1.
D R . A N J A L A T C H I M U T H U K U M A R A N
V I C E P R I N C I P A L
E R A C O L L E G E O F N U R S I N G
S A R F R A Z G A N J , E R A U N I V E R S I T Y
L U C K N O W - 2 2 6 0 0 3
EMPOWERMENT IN NURSING

2.
Content of the chapter
 Introduction
 Definition
 Important
 Empower in nursing
 Meaning of power
 Type of power
 Purpose of power
 source of power
 Kartar theory of power
empowerment
 Contribute nurse
empower in various of
procedure
 Guidelines
 Procedure
 Empower in nursing
assessment
 Professional organization
base empower the
nursing officer
 Importance of power
 Nurses role in empower

3.
Introduction
 In this modern day and age, there are
many challenges in healthcare.
 These challenges include new types of
disease or re-emergence of old diseases.
 However with the advancement of the
healthcare and technology, life can be
saved and life prolonged.
 Furthermore the length of hospitalization
can be shortened. In present modern era
of technology, patients are more educated
and have accessibility to information in
the internet. Hence, demand for quality
care is higher.

4.
What is Empowerment?
 To operate by itself and with enthusiasm.
 Empowerment in working place provides the
chances to learn and grow through the access of
information sharing, support, opportunity for
advancement and resources.
 All staff nurses are working in hospital are given
chance to develop knowledge and skills.

5.
Why empower is need in health care
 They have led to great changes in the nursing career.
"Nursing began as women's work and was a domestic
role where women were expected to fulfill in the
home.” But today, nursing is different from those
days. It has progressed from doctors' "handmaiden"
to being a healthcare professional.
 The responsibility hence, is greater to provide a more
complex nursing care. So, it is important for a nurse
to be empowered and have the empowerment on her
duty. This can improve in health care and patient
quality outcome .

6.
Definition of Empowerment
 Empowerment means is a positive concept of
a power or authority is given on doing
something. It is also associated with growth
and development of a person or an
organization. Critical thinking on own thought,
feeling and reason for action and in the pattern
of activity are also in the empowerment
process.
 The importance of empowerment in nursing is
that nurses will feel that they have the power to
authorize their job, satisfaction in their job and
feel appreciated. Besides, they will feel less
worn-out also in their work. It will also
enhance the care of patient outcomes.

7.
Empowerment in nursing
 Nursing empowerment means the ability to
effectively motivate and mobilize self and
others to accomplish positive outcomes in
nursing practice and work environment.
Quality improvement is an organized process that
assesses and evaluates health services to improve
practice or quality of care

8.
Meaning of Powerless services/person
 A powerless nurse is an ineffective nurse.
 Powerless nurses have more job strain compare to
empowered nurses. this is the cause of burnout in work.
 Powerless nurses are less satisfied with their jobs,
and more susceptible to burnout and depersonalization.
 "Lack of nursing power may also contribute to poorer
patient outcomes".
 Alternatively, "disempowerment, or the inability to
act, creates feelings of frustration and failure in staff
nurses, even though they may still be accountable on
their job".

9.
Definition of power
 The ability to get some one to do something you
want done and make things happen in the way
you want

10.
Purpose of Nursing Empowerment
 To empower nurses in decision making in
relation to patient’s health care needs.
 To demonstrate autonomy and
assertiveness in problem-solving approach
towards patient care.
 To empower nurses in protecting patient
rights and responsibilities

11.
Types of power-
 There are numerous types of power, many of
them are readily available to nurses, but some
of them are not:
 1. Legitimate: The power based on ones
position in the formal hierarchy.
 2. Reward: The promise of money, goods,
services.
 3. Recognition: or other benefits.

12.
 4. Expertise: The special knowledge an individual is
believed to possess
 5. Referent: The power based on identification with a
person who has resources.
 6. Coercion: The power based on fear.
 7. Charismatic power -: It is distinguished by some
from referent power. Referent power is gained only
through association with powerful others, whereas
charisma is a more personal type of power
 8. Informational power-: This source of power is
obtained when people have information that others
must have to accomplish their goal

13.
Sources of power-:
 Resources-: • The money, materials, and human help
needed to accomplish the work
 Support-: • Authority to take action without having
to obtain permission
 Information-:
• Patient care expertise and knowledge about the
organization‘s goals and activities of other
departments.
 There is power at the bottom of the organizational
ladder as well as at the top.
 Patients also have sources of power.
 Various groups of people in a healthcare
organization have different types of power available
to them

14.
Continued
■ Managers-:
• Are able to reward people with salary increases .
• They can also cause economic or psychological pain
for the people who work for them.
■ Patients -:
• Patients can reward health-care workers by praising
them to their supervisors

15.
Continued
 Nurses-: • Have expert power and authority over licensed
practical nurses, aides, and other personnel by virtue of
their position in the hierarchy.
 • Through certification programs,
 Six driving forces that increase nursing’s power base-:
 1.The timing is right.
 2.The size of the nursing profession.
 3.Nursing‘s referent power.
 4.Increasing knowledge base and education for nurses.
 5.Nursing‘s unique perspective.
 6.Desire of consumers and providers for change.

16.
Kanter's Theory of Organizational Empowerment
 Kantar argued that people react rationally to the
situations in which they find themselves .
 When situations are structured in such a way that
employees feel empowered, the organization is likely
to benefits both in terms of the attitudes of
employees and the organization effectiveness .
 The organizational structures or the empowering factors
that Kantar believes are particularly important to the
growth of empowerment are: access to
information, support, resources and opportunity

17.
Karters theory of Empowerment
It is a psychological state, a feeling of competence,
control, and entitlement. It is the process by which
we facilitate the participation of others in decision
making and taking action within an environment
where there is equitable distribution of power.
Power refers to ability, and Empowerment refers
to feelings. Both are of importance to nursing leaders
and managers

18.
The following contribute to nurse empowerment
• Decision-making-: Control of nursing practice within an
organization
• Autonomy -: Ability to act on the basis of one‘s knowledge and
experience
• Manageable workload-: Reasonable work assignments.
• Reward and recognition-: Appreciation received for a job well
done. • Fairness-: Consistent, equitable treatment of all staff.
 Salary-: Adequate and satisfying salary and wages
 Welfare :-Availability of security and insurance services
 continue education :-Staff development.
-Effective communication
-Effective leadership and supervision
 Support staff -Involvement in change process.
-Clear lines of authority and responsibility
-Use delegation appropriately.

19.
Guidelines
 Documented Policy - REF. Document No.
“HH/COP/NCOP/06b”
 It shall be carried out by a registered nurse only.
 It Must be supported with the documentary evidence
guidelines by MOH &FW,NHM, CDC,WHOetc.
 Policy ,regulations, standard, protocol, SOP etc. as per
institutional level to be carried out .

20.
Procedure
 The nursing superintendent need to identify &
recognized the contributions of the nursing officer .
 When the nursing officer feel appreciated, it enhance
in psychological empowerment. Thus, it will have
more job satisfaction and reduced in job strain.
 Besides that, it is important to identify the factors on
the work environment for nursing officer towards
patients to improve the work effectiveness, cost
effectiveness, and quality in patient care.

21.
Empowered to do Nursing Assessment.
 Empowered to define nursing care plan (NCP).
 Empowered to administer 25% dextrose timely to manage
acute hypoglycemia (RBS < 40 mg).
 Empowered to start oxygen administration in case of Spo2 is <
85%.
 Empowered to do cold sponging in case of Hyperpyrexia &
high grade fever.
 Empowered to change dressing in case of wet dressing or
soiled dressing.
 Empowered to make independent decision for positioning, use
of comfort devices in regard to pressure ulcer based on
Pressure Ulcer Risk Assessment.
 Nurses shall ensure safety of patient by ensuring appropriate
hand hygiene practice by colleagues/physicians/other staff.
Procedure: Empowerments

22.
 Nurses shall participate in patient triaging and
escalate immediate requirements to physicians/ senior
nurses.
 Nurses shall be trained in BLS and shall initiate
CPR timely based on critical condition of the patient.
 Nurse shall announce various hospital emergency
codes based on situations.
 Empowered & motivated to report medication
errors and adverse events.
 Empowered to audit infection control practices for
all health care workers.
 Empowered to counsel the patient & family
members regarding various treatment modalities
(Potential to fall counseling/HIC/Wound care etc.).
 Empowered to voice out any incidents of
misbehavior/misconduct at workplace.
 Supported by continuing education, training,
Incentives & Innovations.
 Promoting IPR (Interpersonal Relations).

23.
Professional organizations can empower nurses
in a number of ways-
 Collegiality : The opportunity to work with peers
on issues of importance to the profession
 Commitment : To improving the health and
wellbeing of the people served by the profession
 Representation: Staff nurses can represent
nursing in many committee and meetings or present
the hospitals in many conferences.

24.
Designing and testing a process for
empowerment

25.
The Importance of Power
 Success requires :
 Attention to the distribution of power
 Attention to the circumstances under which power is
used
 Knowledge of tactics and strategies associated with
the effective use of power
 To direct and control of behavior organizational
members to achieve organizational goals

26.
Nurse manager role to empower nurses
• Give power to nurses those who have
demonstrated the capacity to handle the
responsibility.
• Create a favorable environment in which nurses
are encouraged to grow their skills.
• Don‘t second-guess others‘ decisions and
ideas unless it‘s absolutely necessary. This only
undermines their confidence and keeps them from
sharing future ideas with you.
• Give nurses discretion and autonomy over their
tasks and resources

27.
Conclusion
 Hospitals have taken baby steps.
 Need to think beyond a policy document.
 Empower nurses in the true sense and make them
feel proud. Conclusion

28.
References
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https://www.slideshare.net/AHMEDZINHOM/shared-governance-
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Retrieved June 07, 2020 at
http://lippincottsolutions.lww.com/blog.entry.html/2019/02/27/how_s
hared_governanc-oiGj.html

29.
Continued
 6. McKnight H, Moore SM (2019). Nursing Shared
Governance. Retrieved June 18, 2020 at
https://www.ncbi.nlm.nih.gov/books/NBK549862/
 7. Porter-O'Grady, Tim (2001). Is Shared Governance Still
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30.
Thank you so much for your patience listening