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UNIT 2Politics & Power BasesPolitics is the art of using legitimate power wisely.

It requires clear decision making, assertiveness, accountability, and the willingness to express ones own views.

It also requires being proactive rather than reactive and demands decisiveness.

Power may be feared, worshipped, or mistrusted.

It is frequently misunderstood.

Our first experience with power usually occurs in the family unit.

Power, in most ordinary uses of the term, appears to be more aligned with male than with female stereotypes

(Marquis & Huston, 2014)Because childrens roles are likened to later subordinate roles and the parental power position is similar to management, adult views of the managementsubordinate relationship are influenced by how power was used in the family unit.

Although power connotes strength and ability, the term power has different meanings. It can mean the ability to compel obedience, control, or dominate;or it can be a delegated right or privilege as occursin the power to enact the staff nurse role. Powercan be defined as the capability of acting or producingsome sort of an effect, usually associatedwith the ability to influence the allocation of scarceresources. Other definitions identify power as thepotential capacity to exert influence, characteristicallybacked by a means to coerce compliance.A key element of power is its aspect of being potentialas well as actual.

PowerThe capability of acting or producing some sort ofeffect; the potential capacity to exert influence.Relational Aspect of PowerPower is a property of a social relationship.Dependency Aspect of PowerPower resides in the others dependency on thepowerful one.Sanctioning Aspect of PowerPower is an active, direct manipulation of anothersoutcomes.EmpowermentGiving individuals the authority, responsibility, andfreedom to act on what they know and instilling theconfidence to do so.Authority and InfluenceAuthority and influence are two major contentdimensions of power (Bacharach & Lawler, 1980).There have been three conceptualizations of authorityand influence: (1) some authors equate theseterms; (2) others tend to equate power with influenceand assert that authority is a special case ofpower; (3) still others view authority and influenceas distinctly different dimensions of power. Severalpoints of contrast are summarized in Table 12.1.Influence TacticsKipnis and colleagues (1980) were among the firstto investigate the influence behavior of managers.Content analysis led to the identification of 370different forms of influence behavior, which werecondensed into 14 categories. Subsequently, factoranalysis brought about the following 8 forms ofinfluence behavior:1. Assertiveness means expressing ones ownposition to another without inhibiting therights of others.2. Ingratiation means trying to make the otherperson feel importantgiving praise orsympathizing. Ingratiation is attempting toadvance oneself by trying to make anotherperson feel important.3. Rationality means using logical and rationalarguments, providing pertinent information,presenting reasons, and laying out an idea ina logical, structured way.4. Sanctions are threats. Positive sanctions, orrewards, are addressed within motivationmechanisms.5. Exchange means that to persuade, an exchangeis offered; this is sometimes called scratchingeach others back.Upward appeal means going to a higherauthoritythe childhood threat of if youdont play by my rules, I am going to gotell Mom. Upward appeal simply meanstaking the appeal to a higher authority toarbitrate.7. Blocking means deliberately keeping othersfrom getting their way, threatening to stopworking with them, ignoring them, not beingfriendly, or simply attempting to make sureothers cannot accomplish their aims.8. Coalitions are the result of a group of peoplegetting together to speak or negotiate as onevoice.Sources of PowerIndividual Sources of PowerAlthough multiple mechanisms of power have beenidentified, the most widely accepted power base classificationis French and Ravens (1959) five sourcesof power. Their original conceptualization identifiedthe following five power sources (Box 12.1):1. Reward2. Coercive3. Expert4. Referent5. LegitimateWhen reward power is used, people comply becausedoing so produces positive benefits. Coercive powerdepends on fear. An individual reacts to the fear of thenegative consequences that might occur for failureto comply. Referent power is based on admirationfor a person who has desirable resources or personaltraits. Legitimate power represents the power aperson receives as a result of his or her position inthe formal organizational hierarchy. Expert powerresults from expertise, special skill, or knowledge.The problem with the French and Raven typology isthat the list is not exhaustive and it ignores organizationalsources of power. Figure 12.1 shows a combinedconceptual framework for power that blendselements of multiple theories of power.Other Sources of PowerRaven and Kruglanski (1975) and Hersey and colleagues(1979) identified two additional sources ofpower: (1) connection power; and (2) informationpower. A third type of power also has been identified:(3) group decision-making power (Liberatoreet al., 1989). These three other sources of power arerelated to groups and organizations specificallyFrench and Ravens Five Sources of PowerData from French, J., & Raven, B. (1959). The bases of social power. In D. Cartwright (Ed.), Studies in social power (pp. 150-167). Ann Arbor, MI:University of Michigan, Institute for Social Research.1. Reward power is giving something of value. For example, in nursing, rewards may be a pay raise, praise,a promotion, or a job on the day shift. Reward power is based on the ability to deliver desired rewards.2. Coercive power is force against the will. For example, in nursing, coercive power can be the threat of firing, ofdisciplinary action, or other negative consequences. Coercive power is the power derived from an ability to threatenpunishment and deliver penalties. It is a source of power used to apply pressure so that others will meet what isdemanded.3. Expert power means the use of expertise. It is knowledge, competence, communication, and personal power allcombined in a reservoir of knowledge and experience. Expert power is a source of power held by those with somespecial knowledge, skill, or competence in a particular area. For example, the nurse with the greatest expertise inwound dressings will be sought out by other people in the work environment for this expertise. Expertise is an artfulcombination of skill and knowledge. It may be founded on depth of knowledge and/or psychomotor skill. In the useof knowledge and skill is power (i.e., because people need you or can benefit from your expertise, power exists).Therefore the use of expertise can be structured to accomplish or influence movement or action toward certain goals.4. Referent power is a little more difficult to understand because it is subtle. It is the use of charisma to influenceothers. The followers of someone with referent power respond positively to the interpersonal communicationand image of the charismatic person. In organizations, this translates into an informal leadership based on liking,charisma, or personal power. Referent power comes from the affinity other people have for someone. They admirethe personal qualities, the problem-solving ability, the style, or the dedication the person brings to the work.Referent power can be viewed as an inspirational power, because peoples admiration for someone allows thatperson to influence without having to offer rewards or threaten punishments. For example, in the political arena,occasionally there are charismatic political figures or orators. Their influence comes from their followers likingor identification with them. An example in nursing is Florence Nightingale, who became a symbol of professionalnursing. An emotional upsweep is felt by associating with a charismatic person. Referent power is a personal likingand identification experienced by others. Followers attribute referent power to a leader on the basis of the leaderspersonal characteristics and interpersonal appeal. Physical attractiveness may contribute to referent power.5. Legitimate power means position power. It is the right to command within the organizational structure, basedon the hierarchical position held. The President of the United States has power because of holding the position.Legitimate power is the most common source of power. It is what most often is called authority. The authority ofposition gives the person the right to act, order, and direct others. However, leadership and influence need not beconfined to those with authority. Every person possesses the ability to tap different sources of power to use in avariety of situations.The Power of the SubunitSubunit or horizontal power pertains to relationshipsacross departments. Daft (2006) noted thatalthough each department makes a unique contributionto organizational success, some contributionsare greater than others. Pfeffer (1981) identified thefollowing structural determinants of power withinorganizations: Power is derived from dependence. Simplystated, power comes from having somethingthat someone else wants or needs and beingin control of the performance or resource sothat there are few, if any, alternative sourcesfor obtaining what is desired. Power is derived from providing resources.Organizations require a continuing provisionof resources such as personnel, money, customers,and technology in order to continueto function. Those subunits or individualswithin the organization that can provide themost critical and difficult-to-obtain resourcescome to have power in organizations. Theirpower is derived from their ability to furnishthose resources upon which the organizationmost depends. Power is derived from coping with uncertainty.Coping with uncertainty is a critical resourcein the organization since it ensures organizationalsurvival and adaptation to externalconstraints. Power is derived from being irreplaceable.Members must not only provide a criticalresource for the organization but also preventthemselves from being readily replacedin that function. The degree of substitutabilityis not a fixed thing, however, so onemight expect that various strategies will beemployed by individuals and subunits whoare interested in enhancing their powerwithin the organization. Some of these mightinvolve the availability of documentation,use of specialized language, centralization ofknowledge, and maintenance of externallybasedsources of expertise. Power is derived from the ability to affect thedecision process. Because decisions are madein a sequential process, it is possible for anindividual to acquire power because of his orher ability to affect the premises of basic valuesor objectives used in making any decision.A person can gain power by influencingthe information about the alternatives beingconsidered in the decision process. Power is derived if there is a shared consensuswithin the organizational subunit. If individualswithin a subunit share a commonperspective, set of values or definition ofthe situation, they are likely to act and speakin a consistent manner and present to thelarger organization an easily articulated andunderstood position and perspective. Sucha consensus can serve to enhance the powerof the subunit among other organizationalmembers.Gender

Women in power positions in todays healthcare settings are more likely to recognize their innate abilities that support the effective use of power.

A positive or negative familial power experience may greatly affect a persons ability to deal with power systems in adulthood.

Sellers (1999) interviewed many of Fortune magazines 50 most powerful women in America and found that many of them credited their powerful mothers in developing their potential for leading companies.Gender and PowerSuccessful leaders are aware of their views on the use and abuse of power.

Some women, in particular, may hold negative connotations of power and never learn to use power constructively.

Women have traditionally demonstrated, at best, ambivalence toward the concept of power and until recently have openly eschewed the pursuit of power.

This may have occurred because women as a whole have been

socialized to view power differently than men do. For some women, power may be viewed as dominance versus submission; associated with personal qualities, not accomplishment; and dependent on personal or physical attributes, not skill.

Many women may not believe they inherently possess power but instead must rely on others to acquire it. Rather than feeling capable of achieving and managing power, some women may feel that power manages them.However, the historical view of women as less powerful than men appears to be changing.

These changes are taking place within women, in womens view of other women holding power, in organizational hierarchies, and among both male subordinates and male colleagues

Today gender differences regarding power are fading and the corporate world is beginning to look at new ways for leaders to obtain and handle power.

Stahl (1999) maintains that nurse leaders in the 21st century will need to deal with organizational power and politics in a completely different way and will need to develop political strategies for team building and establishing trust Political skill in developing consensus, inclusion, and involvement are also needed, skills that have often been linked to female characteristics (Carli, 1999; Fisher, 1999).

It is notable that these very attributes, which once closed corporate doors and created a glass ceiling, are now welcomed in the boardroom. . These attributes are certainly not limited to women; many male leaders also possess these characteristics.

However, despite significant gains, many women continue to remain unskilled in the art of the political process.

While not all agree (Lips, 2000), many recent studies show that how others view men and women as being powerful has gradually changed over the last 10 years.

At present it is difficult to say with certainty if the male or female is stereotypically viewed as the more powerful in organizations (Fisher, 1999; Ledet & Henley, 2000).Types of PowerFor leadership to be effective, some measure of power must often support it.

This is true for the informal social group and the formal work group.

There are several bases, or sources, exist for the exercise of power: reward power, punishment or coercive power, legitimate power, expert power, and referent power

Reward power is obtained by the ability to grant favors or reward others with whatever they value.

The arsenal of rewards that a manager can dispense to get employees to work toward meeting organizational goals is very broad.

Positive leadership through rewards tends to develop a great deal of loyalty and devotion toward leaders.

Punishment or coercive power, the opposite of reward power, is based on fear of punishment if the managers expectations are not met.

The manager may obtain compliance through threats (often implied) of transfer, layoff, demotion, or dismissal.

The manager who shuns or ignores an employee is exercising power through punishment, as is the manager who berates or belittles an employee

Legitimate power is position power. Authority also is called legitimate power.

It is the power gained by a title or official position within an organization.

Legitimate power has inherent in it the ability to create feelings of obligation or responsibility.

As previously discussed, the socialization and culture of subordinate employees will influence to some degree how much power a manager has due to his or her position.

Expert power is gained through knowledge, expertise, or experience.

Having critical knowledge allows a manager to gain power over others who need that knowledge.

This type of power is limited to a specialized area. For example, someone with vast expertise in music would be powerful only in that area, not in another specialization.

Fralic (2000) feels that Florence Nightingale was the first nurse to effectively use this expert power.

When Nightingale used research to quantify the need for nurses in the Crimea (by showing that when nurses were present, fewer soldiers died), she was using her research to demonstrate expertise in the health needs of the wounded.

Power derived from expert knowledge is fundamental for any profession

(Hegyvary, 2003).

Referent power is power a person has because others identify with that leader or with what that leader symbolizes.

Referent power also occurs when one gives another person feelings of personal acceptance or approval.

It may be obtained through association with the powerful.

People also may develop referent power because others perceive them as powerful. This perception could be based on personal charisma, the way the leader talks or acts, the organizations to which he or she belongs, or the people with whom he or she associates.

People others accept as role models or leaders enjoy referent power.

Physicians use referent power very effectively; society, as a whole, views physicians as powerful, and they carefully maintain this image.

Informational power. This source of power is obtained when people have information that others must have to accomplish their roles and functions or tasks

Feminist power or self-power the power a person gains over his or her own lifeand maintains that this power is a personal power that comes from maturity, ego integration, security in relationships, and confidence in ones impulse. THE AUTHORITYPOWER GAPIf authority is the right to command, then a logical question is, Why do workers sometimes not follow orders?

The right to command does not ensure that employees will always follow orders.

The gap that sometimes exists between a position of authority and subordinate response is called the authoritypower gap. The term manager power may explain subordinates response to the managers authority.

The more power subordinates perceive a manager to have, the smaller the gap between the right to expect certain things and the resulting fulfillment of those expectations by others.The negative effect of a wide authoritypower gap is that organizational chaos may develop.

There would be little productivity if every order were questioned.

The organization should rightfully expect that its goals would be accomplished.

One of the core dynamics of civilization is that there will always be a few authority figures pushing the many for a certain standard of performance.People in the United States are socialized very early to respond to authority figures.

Children are conditioned to accept the directives of their parents, teachers, and community leaders.

The traditional nurseeducator has been portrayed as an authoritarian who demands unconditional obedience.

Educators who maintain a very narrow authoritypower gap reinforce dependency and obedience by emphasizing the ultimate calamitythe death of the patient.

Thus, nursing students may be socialized to be overly cautious and to hesitate when making independent nursing judgments.

Although the authoritypower gap continues to be small, it has grown in the last 20 years. Both the womens movement and the student unrest of the 1960s have contributed to the widening of the authoritypower gap.

This widening gap is evidenced when a 1970s college student asked her mother why she did not protest as a college student; the mother replied, I didnt know we could.

Because of these types of early socialization, the gap between the managersauthority and the workers response to that authority tends to be relatively small. Inother countries, it may be larger or smaller, depending on how people are socializedto respond to authority. This authority dependence that begins with our parentsand is later transferred to our employers may be an important resource to managers.Political PowerWith more than 2 million registered nurses in thenation, the nursing profession should be a tremendousforce in political and public-policy debates.The reality offers the nursing profession a formidablepower base that is largely untapped (Abood,2007). Boswell and colleagues (2005) noted that,more than ever, nurses need to be involved personallyand professionally in the political arena.Increasingly, decisions that influence nursing andhealth care are being made by politicians. All nursesare touched by the impact of policy and politicson health care and nursing practice, research, andeducation. Thus it is essential that nursing becomeinvolved in the political process. Barriers to politicalactivism are thought to include heavy workloads,feelings of powerlessness, time constraints, genderissues, and lack of understanding of a complexpolitical process (Boswell et al., 2005)In a recentarticle, Abood (2007) offered several strategies foreffective action in the legislative arenaentering thelegislative arena, understanding steps in the process,understanding the power players, understandingcommittees, and communicating with legislators.Although today is an extremely turbulent time inhealth care, it is also a time of tremendous opportunityfor the nursing profession. Nursing must acceptthe legitimacy of power and take advantage of theopportunity. Nursing curricula are an integral partof ensuring that nurses are capable of taking on amore active role in initiating and developing healthpolicy processes (Whitehead, 2003). Including theconcept of power in nursing curricula will betterprepare nurses to participate in social and politicaldecisions affecting health care. By creating dependencythrough becoming irreplaceable, demonstratingthe ability to cope with uncertainty, andparticipating in the political process, the nursingprofession will be able to establish its power baseand use that power to facilitate change in health careorganizations and the health care system.As has always been the case, nurses derive theircore power from being the health care providerswhom the public most trusts. Caring generatespower in relationships, and nurses can nurture thisas a power source. Benner (1984) identified six typesof power exercised by nurses (Box 12.5). Benners(1984) six types of nursing practicederived powercan be comparedto French and Ravens (1959) fivesources of power for individuals. For instance, transformationaland participative/affirmative nursingpractice power types would be similar to referentpower. Integrative, advocacy, healing, and problemsolvingtypes of power would be similar to expertpower. French and Ravens (1959) legitimate,reward, and coercive power sources are more frequentlyapplied to nurses as care managers than tonurses as care providers.Individually, nurses can use power conceptsto establish a power base and gain power in theirwork setting. For example, nurses can use informationand expertise to construct powerful, persuasivearguments. Nurses can collect and analyzedata that can be strategically used or controlled. Theycan be visible and persistent in goal pursuit.They can be creative and challenge the system toinnovate. Nurses can use group power strategiessuch as networking, connecting, and collaboratingto achieve professional goals.Influence of money in politics and health care DiscussionInfluence of education in politics and health - Discussion