LEARNING KEY SKILLS IN NURSING MANAGEMENT

 

LEARNING KEY SKILLS IN NURSING MANAGEMENT

a formal reprimand, or recommend termination for a nurse who engages in disruptive behavior. Coercion is used in relation to a manager’s perceived authority to determine employment status.

3. Legitimate power stems from the manager’s right to make a request because of the author- ity associated with job and rank in an organizational hierarchy. Followers comply because they accept a manager’s prerogative to impose requirements, sanctions, and rewards in keeping with the organization’s mission and aims. For instance, staff nurses will com- ply with a nurse manager’s directive to take time off without pay when the workload has dropped below projected levels because they know that the manager is charged with main- taining unit expenses within budget limitations.

4. Expert power is based on possession of unique skills, knowledge, and competence. Nurse man- agers, by virtue of experience and advanced education, are often the best qualified to determine what to do in a given situation. Employees are motivated to comply because they respect the manager’s expertise. Expert power relates to the development of personal abilities through edu- cation and experience. Newly graduated nurses might ask the nurse manager for advice in learn- ing clinical procedures or how to resolve conflicts with coworkers or other health professionals.

5. Referent power is based on admiration and respect for an individual. Followers comply because they like and identify with the manager. Referent power relates to the manager’s likeability and success. For example, a new graduate might ask the advice of a more expe- rienced and admired nurse about career planning.

6. Information power is based on access to valued data. Followers comply because they want the information for their own needs. Information power depends on a manager’s or- ganizational position, connections, and communication skills. For example, the nurse man- ager is frequently privy to information about pending organizational changes that affect employees’ work situations. A nurse manager may exercise information power by sharing significant information at staff meetings, thereby improving attendance.

7. Connection power is based on an individual’s formal and informal links to influential or prestigious persons within and outside an area or organization. Followers comply because they want to be linked to influential individuals. Connection power also relates to the status and visibility of the individual as well. If, for example, a nurse manager is a neighbor of an organization’s board member, followers may believe that connection will protect or ad- vance their work situation.

Managers have both personal and position power. Position power is determined by the job description, assigned responsibilities, recognition, advancement, authority, the ability to with- hold money, and decision making. Legitimate, coercive, and reward power are positional because they relate to the “right” to influence others based on rank or role. The extent to which managers mete out rewards and punishment is usually dictated by organizational policy. Information and legitimate power are directly related to the manager’s role in the organizational structure.

Expert, referent, information, and connection power are based, for the most part, on personal traits. Personal power refers to one’s credibility, reputation, expertise, experience, control of resources or information, and ability to build trust. The extent to which one may exercise expert, referent, information, and connection power relates to personal skills and positive interpersonal relationships as well as employees’ needs and motivations. Box 7-1 illustrates how nurses can learn to use power in organizations.

Using Power Despite an increase in pride and self-esteem that comes with using power and influence, some nurses still consider power unattractive. Power grabbing, which has been the tradition- ally accepted means of relating to power for one’s own self-interests and use, is how nurses

CHAPTER 7 • UNDERSTANDING POWER AND POLITICS 89

often think of power. Rather, nurses tend to be more comfortable with power sharing and empowerment: power “with” rather than power “over” others.

Image as Power A major source of power for nurses is an image of power. Even if one does not have actual power from other sources, the perception by others that one is powerful bestows a degree of power. The same is true for the profession as a whole. If the public sees the profession of nursing as powerful, the profession’s ability to achieve its goals and agendas is enhanced.

Images emerge from interactions and communications with others. If nurses present themselves as caring and compassionate experts in health care through their interactions and communications with the public, then a strong, favorable image develops for both the individual nurse and the profession. Nurses, as the ambassadors of care, must understand the importance and benefits of positive therapeutic communications and image. Developing a positive image of power is important for both the individual and the profession.

BOX 7-1 Guidelines for the Use of Power in Organizations

Guidelines for Using Legitimate Authority

● Make polite, clear requests.

● Explain the reasons for a request.

● Don’t exceed your scope of authority.

● Verify authority if necessary.

● Follow proper channels.

● Follow-up to verify compliance.

● Insist on compliance if appropriate.

Guidelines for Using Reward Power ● Offer the type of rewards that people desire.

● Offer rewards that are fair and ethical.

● Don’t promise more than you can deliver.

● Explain the criteria for giving rewards and keep it simple.

● Provide rewards as promised if requirements are met.

● Use rewards symbolically (not in a manipulative way).

Guidelines for Using Coercive Power ● Explain rules and requirements and ensure that

people understand the serious consequences of violations.

● Respond to infractions promptly and consistently without showing any favoritism to particular individuals.

● Investigate to get the facts before using repri- mands or punishment and avoid jumping to con- clusions or making hasty accusations.

● Except for the most serious infractions, provide sufficient oral and written warnings before resorting to punishment.

● Administer warnings and reprimands in private and avoid making rash threats.

● Stay calm and avoid the appearance of hostility or personal rejection.

● Express a sincere desire to help the person com- ply with role expectations and thereby avoid punishment.

● Invite the person to suggest ways to correct the problem and seek agreement on a concrete plan.

● Maintain credibility by administering punishment if noncompliance continues after threats and warnings have been made.

Guidelines for Using Expert Power ● Explain the reasons for a request or proposal and

why it is important. ● Provide evidence that a proposal will be successful. ● Don’t make rash, careless, or inconsistent

statements. ● Don’t exaggerate or misrepresent the facts. ● Listen seriously to the person’s concerns and

suggestions. ● Act confidently and decisively in a crisis.

Ways to Acquire and Maintain Referent Power ● Show acceptance and positive regard. ● Act supportive and helpful. ● Use sincere forms of ingratiation. ● Defend and back up people when appropriate. ● Do unsolicited favors. ● Make self-sacrifices to show concern. ● Keep promises.

Adapted from Yukl, G. (2007). Leadership in organizations (6th ed.) (pp. 150–156). Upper Saddle River, NJ: Prentice Hall. Reprinted by permission.

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