Nursing has long been seen as a challenging profession but viewed by many as a vocation for the dedicated and the selfless, which relies on nurses being professional, self-aware and motivated educators to lead change. Being caring and compassionate were integral to the role, as was the ability to follow instruction, which for some led to ritualistic practice for a number of years.
The development of nurse education led to evidence-based practice through nursing data and research, which has been key to empowering nurses to influence change, resulting in service improvements and better quality of care, and recognition of the need for nursing to be part of a life-long learning process.
Nursing empowerment is a structural process which supports shared team goals and ability. This is supported by open communication and positive leadership which has the desired outcome of motivating staff to work to the best of their ability which will improve achieving outcomes and creates the capacity to utilise resources and to provide support, opportunity, and information.
Research shows that empowering nurses allows for better decision making, job satisfaction, reduces stress and improved outcomes for patients. Subsequently when nurses are in a position to influence, they are less likely to suffer from ‘burnout’ as they feel listened to and are empowered to work to the top of their job descriptor.
Within the care sector nurses should not only be empowered but expected to work with a high degree of autonomy, and to act as an advocate for the residents, as they can’t always do this for themselves.
According to the RCN ‘One of the most important principles of safeguarding is that it is everyone’s responsibility ’.This requires strength of character to challenge other professionals, who may often hold more senior roles, to ensure the views of the residents are upheld, and more importantly no harm ensues. The quality of care is reliant on nurses measuring risk and harm and being educated and skilled to act appropriately to ensure safe practice.
This is particularly important within the independent care sector to ensure that despite some residents being frail and having cognitive deterioration, that they are still given the opportunities for improvement and achieve a level of stability through preventative programmes
Research would indicate that a move to an inclusive approach empowers residents through self- determination and autonomy although this does require the nursing staff to think differently and be more innovative.
The World Health Organisation (WHO) defines patient empowerment as “a process through which people gain greater control over decisions and actions affecting their health” and should be seen as both an individual and a community process.
This is evident within interventions such as the Care About Physical Activity (CAPA) programme and meaningful activities used with care home nursing, which show that empowerment initiatives provide both a process and an outcome. Research is limited in this field however if empowerment is present for staff then residents may benefit in a way that promotes an awareness of self-ability that can influence goal setting, with the potential to improve quality of life.
So how do we empower our nurse today?
Education, alongside a determination to provide quality care within a positive culture of change has brought nursing to where it is today, but it is through positive leadership that we will harness our nurses to be empowered today and into the future.
We know that disempowerment can be related to deficient leadership interventions. Some nurses may feel that managers are insensitive to their staffing needs, don’t support employee well-being, and don’t invest enough in training or career or professional advancement. This is fundamental to ensure successful recruitment and to retain staff in this field. Many nurses leave their positions because of negative experiences with heavy or unrealistic workloads, as well as a feeling of being unheard and undervalued.
On the other hand, several studies have indicated that when staff rate their managers then they feel that they’re listened to, and more likely to get, and be involved in the decision-making process. This is an indicator of positive leadership. Therefore if our managers’ behaviours support a team -based approach, then this will ultimately impact on empowering our nurses.
Creating supportive environments where staff have the psychological safety to speak out, to have an opinion and ultimately grow, is also a reflection of positive leadership. This should not be underestimated as highlighted within this recent article: https://t.co/9aHI8UPvsb?amp=1
Creating a positive culture that provides access to appropriate training and development will provide staff with the necessary knowledge and skills to carry out their role efficiently and effectively .This will boost self -awareness, give staff a voice, and the ability to be confident to act as a representative across a variety of arenas. It will continue to challenge staff to find solutions and promote nurse led initiatives.
This needs however to be done as a systemic organisational approach, as even when positive changes are adopted where staff are not consulted about these changes in advance then the changes can still be perceived negatively by staff.
Through this visionary intelligent leadership approach a supportive culture will exist that expects staff to question, to take risks and to have the permission to ensure transformational change.
Ultimately the message to our nurses is one that continues to push the boundaries for excellence, promotes our new nursing standards, ensures advocacy for our most vulnerable adults and doesn’t lose sight of our ability to care.
Jacqui Neil
National Workforce Lead for Nursing, Scottish Care
