Power & Politics in

Nursing

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 Objectives
At the end of this unit we will be able to:
• Define politics, power, and policy.
• Discuss the different sources of power.
• Describe reasons why nurses should know
the political strategies.
• Describe ways how power can be used
constructively for professional purposes.

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 Politics
• Influencing the allocation of scarce (limited)
resources, events, and the decisions of
others; a complex of relationships within an
organization, including norms, values, and
culture. (Sullivan & Decker, 2003)
OR
• Influencing allocation of scarce resources,
events, decisions
• Relationships within an organization
including norms, values & culture
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 Power

• The capacity to act and make choices

and decisions; the capacity to create
order and sustain influence.
(Sullivan & Decker, 2003)

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 Power Cont’d…
• Economy makes up who is powerful in
the country.
• Women don’t like the rules of politics,
have not historically been involved
• Politics is like football

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 Policy
• The principles that govern action directed
toward given ends. (Sullivan & Decker, 2003)
Process:
• The course of bringing problems to
government and obtaining a reply.
• The process includes agenda setting,
design, government response,
implementation, and evaluation.
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 Nurses’ Role in Policy
Development
• Define a health problem for a government
agency
• Brief an elected official about the health
problem
• Vote in all elections
• Work in a campaign
• Talk to the media
• Serve as “Nurse of the Day”
• Work on Advisory and Policy-making 7
Bodies
 Sources of Power
• Discuss the different sources of power
a) Legitimate Power: A manager’s right to
make request because of authority
within an organizational hierarchy.
(Sullivan & Decker, 2003; p. 43)
b) Informal Power: Individual who does
not have a specified management role
within an organizational hierarchy.
(Sullivan & Decker, 2003; p. 43)
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 Types of Power
1. Coercive 6. Charismatic power
(punishment) power 7. Expert power
2. Informational 8. Connection power
power
9. Position power
3. Legitimate power
10.Personal power
4. Referent power
5. Reward power
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 Types of Power Cont’d…
1. Coercive (punishment) power: Power based
on penalties an manager might impose if the
individual or group does not comply with
authority.
(Sullivan & Decker, 2003; p. 43)
2. Informational power: Power based on an
individual’s access to valued data.
(Sullivan & Decker, 2003; p. 45)

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 Types of Power Cont’d…
3. Legitimate power: A manager’s right to
make request because of authority within
an organizational hierarchy.
(Sullivan & Decker, 2003; p.
43)
4. Referent power: Power based on the
admiration and respect for an individual.
(Sullivan & Decker,
2003; p. 43)
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 Types of Power Cont’d…
5. Reward power: Power based on
inducements offered by the manager in
exchange for contributions that advance the
manager’s objectives.
(Sullivan & Decker, 2003; p. 43)
6. Charismatic power: Power based on valued
personal characteristics and beliefs.
(Sullivan & Decker, 2003; p. 57)

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 Types of Power Cont’d…
7. Expert power: Power based on the
manager’s possession of unique skills,
knowledge, and competence.
(Sullivan & Decker, 2003; p.
43).
8. Connection power: Power based on
individual’s formal and informal links to
influential or prestigious persons within and
outside an organization.
(Sullivan & Decker, 2003; p. 45). 13
 Types of Power Cont’d…
9. Position power: Power of an individual that
is determined by his / her rank or role within
an organization.
(Sullivan & Decker, 2003; p. 43).
10. Personal power: Power based on an
individual’s credibility, reputation, expertise,
experience, control of resources or
information, and ability to build trust .
(Sullivan & Decker, 2003; p. 45).
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 Reasons why Nurses should
know Political Strategies
1. Influence the health care decisions /
resources
2. Change the image of nursing
3. Replaced distorted stereotypes, e.g.,
Physician handmaiden, Cheap labor,
Self-sacrificing, Angel of mercy,
Vituperative harridan (abusive worn-out
horse).
(Buresh and Gordon)
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 Reasons why Nurses should
know Political Strategies
4. Control the profession
5. Bills to address the nursing shortage
6. Mandatory Overtime

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 Ways to use Power for
Professional Purposes
– Speak up, out, often

– Movie-Men of Honor (court room

scene)

– Expert power, connection power,

reward power, coercion power.
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Informed and Committed Nurses
• Political Assessment
• Skills and Attitudes
• Policy Changes

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 Summary
• Power is not a negative term.
• Power and politics are interdependent.
• There is no political gain in silence and
submission.
• Types of power are not mutually
exclusive.

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 Leadership
• Nurses are usually lacking in risk-taking
• Choose a mentor
• Go for the win-win
• Guard your reputation
• Keep the spotlight
• Gain skills in negotiating conflict

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 References
• Buresh, B. & Gordon, S. (2001). From Silence to
Voice: What Nurses Know and Must
Communicate to the Public. Ottowa: Canadian
Nurses Association.
• Carville, J. & Belaga, P. (2002). Buck up, Suck
up and Come Back When You Foul Up.
• Gebbie, K. M., Wakefield, M., & Kerfoot, K.
(2000). Nursing and health policy. Journal of
Nursing Scholarship, 32 (3), 307-315.
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