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POWER, POLITICS
DELEGATIONS,
AND LABOR RELATIONS
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POWER
Described as the ability to create, get, and useresources to achieve ones goals. If the goals are
self-determined , there is an implication of evengreater power than if the goals are made by orwith others.
It can be seen at various levels: personal,professional, and organizational.
Power, regardless of level, comes from the abilityto influence others or affect others thinking orbehavior.
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SOURCES OF POWER
1. Expertise (Fisher& Koch, 1996)
- the greater the power nurses proficiency in
performing their role, the greater their expertpower. Derived from knowledge and skills.
2. Legitimacy (Fisher & Koch, 1996)
- derived from the position a nurse holds in agroup, and it indicates the nurses degree ofauthority. Based on such factors as licensure,academic degrees, certification, experience inthe role, and title/position in the institution.
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3. Reference (charism) (Fisher & Koch, 1996)
- derived from the admiration, trust, and respect
that people feel toward an individual, group or
organization. The referent person has the ability
to inspire confidence.
4. Reward and Coercion
- the ability to reward or punish others as well as
to create fear in others to influence them to
change their behavior.
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5. Connection
- both personal and professional relationships are
part of a nurses connections. People who are
strongly connected to others, have enhanced
resources, capacity for learning and information
sharing, and increase their overall sphere of
influence. Teamwork, collaboration, networking,and mentoring are some of the ways in which
nurses can become more connected and,
therefore, more powerful.
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6. Information
- based on the information that any person can
provide to the group. If one knows how to get it
and what tot do with it, the greatest power may
be information. Information leaders provide a
sense of stability with the use and synthesis of
information.
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USE OF POWER
Many nursing authors support nurses
involvement in developing and using power in
public policy and health care politics.
Nursing involvement in power and politics
includes using power to improve the position of
patients and nurses.
Nurses can use power in the legal system, their
professional nursing organizations, and the
media to work to improve care.
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Many nurse believe that it is helpful to become
active participants in some formal part of the
nursing profession such as the Philippine NursesAssociation, or any nursing specialty
organizations.
Ultimately, health care will be defined and
controlled by those wielding the most power. Ifnurses fail to exert political pressures on health
policy makers, they will lose ground to others
who are more politically active.
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Nurses strengthen their power by taking ownership of
their problems in serving patients. Leddy and Pepper
(1998) stated, When nurses blame others suchphysicians, administrators, or politicians for the state
of the health care delivery system, they weaken their
position and power base.
Historically, some stakeholders in health care have
never supported nursing as a profession oracknowledged professional roles for nurses. So nurses
must stand up, compete, negotiate and collaborate
with others who lobby health care.
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NURSE SENSITIVE
OUTCOMES:
To be most politically active, nurse must be ableto clearly articulate at least four dimensions ofnursing to any audience or stakeholders:
What nursing is?
What distinctive services nurses provide toclients?
How nursing benefits clients?
What nursing services cost in relation to otherhealth care organizations?
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A PLANFOR PERSONAL
POWER
3 ways to imagine the future:
a. What is possible
b. What is probable
c. What is preferred
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A nurse who wants to experience a
preferred future should think about
what is happening to the nurse as a
person and as a nurse, what
possibilities the nurse faces as a
person and as a nurse, and what thenurse is going to do about it.
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STEPSFORDEVELOPING
PERSONALPOWER
Assess personal needs, patient and community
needs and professional needs. Get involved
beyond direct patient care.
Maintain and develop your expertise. Attend
continuing education conferences, professional
organizations and community meetings.
Read current journals and books in your clinical
practice area. Consider to returning school for a
higher degree.
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Network with others and ask questions. Listen toall sides of the story. Analyze the answers to yourqueries and set priorities for action.
Make a plan with the information acquired. Knowthat there will be always be more information toanalyze.
Take action and evaluate the outcomes.
Report, publicize, and lobby the groups politicalcause. And work for health care regulations thatserve patient needs.
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DELEGATION
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PERSPECTIVESON
DELEGATION
Florence Nightingale is quoted as saying, But
the again to look to all these things yourself does
not mean to do them yourself.. But can you notinsure that it is done when not done by yourself?
Delegation is particularly needed because of the
advent of cost containment, the shortage of
nurses, increases in patient acuity levels, anelderly chronic population and advances in
health care technology.
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DELEGATION
Is defined as the transfer of responsibility for
the performance of an activity from one
individual to another while retainingaccountability for the outcome.
Example: the nurse, in delegating an activity to an
unlicensed individual transfers the responsibility
for the performance of the activity but retains
professional accountability for the overall care.
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2 TYPESOF PATIENT CARE ACTIVITIES
THATMAYBE DELEGATED:
Direct Patient Care Activities
- these data are reported to the RN, who uses the
information to make a clinical judgement about
patient care.
- Activities delegated to UAP do not include health
counselling or teaching, or require independent,
specialized nursing knowledge, skill orjudgement.
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Nursing judgement is defined as the
process by which nurses come to understand the
problems, issues or concerns of patients, to
attend to salient information and to respond to
patient problems in concerned and involved
ways.
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DIRECTPATIENTCAREACTIVITIES
INCLUDES:
Assisting the patient with feeding, drinking,
ambulating, grooming, toileting, dressing and
socializing.
Also involves collecting, reporting and
documenting data related to these activities.
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INDIRECTPATIENTCARE
ACTIVITIES
- are necessary to support patients and their
environment and only incidentally involve direct
patient contact. These activities assist in
providing a clean, efficient, and safe patient care
milieu. They typically encompass chore services,
companion care, housekeeping, transporting,clerical, stocking and maintenance task.
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FIVERIGHTSOFDELEGATION
1. Right task
2. Right circumstances
3. Right person
4. Right direction and communication
5. Right supervision
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OBSTACLESTODELEGATION
Fear of being disliked
Inability to give up any control of the situation
Inability to prioritize using Maslows Hierarchy of
Needs
Lack of confidence to delegate to staff who were
previously ones peers
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Inability to communicate effectively and develop
working relationships with other team members
Thinking of oneself as the only one who can
complete a task the way it is supposed to be
done
Lack of knowledge of the capabilities of staff,
including their competency, experience, and level
of education
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NURSINGTASKSTHATMAYNOT
BEDELEGATED:
Assessment
Planning of nursing care and evaluation of the
clients response to the care rendered
Implementation that requires judgement
Health teachings
Medications
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TASKSTHATAREMOSTCOMMONLY
DELEGATED:
Noninvasive and nonsterile treatments
Collecting, reporting and documentation of data
such as:
Vital signs, height, weight, intake and output,
capillary blood and urine test for sugar and
hematest results
Ambulation, positioning and turning
Transportation of the client within the facility
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Personal hygiene, and elimination including
cleansing enemas
Feeding, cutting up of food, or placing of meal
trays
Socialization activities
Activities of daily living
Reinforcement of health teaching planned or
provided by the RN
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NURSINGTASKSTHATMAYNOTBEROUTINELY
DELEGATED:
Sterile procedures
Invasive procedures, such as inserting tubes in a
body cavity or instilling or inserting substances
into an indwelling tube
Care of the broken skin other than minor
abrasions or cuts generally classified as requiring
only first aid treatment