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

I am scheduled to do two clinical day shifts at Timpanogos Hospital this Saturday and Sunday. My mentor was great to follow last time, and I look forward to having two less shifts to complete by next week.

For the purpose of the assignment, I will focus on my second job for the discussion of patient care models. I work for a home health agency, and the case management care model is utilized. The model works well because of increased work efficiency. The case manager coordinates the care of the patient and is directly involved in the care as well. A disadvantage of the model is the need for prior experience to effectively act in that role due to its extensive requirements.

Reward power is gained by the ability to grant rewards to others. Coercive power is based on fear and punishment. Legitimate power is the power inherent in one's position. Expert power is gained through knowledge or skill. Referent power is gained through association with others. Charismatic power results from a dynamic and powerful persona. Information power is gained when someone has information that another needs. Feminist or self-power is obtained through maturity, ego integration, confidence, and security in relationships. Strategies to increase my personal power base include being polite and kind to everyone I work with in order to build positive work relationships, learning all that I can to increase my knowledge base, and maintaining positive relationships in my personal life. Power can be used for good and less nobel purposes. Advocating for a patient to further facilitate their care is an example of a positive use of power. Attempting to dominate someone simply for the sake of dominance would certainly not be a noble or a long-term productive use of power. I agree with the text book on page 296 when it states that, "Power, therefore, is not good or evil; how it is used and for what purpose it is used determine if it is good or evil."