Lesson 5: Organizational Structure, Power and the Role of the Nurse Leader

The patient care model that is used at the residential treatment program where I work is probably most like that of primary nursing. As the only nursing/medical position on staff, I am responsible for seeing that 100% of patient care is met. My position requires that I develop a relationship with each of the 44 student currently enrolled in our program so that I can get to know their needs specifically and individually and then make a plan to ensure those needs are met. It is my responsibility to communicate with other members of the professional community (including local physicians, dentists, and mental health professionals) and the other members of the treatment to to see that the students medical needs are met. I am also the liaison between the parents and all medical treatment, which also requires that I communicate all medical needs, treatment, and follow-up to the parents of each student.

Power: That which enables one to accomplish goals.
The book describes several different types of power:

• Reward power is gained by grant favors/rewards. 
• Coercive power is punishment power,  which is based on the fear of punishment (transfer, layoff, demotion, or dismissal).
• Legitimate (authority) power is obtained by a title or official position within an organization.
• Expert power is power through knowledge, expertise, or experience.
• Referent power is gained when others identify with that leader or with what that leader symbolizes. 
• Charismatic is personal power. Informational power is gained when people have information that others must have to accomplish their goals.
• Self-power (feminist power) is the power a person gains over his or her own life, which comes from maturity, ego integration, security in relationships, and confidence in one's impulse.

 I feel personal power increases naturally some degree through the process of maturing and growing up. I can help this process and increase my base of personal power as I continue to work to strengthen the personal relationships I currently have, as well as the establishing of new ones. I can further increase my sense of personal power by achieving better balance in my life between work and play. Also, the success seen after the successful accomplishment of newly acquired nursing skills definitely increases the feelings of personal power. I also believe that personal power increases when we aid in empowering another.

I've struggled with people in power in my life because they have often used it in an authoritarian and threatening manner. However, when I started working with mothers over coming substance abuse, a large portion of the psycho education groups were on reclaiming power over your life. I learned so much about myself working there. I think that is why I love the definition of power in the text as that which enables one to accomplish goals. I'm still working on allowing myself to be powerful and to see my goals come to fruition.