Discussion Topic Ch 5

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Organizations, Power, and Empowerment

Chapter 5

Understanding Organizations

Types of Health-Care Organizations

Private not-for-profit
Publicly supported
Private for-profit

Understanding Organizational Culture

Artifact level
Espoused beliefs
Underlying assumptions

Culture of Safety

Acknowledge mistakes.
Detect error-prone situations.
Change aspects of systems that are error-producing.

Care Environments

Collegial relationships
Skilled nurse managers
Staff development
Quality of care

Organizational Goals

Survival
Growth
Profit
Status
Dominance

Organizational Structures

Traditional

Hierarchical
Employees are ranked from top to bottom.
The number of people on the bottom is usually greater than the number on the top.
Authority resides at the top.
Power is distributed.

The Organizational Hierarchy

Administrators

Managers

Staff nurses

Technicians (including LPNs)

Aides, housekeeping, maintenance

CEO

Innovative

Organic structure
Emphasizes flexibility
Less centralized
Decisions are made by the individuals who will implement them.
Emphasizes autonomy

Processes

A way to get things done within an organization
Two mechanisms
Formal
Informal

Power

Definition

Power is the ability to influence other people despite resistance.
Power may be actual or potential.
Power may be intended or unintended.

Sources of Power

Authority
Reward
Expertise/control of information
Coercion

Who Has the Power?

Managers
Clients
Assistants
Nurses

Empowering Nurses

What Feeling Empowered Includes

Self-determination
Meaning
Competence
Impact

Contributors to Empowerment

Participation in decision-making autonomy
Manageable workload
Reward and recognition
Fairness

Shared Governance

Practice councils
Unit budgeting, scheduling
Committees
Peer review

Professional Organizations

Collegiality
Advocacy
Representation
Enhancing competence
Recognition of achievements

Collective Bargaining

Uses the power of numbers for a common cause
Employee protection
Employee benefits

Enhancing Expertise

Participate in team conferences.
Take advantage of CEU offerings.
Attend conferences.
Keep your reading up-to-date.
Participate in nursing research.
Observe experienced nurses and nurse leaders.

Conclusion

Becoming and remaining empowered requires active participation.
Seek organizations whose organizational cultures are a fit with your professional goals.