EMPOWERING NURSING ROLE IN DECISION-MAKING

GHADA KHAWAND AYLVICE-PRESIDENT - ORDER OF NURSES IN LEBANONDIRECTOR AND LECTURER - NURSING SCIENCES DEPARTMENT FACULTY OF HEALTH SCIENCE SAGESSE UNIVERSITY

Medhealth 2011Habtoor 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

Workforce in Health care organizations

Nursing managers and leaders

Staff empowerment

Highest standards of care and meeting patients expectations

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 topoorer patient outcomes (Manojlovich & Recico).

Agenda

I. The concept of power and empowerment

II. The areas of empowerment in nursingIII. The relationship between leadership

behavior and staff empowerment IV. The challenges in the implementation

of staff empowerment

I. The concept of power and empowerment

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

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)

Power

I. The Concept of power and empowerment

Enables one to act

(Chandler 1986)

Empowerment

Connotes having control,

influence or domination (Chandler 1986)

Power

)(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

Arising from the environment(Lashinger, Finegan, Shamian &

Wilk, 2001)

Developing from ones

psychological state (Manojlovich, 2005)

Theory of structural

empowerment

Theory of

psychological empowerment

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)

Opportunity

Information

Support

Resources

Structural Empowerment

For advancement or to be involved in activities beyond ones job description

Data, knowledge and information about the organization

Support throughout ones job responsibilities and decision making.

Time, supplies, and equipment as needed by the employee

Literature evidence on Structural empowerment

Structural empowerment contributes to higher levels of job satisfaction (Manojlovich, 2005)

and is interrelated with nursing leadership (Upenicks, 2003)

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)

Autonomy

Meaning

Impact

Competence

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

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

Autonomy

Meaning

Impact

Confidence

Psychological Empowerment

Positive Work Behaviors and Attitudes

Trust

Commitment

Job Satisfaction

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

Transformational leadership ( Charisma,

Consideration of Individuals and

intellectual stimulation)

Leading with trust, respect

and open communication

Sharing vision, values and

goalsSeeking

involvement and participation in decision making

Designing pathways to

action

Motivating, energizing,

supporting and inspiring

Focusing on collaborative relationships

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, NursAdmin 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 ExcellenceEmpowering Nurses within the Shared Governance Councilor Model,The Health Care Manager Volume 23, Number 3.

Melanie Jasper, Valuing and empowering nurses, Journal of NursingManagement, 2008, 16.

Moore & Hutchison, Developing Leaders at Every Level, Accountabilityand Empowerment Actualized Through Shared Governance, JONAVolume 37, Number 12.

Morrison & All,The Relation between Leadership Style andEmpowerment on Job Satisfaction of Nurses, The Journal of NursingAdministration, Issue: Volume 27 (5), May 1997.

Bibliography

Patrick & Laschinger, The effect of structural empowerment andperceived organizational support on middle level nurse managers rolesatisfaction, Journal of Nursing Management 14, 2006.

Scott & Caress, Shared governance and shared leadership: meeting thechallenges of implementation, Journal of Nursing Management, 2005, 13.

Stephanie M. Slack & All, Shared Decision Making: Empowering theBedside Nurse, Clinical Journal of Oncology Nursing, Volume 9, Number 9.

Vollers & Al, AACNs Healthy Work Environment Standards and anEmpowering Nurse Advancement System, Critical Care Nurse Vol 29, No.

6, DECEMBER 2009.

Empowering nursing role in decision-makingGhada Khawand AylVice-president - Order of nurses in LebanonDirector and Lecturer - Nursing Sciences Department Faculty of Health Science Sagesse University IntroductionIntroductionIntroductionAgenda I. The concept of power and empowermentI. The Concept of power and empowermentI. The Concept of power and empowermentII. The areas of empowerment in nursingTheory of Structural Empowerment (Kanter1993)Theory of Structural Empowerment (Kanter1993) Literature evidence on Structural empowermentTheory of Psychological Empowerment (Spreitzer, 1995)Literature evidence on Psychological empowermentSlide Number 15III. The relationship between leadership behavior and staff empowerment Slide Number 17IV. The challenges in the implementation of staff empowerV. ConclusionBibliographyBibliographyBibliography