Critical Role of Leadership in the Health Care

A Critical Role of Leadership in the Health Care Sector Is the Use of Power and Authority to

Empower Subordinates

Order Instructions:
1.Introduction : outline of use of power to authorize staff

  1. define power and empowerment
    3.Method: use power to deputizing form
  2. other than power, how to empower subordinates e.g. coaching
  3. conclusion


Effective and empowering leadership in modern healthcare institutions is relatively
useful in advancing profitability and skills among nurses and other health professionals.
Furthermore, in a real situation, successful health leaders use their authority and power in
empowering their subordinate staffs. The act of empowering subordinate staffs is relatively
useful in advancing services offered in healthcare institutions. Additionally, the process of
empowering subordinate staffs increases teamwork among healthcare professionals (Tomey,
2009). Therefore, based on the current trend in the contemporary healthcare institutions, the
use of the available resources and powers in empowering healthcare professionals is
relatively critical in advancing their efficiency and effectiveness


Based on the available numerical evidence, there are justifiable and compelling
reasons for empowering nurses and other health professionals. In most instances, powerless
nurses are unproductive and ineffective in their operations. In addition, powerless nurses are
always dissatisfied with their jobs and are more susceptible to depersonalisation and
burnouts. Therefore, nurses’ powers consist of three critical components, appreciation that
there is power and effect on their services, psychological beliefs on individual ability and
power to perform, and the need to create the necessary environment for empowering nurses.
Studies further reveal that competent nurses use their powers and position in advancing their
professionals skills and improving community health status (Bradbury‐Jones, Sambrook &
Irvine, 2008).
In addition, empowering of nurses is critical in helping them adopt and make effective
utilisation of emerging technology to improve healthcare services. However, although
healthcare sector has made tremendous changes in its operations, the available data reveal
that there are insignificant changes in nurse training programs. For instance, studies indicate
that despite endless effort to facilitate gender equality in modern healthcare services, 95% of
nurses in the world healthcare institutions are women (Tomey, 2009). Furthermore, in spite of
the existence of numerous feminist movements, women nurses lack the necessary power to
execute their duties (Lautizi, Laschinger, & Ravazzolo, 2009). Therefore, to progress in the
modern ever-changing and complicated healthcare sectors, health leaders and scholars should
come up with reliable and productive policies for empowering nurses.
Definition of power and empowerment
Health professionals and scholars describe power as the ability to influence, control,
and dominate other health professionals. In addition, power is the ability of ensuring that
other healthcare professionals undertake their responsibility with limited challenges and
criticism. Power in healthcare sector also involves individuals’ ability to mobilise the


available resources and use their skills in helping an organisation attain its goals and long-
term plans. Furthermore, scholars reveal that health professional powers should include
caring practices by nurses that helps in empowering patients and family members. Modern
scholars further view power as an infinite and positive force that helps in the establishment of
the environment that frees professionals from unnecessary oppression and discrimination
(Gilbert, Smith, & Leslie, 2010).
Health experts have identified several types of power, expert power, normative power,
coercive power, and legal power. However, despite the existence of various powers in
modern settings, the most effective and applicable form of power in healthcare system is
expert power. Health scholars define expert powers as individuals’ ability to influence other
professionals by possessing skills and knowledge that are essential and useful to others. An
expert power also helps in ensuring that health professionals and most specifically nurses
have healing and transformative powers. In most instances, healing and transformative power
are critical in supporting the power of caring that is essential among nursing professionals
(Caspar & O’Rourke, 2008).
In modern healthcare settings, power is critical and necessary in influencing group
and individual behaviours and professional skills. As a result, nurses require substantive
powers in order to influence their actions, patients’ activities, physicians and skills, and
operations of other healthcare professionals. In most instances, powerless nurses are
ineffective and less influential in advancing the quality of services offered in modern
healthcare institutions. In addition, powerless nurses express dissatisfactions with their job
hence increasing changes for professionals turn and depersonalisation. Furthermore, the
existence of powerless nurses could lead to poor patient outcome. Equally, studies reveal that
powerless nurses have limited morale and motivation of executing their duties (Stewart,
McNulty, Griffin & Fitzpatrick, 2010).


In order to realise the significant of empowering nurses, nurse’s power over nursing
operation and practice should include educational factors, social needs, and cultural practices
and values. Cultural and social factors should aim at eliminating the perception that nursing is
the role of women. Instead, nursing professionals should involve both male and female
professionals. The inclusion of both genders in the management of nurses will be critical in
empowering the profession. On the other hand, educational factors should aim at improving
nurses’ professional skills and position in the entire healthcare system. Historically, nurses
attained their training in hospital as opposed to colleges and universities. The act of training
nurses in hospitals lower nurses’ status and relation with other healthcare providers.
Besides, studies indicate that a good number of nurses are diploma holders (Tomey,
2009). As a result, the low education level among nurses has regrettable effects in lowering
the power and position of nurses in modern healthcare institutions. Therefore, improving the
educational levels among nurses will be relatively useful in making nurses powers productive
in modern healthcare institutions. In addition, the multiple entry levels to nursing
professionals is a major challenge that the dissipate nurse influence in the modern healthcare
system (Gilbert, Laschinger & Leiter, 2010).
Consequently, based on the current position and influence of nurses in modern health
settings, the profession require significant transformation. Current lack of power among
nurses is due to societal reluctant to accept the role of nurses in advancing the society health
situation. In addition, nurses are unwilling to insert their power and influence in modern
healthcare institutions. Studies further reveal that nurses in undeveloped and developing
states have difficulties in appreciating and acknowledging their influence and power to the
society (Tomey, 2009). Furthermore, society views power as an outcome of masculinity and
contrary to the caring role of nurses. Essentially, nurses’ role in healthcare institution is more
of femininity and caring that requires powerless professionals. Therefore, a good number of


modern nurses are unwilling and reluctant to use and access power due to the nature of their
profession (Rhéaume, Clément, & LeBel, 2011).
On the other hand, modern scholars collectively agree that health professionals
acquire power through empowerment process. As a result, empowerment is the act of raising
social structure in the workplace that enables employees get satisfied with their jobs. In most
instances, empowerment emerges from relationships as opposed to influence, authority, and
control. In addition, empowerment involves two critical steps, group attribute and change in
individual trait. Therefore, empowerment may emerge from own psyche or working
environment. Studies reveal that highly motivated nurses have the ability and skills of
empowering and motivating others thorough systematic sharing of new ideas and
innovations. Furthermore, empowered nurses have limited job strains and burnout in their
operations (Cole, Ouzts, & Stepans, 2010).
On the contrary, disempowered nurses experience the sense of frustration and are
unable to act in demanding situations. Modern scholars further assert that the main
contributor for powerless nurses is the fact that nurses do not understand the most effective
mean of developing power from their relationship. Similar to women in the society, nurses
should empower themselves by establishing and maintaining effective and productive
relationship (McGuckin, Storr, Longtin, Allegranzi, & Pittet, 2011).
The theory of structural empowerment is relatively useful in explaining some of the
most reliable means of establishing a mutual relationship among nurses. The theory states
that the creation of productive relationship will be paramount in empowering healthcare
professionals. Theory of structural empowerment further indicates that powers and
opportunity in an organisation are relatively vital in empowering healthcare professionals.
Therefore, in order to support the entire empowerment process, healthcare institutions should
provide empowerment opportunities to facilitate maximal organisation success and


effectiveness. Consequently, nurses have the mandate of using opportunities created by
modern healthcare settings in empowering and positioning themselves effective in the
modern society.
Recent studies further present four critical contributors to nurses’ empowerment
(Tomey, 2009). First, health leaders and managers should provide advanced empowerment
opportunities by involving nurses in the management of the health centres. Secondly,
healthcare leaders should ensure that nurses access all critical information regarding the
operation and management of healthcare centres. Nurses should as well have access to all
resources that could enhance systematic professional development. Finally, managers have
the mandate of offering the necessary development support to all nurses (Regan & Rodriguez,
Modern health scholars further assert that empowerment is a continuous process and
vary from one health institution to another. Furthermore, empowerment responds to change in
structural condition and work settings. In most instances, employees’ behaviours and
empowerment occur when organisation are structured to provide the necessary development
and empowerment opportunities. Further studies indicate that organisational interaction
strategies are critical in empowering healthcare professionals. Therefore, in order to realise
nurses’ empowerment, modern healthcare institutions should ensure that all professionals
take an active role in organisation’s management, job enrichment, and in making meaningful
organisation decisions. The available literature further reveals that structural empowerment is
critical in improving job satisfaction level. Consequently, nursing leaders should adopt a
policy of empowering themselves by accessing empowering working environment structures
(Mills & Hallinan, 2009).
Additionally, scholars observe that the empowerment is largely a psychological
experience. In most instances, empowerment is personals attribute and motivational construct


as opposed to environmental influence. In an ideal situation, empowerment plays a critical
and noticeable role in enhancing personal and professional effectiveness and efficiency. In
addition, studies indicate that the empowerment process involves four critical cognition
initiatives impact, self-determination, meaning and competencies (Tomey, 2009). Meaning in
the entire motivation process emerges when there is congruence between nurses’ job
requirement and nurse behaviours, value, and beliefs. On the other hand, competence is
confidence on individual ability to perform the set job successfully. Self-determination is the
feeling of control that emerges from an individual skills and confidence. Impact is a sense of
having the ability to influence critical organisational outcomes.

Use of power to deputise form
In modern healthcare institutions, nurses and other professionals use their power to
deputise their leaders. Besides, a good number of successful healthcare professional leaders
use their power in delegating their role to other health professionals including nurses.
Therefore, based on the complicated nature of managing modern healthcare institutions,
nurses have the role of understanding their duties as deputy leaders. Equally, modern training
institutions should ensure that nurses have the necessary leadership skills and competence for
enabling them serve as deputy leaders. Nurses also have an individual and collective
responsibility of practising their leadership skills in their duties (Clark, 2010).
On the other hand, in delegating their works, nurse managers should understand and
make effective utilisation of the existing empowerment models. First, before delegating
power to subordinate staffs, nurse manager should identify duties that require delegation. In
most instances, top leadership in modern healthcare setting delegate simple and less
demanding work to their deputies. Therefore, understanding on the most appropriate job to


delegate will be useful in minimising job confusion and conflict of interested. Equally,
deputy nurses should have the skills of executing the delegated job with limited constraints.
In addition, in order to empower nurses, nurse managers should ensure that they delegate
most of their technical work to increase employees’ leadership experience
Serving as deputy nurse in any healthcare setting is also a critical undertaking in
empowering nurses. Therefore, nurses who serve as deputy leaders should play a noticeable
role in identifying and establishing the organisation objectives. Nurses should also understand
and appreciate the significant of serving as deputy leaders. Deputy Nurses should also
understand their influence in the new position and the most reliable mean of using the new
position in empowering other nurses. In addition, deputy nurses have the mandate of
understanding their role in improving services offered in healthcare institutions (Rezaei-
Adaryani, Salsali & Mohammadi, 2012).
In an ideal situation, the role of empowered deputy nurses is to act and execute duties
on behalf of their leaders. Deputy Nurses also have the mandate of demonstrating nurses’ role
in enhancing the success of the entire organisation. Therefore, in their deputy role, nurses
should use the new opportunity and serve on behalf of other nurses. In addition, nurses who
serve as deputy leaders should create favourable empowerment environment for other nurses.
Deputy Nurses also have the mandate of demonstrating nurses’ leadership skills to other
professionals. Studies further reveal that nurses who serve as deputy leaders have the role of
developing effective and realistic action plans for improving nurses’ position in the
contemporary healthcare institutions (Rezaei-Adaryani, Salsali & Mohammadi, 2012)
Nurses who serve as deputy leaders should as well assist in developing skills of other
employees in order to strengthen the entire organisation. Ideally, nurses have essential skills
that enable them create favourable development environment. Deputy Nurses also have sole
responsibility of making decisions on behalf of other health professionals. Therefore, deputy


nurses have the mandate of allowing subordinate to make critical mistakes and learn from the
committed mistakes. In addition, empowered and successful nurses do not have the mandate
of making decisions on behalf of subordinates. Instead, deputy nurses should use their
positions in creating an environment for developing individual skills. In addition, leader
should desist from telling other nurses on the most effective means of executing their duties.
Instead, nurse managers should help nurses in rectifying the committed mistakes (Clark, &
Davis Kenaley, 2011)

How to empower subordinates
Healthcare managers have the mandate of empowering their staffs and most
specifically nurses. Empowerment in healthcare settings describes employee mindset on
autonomy, responsibility, capability and accountability. Empowered health professionals
have the skills and competence of ensuring that the organisations attain their objectives in the
most cost-effective manner. Therefore, by considering the encouraging benefits of
empowered health professionals, healthcare managers should empower their employees by
creating and fostering favourable environment that support teamwork. So far, scholars have
identified various strategies and methodology for empowering their workers (Gianfermi &
Buchholz, 2011)
Coaching is one of the key empowerment strategies in the contemporary healthcare
institutions. Coaching empowers nurses by ensuring that they get the support essential in
assisting them attain their professional and personal goals and objectives. In the modern
healthcare system, coaching involve two critical methods, formal training and informal
training. Formal training involves the process where healthcare professionals use their


existing institutions to improve their skills. Formal training also involves the use of qualified
professionals to help nurse understand their role in modern healthcare institutions. Moreover,
formal trainings have a specific objective that it intends to achieve within a given period. On
the contrary, informal coaching involves training employees in a non-formal environment.
Largely, informal training takes place in working places and involves the systematic
interaction with colleagues and other health professionals. In most instances, informal
motivation is less costly and does not have a specific target goal (Çavuş & Demir, 2010).
Creating a favourable and welcoming environment is also another reliable strategy for
empowering professionals in modern health institutions. Studies reveal that creating a
friendly and fun working environment is essential in empowering and motivating nurses
(Rezaei-Adaryani, Salsali & Mohammadi, 2012). Nurses who work in a friendly environment
get the chance to learn new skills from their colleagues and leaders. Creation of favourable
working environment is also vital in ensuring that nurses have an effective opportunity for
exercising their learnt skills. Sharing of new ideas in a favourable working environment is
also critical in empowering staffs. Leaders in modern healthcare institution also use the
existing environment in identifying leadership skills among professionals. Favourable
environment also gives leaders the necessary opportunity for challenging the
underperforming professionals in a mutual and constructive manner (Rao, 2012)
Encouraging the creation of mutual and productive teamwork is also critical in
empowering health professionals. Furthermore, in order to empower nurses, healthcare
leaders should support and encourage outside team-building activities. Outside team-building
enables nurses to understand operations and work that is outside their working place. In
addition, successful and effective teamwork assists in supporting internal skills development.
Groups also create reliable opportunity where professionals could interact and share
productive skills that support both professionals and personal development. Teamwork also


ensures that less performing professionals learn from their colleagues on some of the most
productive skills for advancing their performance. In addition, healthcare leaders use groups
to identify professionals with unique skills that can assist an organisation attain its goals
(Men & Stacks, 2013).
The provision of skills training is also critical in empowering health professionals. A
good number of the current successful healthcare institutions have useful and productive
training programs. In most instances, successful organisation use seminars and conferences
for empowering their professionals. Seminars and conferences provide interaction
opportunities for juniors professionals and experienced scholars. Seminars and other training
opportunities are also vital in educating nurses on emerging skills and competence. Equally,
training programs empower nurses by demonstrating leaders’ confidence on their skills and
contribution. Healthcare leaders spend a huge amount of the institution resources in ensuring
that all employees have the opportunity of advancing their professional and personal skills.
The act of spending huge resources to improve employees’ skills plays a critical role in
motivating and empowering health professionals (Engström, Wadensten, & Häggström,
Provision of positive reinforcement among performing nurse is also a key initiative
towards empowering nurses. In most instances, reinforcement initiatives aim at encouraging
employees improves their performance. Additionally, reinforcement initiatives are critical in
defining and shaping employees’ position in an organisation. Provision of reinforcement also
helps healthcare institutions offer the necessary incentives to well-performing nurses.
Incentive plays a critical role in making nurse feel the important of their contribution in the
modern health system. Incentives are also useful in helping organisations maintain their high
performing professionals. Studies reveal that empowered professionals have the willingness
to being associated with organisations that help them attains their career goals. Therefore,


incentives that support professional development are paramount in empowering nurses and
other health professionals (DeFrino, 2009)
Subsequently, based on the available wide range of empirical evidence, nurse power
is relatively vital in defining the success of modern healthcare institutions. Competence and
empowered nurses play a critical role in improving services offered in modern health
services. Studies further indicate that empowered nurses are relatively useful in supporting
the management of contemporary health institutions. The available data further present
various strategies and means of empowering nurses and other health professionals. As
indicated in the available literature, healthcare institutions have a critical role in providing
appealing and favourable empowerment environment. The existing theories and model
further highlight the role of nurses and leaders in supporting nurses’ empowerment
initiatives. Modern scholars also collectively agree that nurses’ powers emerge from three
critical components, knowledge that there is power in effective relationship and interaction,
psychological beliefs, and provision of effective empowerment environment. Therefore, to
motivate and empower nurses, healthcare leaders and other professionals have a collective
responsibility of creating a favourable environment for supporting and appreciating nurses
role in the modern healthcare settings




Bradbury‐Jones, C., Sambrook, S., & Irvine, F. (2008). Power and empowerment in nursing:
a fourth theoretical approach. Journal of Advanced Nursing, 62(2), 258-266.
Caspar, S., & O’Rourke, N. (2008). The influence of care provider access to structural
empowerment on individualized care in long-term-care facilities. The Journals of
Gerontology Series B: Psychological Sciences and Social Sciences, 63(4), 255-265.
Çavuş, M. F., & Demir, Y. (2010). The impacts of structural and psychological
empowerment on burnout: a research on staff nurses in Turkish state hospitals.
Canadian Social Science, 6(4), 63-72.
Clark, C. M., & Davis Kenaley, B. L. (2011). Faculty empowerment of students to foster
civility in nursing education: A merging of two conceptual models. Nursing outlook,
59(3), 158-165.
Clark, F. A. (2010). Power and confidence in professions: Lessons for occupational therapy.
Canadian Journal of Occupational Therapy, 77(5), 264-269.


Cole, S., Ouzts, K., & Stepans, M. B. (2010). Job satisfaction in rural public health nurses.
Journal of Public Health Management and Practice, 16(4), E1-E6.
DeFrino, D. T. (2009). A theory of the relational work of nurses. Research and theory for
nursing practice, 23(4), 294-311.
Engström, M., Wadensten, B., & Häggström, E. (2010). Caregivers’ job satisfaction and
empowerment before and after an intervention focused on caregiver empowerment.
Journal of nursing management, 18(1), 14-23.
Gianfermi, R. E., & Buchholz, S. W. (2011). Exploring the relationship between job
satisfaction and nursing group outcome attainment capability in nurse administrators.
Journal of nursing management, 19(8), 1012-1019.
Gilbert, S., Laschinger, H. K., & Leiter, M. (2010). The mediating effect of burnout on the
relationship between structural empowerment and organizational citizenship
behaviours. Journal of Nursing Management, 18(3), 339-348.
Gilbert, S., Smith, L. M., & Leslie, K. (2010). Towards a comprehensive theory of
nurse/patient empowerment: applying Kanter’s empowerment theory to patient care.
Journal of Nursing Management, 18(1), 4-13.
Lautizi, M., Laschinger, H. K., & Ravazzolo, S. (2009). Workplace empowerment, job
satisfaction and job stress among Italian mental health nurses: an exploratory study.
Journal of nursing management, 17(4), 446-452.
McGuckin, M., Storr, J., Longtin, Y., Allegranzi, B., & Pittet, D. (2011). Patient
empowerment and multimodal hand hygiene promotion: a win-win strategy.
American Journal of Medical Quality, 26(1), 10-17.
Men, L. R., & Stacks, D. W. (2013). The impact of leadership style and employee
empowerment on perceived organizational reputation. Journal of Communication
Management, 17(2), 171-192.


Mills, J., & Hallinan, C. (2009). The social world of Australian practice nurses and the
influence of medical dominance: An analysis of the literature. International Journal
of Nursing Practice, 15(6), 489-494.
Rao, A. (2012). The contemporary construction of nurse empowerment. Journal of Nursing
Scholarship, 44(4), 396-402.
Regan, L. C., & Rodriguez, L. (2011). Nurse empowerment from a middle-management
perspective: nurse managers’ and assistant nurse managers’ workplace empowerment
views. The Permanente Journal, 15(1),99-101.
Rezaei-Adaryani, M., Salsali, M., & Mohammadi, E. (2012). Nursing image: An evolutionary
concept analysis. Contemporary nurse, 43(1), 81-89.
Rhéaume, A., Clément, L., & LeBel, N. (2011). Understanding intention to leave amongst
new graduate Canadian nurses: a repeated cross sectional survey. International
Journal of Nursing Studies, 48(4), 490-500.
Stewart, J. G., McNulty, R., Griffin, M. T. Q., & Fitzpatrick, J. J. (2010). Psychological
empowerment and structural empowerment among nurse practitioners. Journal of the
American Academy of Nurse Practitioners, 22(1), 27-34.
Tomey, A. N. N. (2009). Nursing leadership and management effects work environments.
Journal of Nursing Management, 17(1), 15-25.