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Uses of informal power by nurses.

Paynton, S. T. (2008, October 27). Reviewed by Wallace J. Henkelman, MSN, RN

This article reports on the utilization of a qualitative research process to study methods used in communication by nurses to be effective as patient advocates. The researcher is an Associate Professor of Communication, not a nurse.

Six experienced nurses were interviewed to generate narratives of their practices in the use of informal power in an attempt to influence patient care. Background material in a literature review were used to establish that nurses, in general, lack formal power to influence health care decisions and must, therefore rely, on informal methods.

The six nurses were interviewed three times each, which generated 183 single-spaced pages of narrative for analysis. Four categories of utilization of informal power as patient advocates were extracted through the analysis of those narratives. The informal strategies used were the doctor-nurse game frequently described in past literature, organizational work-arounds, circumnavigation of directives, and direct confrontation. The last would probably be better classified as a direct rather than an indirect communication method, although the outcomes still demonstrated the power of doctors over the nurses.

This research clearly emphasizes the distance nurses have yet to travel to be considered professional members of the health care team. Groups that are considered subservient or consider themselves subservient and relatively powerless in a system play games such as these. More education in communication techniques and assertiveness for nurses and nursing students might help improve the situation. Replication of this research with different groups of nurses would certainly be illuminating.

The informal power of nurses for promoting patient care. OJIN: The Online Journal of Issues in Nursing, 14(1). Retrieved November 7, 2008, from ANAPeriodicals?OJIN/TableofContents/Vol142009/No1Jan09/ ArticlePreviousTopic/InformalPowerofNurses.aspx

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Article Details
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Title Annotation:Clinical/Research Corner
Author:Paynton, S.T.; Henkelman, Wallace J.
Publication:Nevada RNformation
Article Type:Report
Geographic Code:1USA
Date:Feb 1, 2009
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