Surveys show that far too many nurses feel powerless in their jobs, unable to act autonomously or even have a voice in the policies that affect them. If you’re a nurse manager who started your career as a staff nurse, you’re probably familiar with this perception of powerlessness.
Some of it is rooted in the historical view of nursing as “women’s work” within a patriarchal medical hierarchy. But past standards of nursing education are a contributing factor as well – nurses historically received no training in leadership skills, which are known to foster self-confidence.
In theory, nurses who have advanced to management positions have acquired, either through education or experience, a sense of personal empowerment. Yet, research suggests we might still have a long way to go. A 2011 study found that nurses in middle management in an acute care hospital setting did not feel fully empowered. A more recent study, published in 2014 in the Journal of Nursing Administration, found only moderate levels of empowerment among 140 clinical nurse managers at one large health care system in the northeast. And in 2012, researchers who took a close look at nine empirical studies conducted between 1990 and 2009 concluded that, “The empowerment of nurse managers correlated positively with job satisfaction, perceived organizational support, role satisfaction, and managerial self-efficacy, and correlated negatively with emotional exhaustion and own health outcomes.”
The problem with powerlessness within the nursing profession is clear: it creates job dissatisfaction, stress, and burnout. It can lead to ineffective nursing management that compromises patient safety. And it’s incompatible with today’s increasing emphasis on multi-disciplinary care, where collaboration is key.
In the corporate world, organizational studies have found that successful process improvement plans often come not from the executive level, but from engaged employees and middle managers who feel like stakeholders in the processes being targeted for change. There’s no reason why this shouldn’t apply to health care as well.
Empowered managers tend to be engaged employees who feel like important stakeholders in their workplace and the processes that keep it running. Nurse managers are more likely to develop a sense of personal empowerment when they work at an organization that values structural empowerment – for example, by including nursing representatives in the process of creating policies staffing models, and administrative committees. Structural empowerment gives nurse managers a measure of influence in areas that have traditionally been governed by the executive-level administration, and it helps to promote the highest level of nursing excellence.
One of the most important traits of empowered leaders is that they are facilitators of change. They feel capable of identifying areas that need improvement and working to bring about transformation. Most health care organizations have compliance programs in place to deal with government-mandated change. Many also have some sort of process improvement plan that functions at the executive level, with goals of reducing costs, enhancing efficiency, and improving patient care. But how much input comes directly from nursing managers? Managers who have a clear vision of the future can develop a strategy around that vision to bring about change.
This ability to initiate and manage change is a skill that can be taught. In recognition of this, American Sentinel University has forged a commitment to empowering nurses through leadership-oriented education. The Capstone Project, an exercise in applied learning, is one example of this. It allows students to design and implement a project that closely integrates their current work experience with their coursework, under the guidance of an academic advisor. American Sentinel’s online MSN, management and organizational leadership specialization degree is designed for experienced nurse professional who seek to develop both management and leadership skills.