The Power of Professional Nursing Practice
Understanding power and learning how to use it is critical if nurses' efforts to shape their practice and work environments are to be successful. As part of our efforts to develop a Fast-Track BSN-to-PhD nursing program, we met with nurse leaders from six organizations to explore what power means, how nurses acquire it, and how they demonstrate it in their practice. Through these discussions, we identified eight characteristics of powerful nursing practice that, together, form a framework that can guide nurses' efforts to develop a powerful practice and shape the health care delivery settings and academic institutions in which they work. In this article we review recent studies of organizational power and share discussions which helped us better understand nursing power and the ways in which it is manifested. We also reflect on what power means for individual nurses and the profession and discuss how our insights influenced our Fast-Track program.
Nursing power – what it is and how it is obtained and manifested – is an abstract concept for many nurses, even for those who hold substantial power and use it regularly. The confusion surrounding power is compounded by a profusion of sometimes conflicting definitions of power and by the negative connotations that power fosters for many nurses, including some nurse leaders (Maslin-Prothero, Ed, & Masterson, 2002; Sieloff, 2003). Increasingly, however, nurse leaders recognize that understanding and acknowledging power and learning to seek and wield it appropriately is critical if nurses' efforts to shape their own practice and the broader health care environment are to be successful.
Our interest in understanding nursing power stems from our recent work to develop a Fast-Track BSN-to-PhD Nursing Program. Over the past few years, the University of Massachusetts Boston (UMB) School of Nursing and the nursing departments from the five hospitals affiliated with the Dana-Farber/Harvard Cancer Center (DFHCC) collaborated to develop a Fast-Track program that aims to increase the number of minority nurses on the School of Nursing's faculty and in other nursing leadership roles in service, academia, and research. From the start, one of our primary objectives for the Fast-Track program was to help nurses develop and demonstrate characteristics that are associated with power and to help them attain positions of power within health care and academic systems. Although this is an objective for the entire Fast-Track program, it is particularly relevant to the program's mentoring component in which PhD students are paired with nursing leaders from academic and health care organizations.
As we worked to develop the mentoring component, we debated how mentors would help students understand how to acquire and use power wisely. Through these deliberations we began to realize that our own understanding of nursing power was limited, and that to design a program that promotes the power of individual nurses we first needed to obtain a better appreciation for what nursing power means and how it is achieved and manifested by practicing nurses.
To explore the concept of nursing power, we reviewed the nursing literature and then conducted a series of discussions with practicing nurses and nurse leaders from the six institutions involved in developing the Fast-Track program. Through these conversations, we began to understand how nurses in clinical, administrative, and academic leadership positions view power and identified key characteristics of a powerful nursing practice. We also gained insights into how nurses use power to promote patient and family centered care, strong administrative leadership, excellence in teaching, and rigorous and innovative research. In this article we review recent studies of organizational power and share discussions which helped us better understand nursing power and the ways in which it is manifested. We also reflect on what power means for individual nurses and the profession and discuss how our insights influenced our Fast-Track program.
Abstract and Introduction
Abstract
Understanding power and learning how to use it is critical if nurses' efforts to shape their practice and work environments are to be successful. As part of our efforts to develop a Fast-Track BSN-to-PhD nursing program, we met with nurse leaders from six organizations to explore what power means, how nurses acquire it, and how they demonstrate it in their practice. Through these discussions, we identified eight characteristics of powerful nursing practice that, together, form a framework that can guide nurses' efforts to develop a powerful practice and shape the health care delivery settings and academic institutions in which they work. In this article we review recent studies of organizational power and share discussions which helped us better understand nursing power and the ways in which it is manifested. We also reflect on what power means for individual nurses and the profession and discuss how our insights influenced our Fast-Track program.
Introduction
Nursing power – what it is and how it is obtained and manifested – is an abstract concept for many nurses, even for those who hold substantial power and use it regularly. The confusion surrounding power is compounded by a profusion of sometimes conflicting definitions of power and by the negative connotations that power fosters for many nurses, including some nurse leaders (Maslin-Prothero, Ed, & Masterson, 2002; Sieloff, 2003). Increasingly, however, nurse leaders recognize that understanding and acknowledging power and learning to seek and wield it appropriately is critical if nurses' efforts to shape their own practice and the broader health care environment are to be successful.
Our interest in understanding nursing power stems from our recent work to develop a Fast-Track BSN-to-PhD Nursing Program. Over the past few years, the University of Massachusetts Boston (UMB) School of Nursing and the nursing departments from the five hospitals affiliated with the Dana-Farber/Harvard Cancer Center (DFHCC) collaborated to develop a Fast-Track program that aims to increase the number of minority nurses on the School of Nursing's faculty and in other nursing leadership roles in service, academia, and research. From the start, one of our primary objectives for the Fast-Track program was to help nurses develop and demonstrate characteristics that are associated with power and to help them attain positions of power within health care and academic systems. Although this is an objective for the entire Fast-Track program, it is particularly relevant to the program's mentoring component in which PhD students are paired with nursing leaders from academic and health care organizations.
As we worked to develop the mentoring component, we debated how mentors would help students understand how to acquire and use power wisely. Through these deliberations we began to realize that our own understanding of nursing power was limited, and that to design a program that promotes the power of individual nurses we first needed to obtain a better appreciation for what nursing power means and how it is achieved and manifested by practicing nurses.
To explore the concept of nursing power, we reviewed the nursing literature and then conducted a series of discussions with practicing nurses and nurse leaders from the six institutions involved in developing the Fast-Track program. Through these conversations, we began to understand how nurses in clinical, administrative, and academic leadership positions view power and identified key characteristics of a powerful nursing practice. We also gained insights into how nurses use power to promote patient and family centered care, strong administrative leadership, excellence in teaching, and rigorous and innovative research. In this article we review recent studies of organizational power and share discussions which helped us better understand nursing power and the ways in which it is manifested. We also reflect on what power means for individual nurses and the profession and discuss how our insights influenced our Fast-Track program.