WEEK 6 DISCUSSION POST – Group A (Angela Crain, Amber Lonergan, Natalie Sorensen, April Weber, and Paolo Vega)
After 5 years as a public health nurse, you have just been appointed as Supervisor of the Western region of the county health department. There is one Supervisor for each region, a Nursing Director, and an Assistant Director. You have eight nurses who report directly to you. Your organization seems to have few barriers to prevent staff empowerment, but in talking with the staff who report to you, they frequently express feelings of powerlessness in their ability to effect lasting change in their patients or in changing policies within the organization. Your first planned change, therefore, is to develop strategies to empower them.
Devise a political strategy for successfully empowering the staff who report directly to you. Consider the three elements necessary in the empowerment process: professional traits of the staff, a supportive environment, and effective leadership. Of these things, what is in your sphere of control? Where is the danger of your plan being sabotaged? What change tactics can you use to increase the likelihood of success?
Nurses need to use power to advocate for their patients as well as influence the direction of change in healthcare systems such as hospitals. Decision makers — like nursing leaders are viewed as being responsible for their choice and its consequences. Kirsh (2015) asserted that leaders’ actions could be evaluated, as instances of responsible behavior. The study revealed that managers who depart from the default or “normal” course of action, by choosing a new (versus familiar) alternative, changing (versus sticking to) an initial decision, or going against (versus following) the advice of a management team, are rated as more responsible for the outcomes of their decision. At the same time, individuals occupying high-level positions are expected to advocate the cause of others — or of people, they are leading. Advocacy work can take place at the level of ‘‘cases’’ or ‘‘causes’’ as highlighted by Kirsh (2015). Case advocacy involves representing individuals or groups with the aim of promoting their rights and opportunities.
Powerlessness and Staff Empowerment
In the case of the scenario provided, staff empowerment is one of the domains of nursing leadership. As a powerful, influential operator, nursing leaders must be able to empower others, create and sustain a work environment that fosters common values. Choi and Ahn (2016) emphasized that nurse managers – in their practice of authentic leadership can impact organizational commitment and job satisfaction of their nurse subordinates, which is by the mediating effects of empowerment. In the same manner, nurses’ shared perceptions of structural empowerment indirectly influence shared perceptions of unit effectiveness, which also impacted an indirect effect on job satisfaction through increased psychological empowerment.
With the clear role of empowerment established, its operationalization becomes an increasing concern. Marquis and Huston (2016) emphasized the need for managers to bridge the authority-power gap to diffuse the negative politics of the organization. To address the staff concern presented in the scenario provided, Marquis and Huston (2016) recommend political strategies helpful in negating the negative effects of organizational politics, such as:
- Manage information sharing expertly. This involves becoming artful in acquiring information and questioning. The nursing staff reporting of their frustrations must be listened to. However, it is the duty of the manager to investigate further the root cause of feelings of frustration and work through the details. Several questions can be asked: are there policies in place and are followed? If not, what are the reasons?
- Be a responsible, proactive decision-maker. This is by preparing for what’s ahead, rather than devoting more time dealing with past challenges. At the same time, leaders must be bold in creating opportunities for change, such as new ways of doing old things, and new positions to do new tasks. Several questions can be asked, “are there newer ways to better do the tasks required of the nursing staff?” or “do we need more warm bodies to get things done?”.
- View personal and unit goals regarding the organization. It is fitting to accept the problem by considering the overall direction of the organization. The way forward is to match both personal and unit goals to the organizational goals. This will prevent friction and frustrations of the nursing staff, as well as the manager.
The task of empowering can be a difficult one to undertake. A clear process is not easy to uncover, as explained in Kennedy, Hardiker and Staniland (2015), it is unique to the culture of the group being an abstract concept that is misunderstood by many. As it is a unique process there is no one way to go about it; however, one theme is clear that a good leader must learn what the major areas within their units or areas are. Kang and Jeong (2018), suggest that the empowering process is one using the grounded theory, which follows the steps of cultivating, seeding, grafting and grounding. One possible first step is forming a committee that will allow the leader to have input on subjects as well as an excellent way to empower the staff from the start. By a leader showing that they are engaged and are taking an interest in the unit, it starts the cultivating step. The seeding step is planting seeds for future empowerment, planning for what can be done down the road. Grafting is sorting thru – finding out how the past experiences affect the perceived empowerment status. The final stage is grounding to which is when the employees start to get familiar with the empowerment they have been given – it is time to renew and reinvest to try to avoid losing interest. Empowerment is a continuous and ever-changing process throughout the employees work years and individuals often moving back and forth between experiencing feelings of empowerment and disempowerment; the process needs to be ever moving.
Sphere of Control
Spheres of control is a description of an individual’s control over certain aspects of their lives which divides into three categories. The categories are personal efficiency, interpersonal control, and socio-political control (Bairaktarova & Woodcock, 2017). Personal efficacy is the inner circle category that describes self-achievements. Interpersonal control is the level which surrounds personal efficiency and represents the regulation of control a person has with people in a group. Socio-political control is the outermost circle that concerns with controlling facilities or organizations (Bairaktarova & Woodcock, 2017). To empower the staff, the nurse leader needs to be a motivator and have self-accomplishments to share with the team which will encourage the staff to achieve. Managers or leaders must demonstrate mutual trust with employees to establish interpersonal control. Nurses leaders need to have a respectful and trusting relationship with the healthcare organization or facility to present a need for change. When a manager or leader has a positive and productive sphere of control, subordinate employees build a sense of trust and believe that empowerment is possible.
Increasing Likelihood of Success
Transformational leadership is the pathway to success. The strategy of transformational leadership allows the nurse manager to share their vision and can empower subordinate staff with the vision (Marquis & Huston, 2017). Employees feel a sense of empowerment with open communication which allows them to utilize their talents and creativity. Subordinate staff explores and researches tactics to achieve the nurse manager’s vision, in a respectful and professional environment. Transformational leadership leads to employee satisfaction because staff members can explore individual self-interests while meeting the goals of the department and organization (Ross, Fitzpatrick, Click, Krouse, & Clavelle, 2014). Another strategy is creating shared governance among the staff. Allowing nurses to participate in the decision-making process collaboratively will increase their participation in achieving the goal. Shared governance will enable nurses to make meaningful and sustainable clinical improvements which build confidence and complete challenges (Gordon, 2016).
Empowerment of the staff is the decentralization of power which allows others to share ideas and be creative in achieving a vision. Nurse leaders are influential members of the staff as they are advocates for patients. The direction of healthcare is changing into an interactional style of leadership. Managers and employees are working together as a team to accomplish goals. Each staff members’ personality and behavior will influence the outcome. Organizations are seeking leaders who are willing to work past barriers and empower employees to achieve the vision.
Bairaktarova, D., & Woodcock, A. (2017). Engineering student’s ethical awareness and behavior: A new motivational model. Science and Engineering Ethics, 23(4), 1129-1157. doi: http://dx.doi.org.ezp.waldenulibrary.org/10.1007/s11948-016-9814-x.
Choi, H. G., & Ahn, S. H. (2016). Influence of nurse managers’ authentic leadership on nurses’ organizational commitment and job satisfaction: focused on the mediating effects of empowerment. Journal of Korean Academy of Nursing, 46(1), 100-108.
Gordon, Jeanine N, MSN, RN, O.C.N, N.E.B.C. (2016). Empowering oncology nurses to lead change through a shared governance project. Oncology Nursing Forum, 43(6), 688-690. doi: http://dx.doi.org.ezp.waldenulibrary.org/10.1188/16.ONF.688-690.
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Marquis, B. L., and Huston, C. J. (2017). Leadership roles and management functions in nursing: Theory and application (9th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.
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