EMPOWERING NURSING ROLE IN DECISION-MAKING

GHADA KHAWAND AYL

VICE-PRESIDENT - ORDER OF NURSES IN LEBANON DIRECTOR AND LECTURER - NURSING SCIENCES DEPARTMENT FACULTY OF HEALTH SCIENCE SAGESSE UNIVERSITY

Medhealth 2011 Habtoor Hotel/ March 10th, 2011

Introduction
Increasing complexity of healthcare environment

Challenges to nursing profession

Nurses : highly competent, innovative, have leadership potential, and demonstrate flexibility in adapting to changes throughout their functions and professional relationships (Porter Ogrady, 2003)

Introduction

Nursing managers and leaders

Staff empowerment

Highest standards of care and meeting patients expectations

Workforce in Health care organizations

Introduction
Researches in nursing : Empowering staff nurses ensure excellence in nursing care (Marquis and Huston, 2000). Powerless nurses are:
Ineffective

nurses (Page, 2004). Less satisfied with their jobs (Manojlovich & Lashinger,
2002).
More

susceptible to burnout and depersonalization

(Leiter and Lashinger, 2006).

Lack of nursing power may also contribute to poorer patient outcomes (Manojlovich & Recico).

Agenda

I.

II. III.

IV.

The concept of power and empowerment The areas of empowerment in nursing The relationship between leadership behavior and staff empowerment The challenges in the implementation of staff empowerment

I. The concept of power and empowerment

Power
Ability 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 (Kanter, 1993)

Nurses need power to be able to influence patients, physicians, and other care professionals, as well as each other

I. The Concept of power and empowerment

Enables one to act

(Chandler 1986)

Power
Connotes having control, influence or domination
(Chandler 1986)

Empowerment

(Kanter 1993)

I. The Concept of power and empowerment

Empowered nurses
highly

motivated (Lashinger & Havens, 1996) able to motivate and empower others by sharing the sources of power (Lashinger & Havens, 1996) less burnout (Lashinger, Finagan, 2003) less job strain (Lashinger, Shamian, 2001)

Disempowerment, or the inability to act

frustration failure

in staff nurses (Lashinger & Havens, 1996)

II. The areas of empowerment in nursing

Theory of structural empowerment
Arising from the environment
(Lashinger, Finegan, Shamian & Wilk, 2001)

Theory of psychological empowerment

Developing from ones psychological state
(Manojlovich, 2005)

Theory of Structural Empowerment

(Kanter1993)
Employees

work behavior:

Conditions and situations in the work place Not personal attributes (Lashinger & Harvens, 1996)

Organizational output increases and improves (Kanter 1993)

Theory of Structural Empowerment

(Kanter1993)
Structural Empowerment Opportunity
For advancement or to be involved in activities beyond ones job description Data, knowledge and information about the organization

Information

Support

Support throughout ones job responsibilities and decision making. Time, supplies, and equipment as needed by the employee

Resources

Literature evidence on Structural empowerment

Structural empowerment

contributes to higher levels of job satisfaction (Manojlovich, and is interrelated with nursing leadership (Upenicks, 2003)

2005)

Nursing leaders
must empower themselves accessing empowering work environment structures moving forward to offer some empowering work conditions to their staff (Upenicks, 2003)

Theory of Psychological Empowerment

(Spreitzer, 1995)

Psychological Empowerment Congruence between nurses beliefs, values, behaviors and job requirements Confidence in ones abilities to perform the job Feelings of control that are exerted over ones work Sense of being able to influence organizational outcomes

Meaning

Competence

Autonomy

Impact

Literature evidence on Psychological empowerment

Psychological empowerment

nursing burnout nursing job satisfaction

(Laschinger, Finegan & Shamian 2001)

Both forms of empowerment are necessary to sustain professional practice behaviors (Manojlovich 2005)

Structural Empowerment Opportunity Information Support Resources

Psychological Empowerment Meaning Confidence Autonomy Impact

Positive Work Behaviors and Attitudes Job Satisfaction Commitment Trust Low Burnout

III. The relationship between leadership behavior and staff empowerment

Empowerment
Process

by which a leader shares powers with others or enables them to act Basis of transformational leadership

Transformational leadership

Empowering others to act toward a common purpose

Sharing vision, values and goals Motivating, energizing, supporting and inspiring Seeking involvement and participation in decision making

Transformational leadership ( Charisma, Consideration of Individuals and intellectual stimulation)

Designing pathways to action Focusing on collaborative relationships Leading with trust, respect and open communication

IV. The challenges in the implementation

of staff empower
Policy:
- Allowing staff to develop professional autonomy - Involving staff in all decisions - Establishing collaborative procedures between staff and management - Making available work environment structures

Organization

Nursing managers Nurses

V. Conclusion
Empowering nurses
Better staff performance Ownership and autonomy Job satisfaction Staff retention Productivity, work and cost effectiveness Higher standards of care Greater patient satisfaction

Bibliography

Heather K. Spence Laschinger & Joan Finegan, Empowering Nurses for Work Engagement and Health in Hospital Settings, JONA Volume 35, Number 10. Kowalik & Yoder, A Concept Analysis of Decisional Involvement, Nurs Admin Q, Volume 34. Manojlovich, Predictors of professional nursing practice behaviors in hospital settings. Nursing Research, 55(2), 2005. Manojlovich, Promoting nurses self-efficacy: A leadership strategy to improve practice. JONA, 35(5), 2005. Manojlovich, The effect of nursing leadership on hospital nurses professional practice behaviors. JONA, 35(7/8), 2005.

Bibliography

Mary VanOyen Force, Creating a Culture of Service Excellence Empowering Nurses within the Shared Governance Councilor Model, The Health Care Manager Volume 23, Number 3. Melanie Jasper, Valuing and empowering nurses, Journal of Nursing Management, 2008, 16. Moore & Hutchison, Developing Leaders at Every Level, Accountability and Empowerment Actualized Through Shared Governance, JONA Volume 37, Number 12. Morrison & All,The Relation between Leadership Style and Empowerment on Job Satisfaction of Nurses, The Journal of Nursing Administration, Issue: Volume 27 (5), May 1997.

Bibliography

Patrick & Laschinger, The effect of structural empowerment and perceived organizational support on middle level nurse managers role satisfaction, Journal of Nursing Management 14, 2006. Scott & Caress, Shared governance and shared leadership: meeting the challenges of implementation, Journal of Nursing Management, 2005, 13. Stephanie M. Slack & All, Shared Decision Making: Empowering the Bedside Nurse, Clinical Journal of Oncology Nursing, Volume 9, Number 9. Vollers & Al, AACNs Healthy Work Environment Standards and an Empowering Nurse Advancement System, Critical Care Nurse Vol 29, No. 6, DECEMBER 2009.