Are you an empowered nurse?

Last semester I completed my Nursing Leadership course. For one of our assignments, we developed a topic from our clinical hours observing nurses in management positions. Based on discussions during my experiences in this clinical time, I decided to address nursing satisfaction, or rather lack therof. With student access, I was able to utilize the nursing academic database CINAHL. Recently we have heard a lot about union strikes and media attention about nurse staffing ratios. I made the assumption that hospitals cutting back on staffing to save money primarily contributed to the current prevalence of dissatisfaction among nurses. I fumbled through brainstorming to narrow down my topic until I came across a common theme throughout studies done on nurse satisfaction. To avoid wasting time with useless searching online or in databases, use Purdue University's Online Writing Lab (OWL). I always have their site open when I am researching or writing any MLA or APA paper.

Moving on...my research led me to the numerous studies on nurse empowerment. Many of the studies measured the success of empowerment strategies with indicators of nurse satisfaction and innovative thinking.

I focused on two major studies for my literature review. Each one approached their thesis from a different angle:

• Focus #1: Management’s role in determining levels of nurse empowerment through the evaluation of job satisfaction and organizational commitment in relation to the originating factors of structural empowerment, interactional justice, trust, and respect. When evaluating the components of an empowered nurse, this study assigns significant implications to communication and interaction with management. Citation found here.
  
• Focus #2: Connecting the context of the structural environment to psychologically empowering elements, and furthermore linking this connection to positive effect on innovative behavior in nurses. The psychological dimension implicates the necessity for an ongoing interaction between structural forces of management, professional organizations, and other nursing structures with the nurse as an individual self-determinant over his or her practice. Abstract found here.

Here's a summary of some potential resolutions based on a small selection of studies:

• Nurses and management should collaborate to implement practices that correspond with recommendations made by professional nursing organizations. Example: AACN Standards for Establishing and Sustaining Healthy Work Environments that includes skilled communication, true collaboration, effective decision making, appropriate staffing, meaningful recognition, and authentic leadership.
  
• Nurses given informal power and impact by recognizing the meaning of their work in a shared governance model. Based on a strategy implemented for critical care units at the Miriam Hospital in Providence, RI. Citation found here.
  
• Other studies include an empowering nurse advancement system and promoting certification on critical care units. Find the Abstract of study on certification and advancement system with AACN standards citation.
  

Here is an excerpt from my conclusions after some evaluation of major studies on nurse empowerment:

Even in seemingly desperate times in healthcare, hospitals can implement programs that recognize the crucial role nurses have in determining the quality of patient care. Hospitals that incorporate nurses into planning and communicate effectively with nursing staff create positive work environments. The uncertainty in healthcare is a major stressor on nurses-affecting communication, commitment to the hospital, and a number of other factors that all in turn affect the quality of patient care.

Hospitals' increased attention and drive toward achieving Magnet status is a positive move for empowering nurses. Even among bloggers you can see hospitals attempting to achieve increased trust and open communication among management and employees. Paul Levy, the president and CEO of Boston's Beth Israel Deaconess Medical Center, has a blog about his experiences in this position called "Running a hospital." He has links to other "CEO Bloggers" if you scroll down along the sidebar.

For now, I am going to keep empowering strategies in the back of mind so I can look out for those in future employers. I'm aware that nursing is not always pretty, and it's definitely challenging when it comes to long hours, short staff, charting, and a lot of patients. That's why I am going to search for an employer that can effectively empower me and my coworkers as intelligent, capable nurses.

Nurses--Do you feel the management at your place of employment empowers you as a nurse? Have any strategies been implemented to promote the empowerment of the institution's nurses (as a whole or specifically on your unit)? Do you have any experience with trying to promote these areas of empowerment?

Nursing students--Have you worked with nurses who you recognized as being empowered? Have you received advice from nurses on what to look for when searching for future employers?