Empowerment of Nurses (Politics and Power in Nursing Leadership)

After the discussion, you should be able to:

Define Politics and Political Involvement

State the rationale for nurses involvement in the political process List specific strategies needed to begin to affect the laws that govern the practice of nursing and health care system

Discuss different types of power and how each is obtained

Describe the function of a political action committee Discuss selected issues affecting nursing: multistate licensure, nursing and collective bargaining, and equal pay for comparable value

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EMPOWERMENT

Many dictionaries only show a pre twentieth century definition of the verb 'to empower', as 'to give power to'. The word was first used in the 17th century and has meanings like 'authorise, delegate, or enable. Some dictionaries have no entry for ''empowerment". Nowadays, empowerment is a complicated idea. It implies a transfer of power in a dynamic way over a period of time.
Empowerment seems to come in 2 flavours: - one with benefits to both an empowerer and those empowered. I propose to call this type simply 'empowerment'. - another where power is created out of nothing by somebody who previously perceived themselves to be powerless and then woke up to their own power. This could be called 'self-empowerment'.

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3 components of political empowerment:

Consciousness raising about the sociopolitical realities of a nurses life and work within society
A sense of self efficacy or self esteem regarding nurses ability to participate in the policy making process Development of skills to influence the policy-making process: knowing how to use traditional methods as well as new methods of relating power and politics

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POLITICS

The process of influencing the allocation of scarce resources

Enables the nurse to nurse smarter
-Mason and colleagues (2007, p. 4)

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 Involvement in the political process gives an individual nurse a tool that augments his/her power to improve the care provided to clients
Whether on the community, hospital or nursing unit level Political skills enable the nurse to identify needed resources, gain access to those resources, and overcome obstacles, thus facilitating the movement the client to higher levels of health or function

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Let us look first at the nursing unit level:

Your hospital is in the process of selecting a new supplier of IV pumps. You and the other nurse on your unit want to have input into that decision, because IV pumps are essential to the care of your clients and you have a definite opinion about the type of IV pump that works best. But the intensive care unit nurses , who are thought to be more important and valuable because the nursing shortage has made them as rare as hens teeth, have the only nurse position on the review committee (and therefore the directors ear!) You and the nurses on your unit strategize to secure input into this decision

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Your plan might look like this:

Gather data about IV pumps cost, suppliers, possible substitutes and so on

Communicate to the head nurse and supervisor your concern about this issue and your plans to get involved in the decision (by using appropriate channels of communication) State clearly what you want (perhaps a seat in the community when the opportunity arises

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 Summarize in writing your request and the rationale, submitting it to the appropriate people
Establish a coalition with the intensive care unit nurses and other concerned individuals

Recall that the mother of the vice president of purchasing was a client on your unit and needed an IV pump in her car and be sure to include this example in your written report
Get involve with other hospital issues and contribute in a credible fashion (do not be a single issue person)

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What are the skills that make up a Nurses Political Savvy?

Ability to analyze an issue

Ability to present possible resolution in clear and concise terms Ability to participate in a constructive way Ability to voice ones opinion (understand the system) Ability to analyze and use power bases

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What is power and where does it come from?

Five Laws of Power (Sanford, 1979)

Law 1: Power Invariably fills any vacuum Law 2: Power is invariably personal Law 3: Power is based on a system of ideas and philosophy Law 4: Power is exercised Through and depends on Institutions Law 5: Power is invariably confronted with and acts in the presence of field of responsibility

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Another way to look at power and where to get it

Five sources of power (French and Raven, 1959)

(in order of importance) 1. Reward power strongest source of power e.g. giving of money, ability to commit voters to a candidate through endorsements 2. Power to coerce or punish

e.g. ability to remove person from office

3.Legitimate power e.g. membership in a respected profesion

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 4. Referent or mentor power

E.g. faculty members joining with the student to solve problem 5. Expert or informational power weakest of the power bases

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Networking among colleagues

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Building Coalitions

Coalition is a group of individuals or organizations who share common interest in a single issue

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What about?

Trade offs

Compromises

Negotiations

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Participation in the election process

Participation in the election process
How important is one vote: In 1645 one vote gave Oliver Cromwell control of England In 1649 one vote caused Charles I to be executed In 1776 one vote gave America the English Language instead of German In 1845 one vote brought Texas into the Union In 1875 one vote changed France from Monarch to a republic In 1876 one vote gave Rutherford Hayes the presidency of the US

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What is the Political Action Committee

Another way that nurses an influence the elective process is through involvement in an organizations political action committee
The ANA National Political Action Committee is called ANA-PAC. Through this vehicle nurses across the country organize to collectively endorse and support candidate for national offices State nurses association have state-level PACs to influence statewide elections

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 PACs play an important role in the political process, because they provide a mechanism whereby small contributors can act as collective, participating in the electoral process

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Four points regarding PACs

(based on ANAs endorsement handbook)

POLITICAL FOCUS
Endorse candidates for public office Supply them with political and financial support

NO LEGISLATIVE ACTIVITIES
No lobbying of elected officials, it is the job of ANA

NOT DIRTY
It does not buy a candidate or a vote

HEALTH CARE ONLY

Evaluate candidates on health care concerns only

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AN RNs ACTIVIST TOOL KIT

(ANAs Program that unifies nurses political voices)

ANA-PAC ENDORSEMENT
Endorses candidate who have demonstrated strong support for nursing and Health care issues

NURSES STRATEGIC ACTION TEAM (N-STAT)

Unites thousands of nurses across the nation to inform lawmakers how nurses feel about key bills as they move through congress Let other nurses know when will their emails, phone calls and letters make the most impact via action alerts

NURSE POLITICAL ACTION LEADERS N-PAL

Reach out to nursess elected officials on issue of concern to the profession
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After getting them elected, then what?

Lobbying
Attempt to influence or sway a public official to take a desired action Characterized as the education of the legislator about nursing and its issues Educating officials, like educating clients, is an important part of the nurses role

Nurses can lobby in several ways: First and best opportunity: when a nurse first meets the candidate and evaluates him as a potential office holder Second Opportunity: when the official needs information to decide how to vote on an issue

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CONTROVERSIAL POLITICAL ISSUES AFFECTING NURSING

Nursing and collective Bargaining

The national Labor Relations Act is a federal law regulating labor relations in the private business sector. Grants employee the right to organize and bargain with their employer through a representative of their own choosing

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ARGUMENT
(on collective bargaining)

PRO COLLECTIVE BARGAINING -Tool to force positive changes in the practice setting -Controlling the practice setting

ANTI COLLECTIVE BARGAINING -A strike, is an ultimate tool of any labor dispute and should not be used -Practice standards are not negotiable

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 LEGISLATIVE CAMPAIGN FOR SAFE STAFFING

ANA launched a campaign for legislative changes to address safe staffing SAFE STAFFING SAVES LIVES is a national campaign to advocate for safe staffing legislation

ANA believes that staffing rations should be required by the legislation, but the number itself must be set at the unit level with RN input, rather than by the terms of the legislation
-www.safestaffingsaveslives.org

The position of the ANA is not to demand fixed nurse-client ratios, but to develop system that takes into account the variables that are present and to determine a safe staffing ratio

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