Powerlessness and Empowerment

Powerlessness and Empowerment

When staff experience conflict, powerlessness and empowerment, as well as aggressiveness and passive-aggressiveness, become important. When staff members feel that they are not recognized, appreciated, or paid attention to, then they feel powerless. What happens in a work environment when staff feel powerless? First, staff members do not feel they can make an impact; they are unable to change situations they think need to be changed. Staff members will not be as creative in approaching problems. They may feel they are responsible for tasks yet have no control or power to effect change with these tasks. The team community will be affected negatively, and eventually the team may feel it cannot make change happen. Staff may make any of the following comments: “Don’t bother trying to make a difference,” “I can’t make a difference here,” and “Who listens to us?” Morale deteriorates as staff feel more and more powerless. New staff will soon pick up on the feeling of powerlessness. In some respects, the powerlessness really does diminish any effort for change. As was discussed in Chapter 3, responding to change effectively is very important today. In addition, when staff feel powerless, this greatly impacts the organizational culture Powerlessness and Empowerment.

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Power is about influencing decisions, controlling resources, and affecting behavior. It is the ability to get things done—access resources and information, and use them to make decisions. Power can be used constructively or destructively. The power a person has originates from the person’s personal qualities and characteristics, as well as the person’s position. Some people have qualities that make others turn to them—people trust them, consider their advice helpful, and so on. A person’s position, such as a team leader or nurse manager, has associated power.

Power is not stagnant. It changes as it is affected by the situation. There are a number of sources of power. Each one can be useful depending on the circumstances and the goal. An individual may have several sources of power. The common sources of power include the following: Powerlessness and Empowerment

• Legitimate power. This power is what one typically thinks of in relation to power. It is power that comes from having a formal position in an organization such as a nurse manager, team leader, or vice president of patient services. These positions give the person who holds the position the right to influence staff and expect staff to follow requests. Staff members recognize that they have tasks to accomplish and job requirements. It is important to note that a leader must have legitimate power. This is a critical concept to understand about leadership and power. However, it takes more than power to be an effective leader and manager. The leader must also demonstrate competency.
• Reward power. A person’s power comes from the ability to reward others when they comply. Examples of reward power include money (such as an increase in salary level), desired schedule or assignment, providing a space to work, and recognition of accomplishment.
• Coercive power. This type of power is based on punishment initiated when a person does not do what is expected or directed. Examples of punishment may include denial of a pay raise, termination, and poor schedule or assignment. This type of power leads to an unpleasant work situation. Staff will not respond positively to coercive power, and this type of power has a strong negative effect on staff morale.
• Referent power. This informal power comes from others recognizing that an individual has special qualities and is admired. This person then has influence over others because they want to follow the person due to the person’s charisma. Staff feel valued and accepted.
• Expert power. When a person has expertise in a particular topic or activity, the person can have power over others who respect the expertise. When this type of power is present, the expert is able to provide sound advice and direction Powerlessness and Empowerment.

Box 13-3 Types of Power

• • Legitimate
  • Reward
  • Coercive
  • Referent
  • Expert
  • Informational
  • Persuasive
• Informational power. This type of power arises from the ability to access and share information, which is critical in the Information Age.
• Persuasive power. This type of power influences others by providing an effective point of view or argument (Finkelman & Kenner, 2016). (Box 13-3 highlights the types of power.)

All HCOs experience their own politics, and this usually involves some staff trying to gain power, hold on to power, or expand power. As has been said, power can be used negatively, and this can also lead to the unethical use of power or not doing the right thing with the power. Chapter 2 discusses examples of ethical issues. There is no doubt that there are managers who use their power to control staff, as well as staff who use power to control other staff, but this is not a healthy use of power. Rather, it is a misuse of power and does not demonstrate nursing leadership.

A self-appraisal of a person’s personal view of power allows the individual to better understand how the person uses power and how it then affects the person’s decisions and relationships. This can lead to more effective responses to change during planning and decision making, coping with conflict, and the ability to collaborate and coordinate.

Empowerment is often viewed as the sharing of power; however, it is more than this. “To empower is to enable to act” (Finkelman & Kenner, 2016). Power must be more than words; it must be demonstrated. Participative decision making empowers staff but only if staff really do have the opportunity to participate and influence decisions. Recognizing that one’s participation is accepted makes a difference. True empowerment gives the staff the right to choose how to address issues with the manager. Powerlessness and Empowerment

Should all staff be empowered? A critical issue to consider when answering this question is whether or not staff can effectively handle decision making. This implies that staff members need leadership qualities and skills to make sound decisions and participate together collaboratively. They need to be able to use communication effectively. When staff members are selected, all these factors become important. Empowerment is not gained just by being a member of the staff, but rather staff members become empowered because they are able to handle it. Management who want to empower staff must transfer power over to the staff, but management must first feel confident that staff can handle empowerment.

When staff are empowered, some limits or boundaries need to be set, or conflict may develop. Some of these boundaries are established by the HCO’s policies, procedures, and position descriptions; education and experience; standards; and laws and regulations (for example, state nurse practice acts). The manager must be aware of these boundaries and establish any others that may be required (for example, direct involvement of staff in the selection process for new equipment). If staff members are involved in the decision making, then they should first be given a list of several possible equipment choices that meet the budgetary requirements and criteria to use in the evaluation process. It is critical that the manager make clear the boundaries, or staff members will feel like their efforts are useless if their suggestions are rejected because they were not given the boundaries. Setting staff up by not giving them full information leads to poor choices and is not effective. What does this mean? Roles and responsibilities need to be clearly described, and if they change, they need to be discussed. At the same time, the nurse manager or the team leader must not control, domineer, or overpower staff. This type of response is usually seen in new nurse managers or team leaders who feel insecure. Ineffective use of empowerment can be just as problematic as a lack of empowerment.

Although empowering oneself may seem like an unusual concept, it is an important one. The amount of power a person has in a relationship is determined by the degree to which someone else needs what the other person has. Anger is related to expectations that are not met, and when these expectations are not met, the person may act out to gain power. It is the responsibility of the nursing profession to communicate what nurses have to offer to patient care and to the healthcare delivery system, but individual nurses also need to understand what they have to offer as nurses. To have an impact, this communication and development must be ongoing. Empowerment can be positive if the strategies that are used to gain empowerment are constructive (for example, gaining new competencies, speaking out constructively, networking, using political advocacy, increasing involvement in planning and decision making, getting more nurses on key organization committees, improving image through a positive image campaign, and developing and implementing assertiveness). There are many other strategies that can result in empowerment that improves the workplace and the nurse’s self-perception. Powerlessness and Empowerment

Aggressive and Passive-Aggressive Behavior

Aggressive and passive-aggressive behavior can interfere with successful conflict resolution and might even be the cause of conflict. When staff members are hostile to one another, the team leader, or the nurse manager, anxiety rises. Hostile behavior can be a response to conflict. It is important to recognize personal feelings. The first response should be to get emotions under control and communicate control to the hostile staff member. The nurse manager or team leader may be the one who is hostile, which makes it even more complex and requires assistance from higher-level management. It is hoped someone will recognize the need to bring the situation under control and try to move to a private place. Demonstrations of open conflict with hostility should not take place in patient or public areas. If the suggestion to move to a private area does not work and the situation continues to escalate, simply walking away may help set some boundaries. Cool down time is definitely needed.

There are many times when more information is really required before a response can be given. If this is the case, everyone concerned needs to be told that when information is gathered, the issue or problem will then be discussed. No one should be pressured to respond with inadequate information as this will lead to ineffective decision making and may lead to further hostility. It is critical that after further assessment is completed there be additional discussion and a conclusion.Powerlessness and Empowerment

When there are conflicts with patients and families, what is the best way to cope? Many of the same strategies mentioned earlier can be used. Safety is the first issue, as it must be maintained. It is never appropriate to allow patients or families to demonstrate anger inappropriately. When this occurs, someone needs to set reasonable limits that are based on an assessment of the situation. There may be many reasons for anger and inappropriate behavior, such as pain, medications, fear and anxiety, psychosis, dysfunctional communication, and so on. Staff need to avoid taking things personally as this will interfere with thoughtful problem solving. When one gets defensive or emotional, interventions taken to resolve a conflict may not be effective. Active listening is critical to cope with emotions. If a different culture is involved, then this factor needs to be considered. (For example, some cultures consider it appropriate to be very emotional, and others do not.) In the long term, clear communication is critical during the entire process. Powerlessness and Empowerment