TAN Issue: November/December 1999 - As I See It

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The 'power' within empowerment: You

By Patti L. Bieber, RN, and Laura L. Swenson, MS, RN

We have all heard the word empowerment. But do we really understand what it means? Empowerment comes from each one of us. It cannot be given to us if we do not want to be empowered. It is also not something that one person can do alone if he or she wants to really make a difference. Empowerment means we make the commitment to be involved in our practice and the decisions that drive it.

Empowerment is being accountable to society and to our professional nursing practice. It is being responsible and making the commitment to be involved in the decisions that guide our practice. As nurses, we must apply our knowledge and experience and continually seek opportunities to better our practice. We respond to the changing social needs and demands and work in collaboration with our health care colleagues. We are each ultimately responsible for the work we do, the service we provide and our own continued personal and professional growth and development.

Our nursing vision is also essential to empowerment. Vision provides direction for our mission and goals. Our nursing vision of caring and quality patient care supports our mission of social responsibility and guides us in our practice. Participation in the decision-making process helps us work toward the vision. It enhances our control of nursing practice and influences successful patient outcomes. As empowered nurses, we are more likely to have greater job satisfaction because we will be active contributors in the decisions that guide our practice.

Nurses must participate in the committees that impact our professional practice. Committee involvement should occur at both the unit and organizational levels and may focus on such issues as diversity, education or practice. We are able to provide a keen perspective based on our knowledge, education and experience in providing quality, effective patient care. These committees, or teams, are empowered groups. As part of empowered teams, we will experience personal fulfillment, mutual respect for each other and other members of the health care team, and ownership of our nursing practice.

For example, we may notice an increased incidence of patients with skin breakdown on our unit. The unit decides to undertake a quality assurance project to decrease skin breakdown. First, nurses need to be willing to be part of the team to investigate why this is occurring. What are the current practices that affect skin integrity? Literature and research can be reviewed to determine what the recommendations are for preventing skin breakdown. A clinical nurse specialist can be an excellent resource for information and guidance. Documentation of patient care activities affecting the skin can be monitored. Once all the information and data is gathered, a skin integrity care plan can be developed. Many nurses can be involved in this process, and all nurses on the unit should be informed of the project. Networking with the organization's practice committee should also occur to assist in the standardization of practice.

There are many opportunities to enhance our professional practice. We should be evaluating the things we do every day and asking if what we are doing is best for the patient, the department and the institution. Leaders and managers provide essential guidance and support to empowered nurses. They are an excellent resource for providing information, explaining boundaries within decision-making, and facilitating the decision-making process of shared governance. Nurses must realize that there will always be decisions that will be made by management, specifically those that affect the organization as a whole, such as decisions related to financial resources or systems issues that involve multiple areas. However, in many of these cases, opportunities still exist for staff nurses to give input into these decisions.

Each nurse has to determine the time they can commit to being involved in enhancing our professional practice. There is a role for every nurse whether it be as a committee member or sharing ideas about nursing practice with members. The need to help identify issues and offer potential solutions and feedback is the responsibility of every nurse. The more nurses involved in the decision-making process, the more supported the decision will be.

Empowered nurses make the commitment to being responsible, accountable and dedicated to our patients and practice. Nurses have to be partners in making decisions at the point of care that support both the goals of the organization and professional nursing practice.

Empowerment combines hope, excitement and energy to influence our professional practice. It is a commitment to the highest quality of patient care.

Patti L. Bieber, RN, and Laura L. Swenson, MS, RN, a member of the Minnesota Nurses Association, are nurses at Mayo Clinic, Rochester, MN, and have both served as co-chairs of the Mayo Nursing Council, the organization's committee committed to promoting and facilitating shared decision-making.