empow-
people who work for them, particularly through
ered. Power refers to ability, and empowerment
their authority to evaluate and fire people but
refers to feelings. Both are of importance to nurs-
also through their responsibility for making
ing leaders and managers.
assignments, allowing days off, and so on.
Feeling empowered includes the following:
■ Patients at first appear to be relatively powerless
within the health-care organization. However, if ■ Self-determination. Feeling free to decide how
patients refused to use the services of a particular to do your work
organization, that organization would eventually ■ Meaning. Caring about your work, enjoying it,
cease to exist. Patients can reward health-care and taking it seriously
workers by praising them to their supervisors. ■ Competence. Confidence in your ability to do
They can also cause problems by complaining your work well
about them. ■ Impact. Feeling that people listen to your ideas,
■ Assistants and technicians may also appear that you can make a difference (Spreitzer &
to be relatively powerless because of their Quinn, 2001)
low positions in the hierarchy. Imagine, how-
The following contribute to nurse empowerment:
ever, how the work of the organization (e.g.,
hospital, nursing home) would be impeded ■ Decision-making. Control of nursing practice
if all the nursing aides failed to appear one within an organization
morning. ■ Autonomy. Ability to act on the basis of one’s
■ Nurses have expert power and authority over knowledge and experience (Manojlovich, 2007)
licensed practical nurses, aides, and other per- ■ Manageable workload. Reasonable work assign-
sonnel by virtue of their position in the hierar- ments
chy. They are critical to the operation of most ■ Reward and recognition. Appreciation received
health-care organizations and could cause for a job well done
considerable trouble if they refused to work, ■ Fairness. Consistent, equitable treatment of all
another source of nurse power. staff (Spence, Laschinger, & Finegan, 2005)

Fralic (2000) offered a good example of the power of The opposite of empowerment is disempower-
information that nurses have always had: Florence ment. Inability to control one’s own practice leads
Nightingale showed very graphically in the 1800s to frustration and sometimes failure. Work over-
that wherever her nurses were, far fewer died, and load and lack of meaning, recognition, or reward
wherever they were not, many more died. Think produce emotional exhaustion and burnout
of the power of that information. Immediately, (Spence, Laschinger, & Finegan, 2005). Nurses,
people were saying, “What would you like, Miss like most people, want to have some power and to
Nightingale? Would you like more money? Would feel empowered. They want to be heard, to be
you like a school of nursing? What else can we do for recognized, to be valued, and to be respected.
you?”She had solid data, she knew how to collect it, They do not want to feel unimportant or
and she knew how to interpret and distribute it in insignificant to society or to the organization in
terms of things that people valued (p. 340). which they work.