Empowerment in Nursing Practice Essays

Empowerment in Nursing Practice Essays Empowerment in Nursing Practice Paper Empowerment in Nursing Practice Paper The concept of empowerment is one that is often discussed in the context of modern nursing practice. Empowerment has become somewhat of a ‘buzz’ word in the health care system and is often used out of context and without a true understanding of it’s meaning or implications to practice. This essay will attempt to conceptualise empowerment, specifically in nursing practice. Three areas will be analysed in an attempt to provide a simple overview of the empowerment approach to nursing. First, definitions of empowerment, second methods of empowerment, and finally barriers to empowerment will be explored. The first emergence of the concept of empowerment in health care can be traced to the Alma Ata Declaration of 1977 (Falk-Rafael, 2001). In that document health was recognised as an issue of social justice, a fundamental human right. Following that empowerment became the central ideology of the â€Å"new public health† (Grace, 1991) aligning with the Ottawa Charter’s definition of health promotion as a â€Å"process of enabling people to increase control over, and to improve their health. † The word Power is derived from the Latin verb â€Å"potere† (to be able). Simply, power can be defined as that which enables one to achieve their goals (Davidhizar and Dowd, 1999). With this definition in mind it would then follow that the empowering nurse needs to move from the traditional role of understanding and caring, to a role of facilitating the patient to define for themselves the direction in which their health care plan should develop in order to achieve their goals, thus enabling them to work towards maximizing the quality of their lives (Melville, 1997). According to Aoki (2002), empowerment can also be defined as a collective process acknowledging, promoting and enhancing an individual’s ability to meet their own needs, decipher problems and muster the necessary resources to be in control of their own lives. However, Kuokkanen and Leino-Kilpi, (2000), state that empowerment is not a clear concept, they say that although in it’s fundamental state, referring to solutions rather than problems, empowerment is positive; empowerment is a ‘dynamic’ concept where power is shared, taken over and given away. Regardless of definition it appears to be generally accepted that patients need to be in control of their own lives. Empowerment may take on different forms for different patients depending upon their circumstances and ability or desire to be empowered (Davidhizar and Dowd, 1999). Ultimately the desired result is for the individual to achieve a sense of control and direction that enables them to attain a better quality of life (Aoki, 2002). It is through the concept of maximising the quality of an individual’s life that the consequences of empowerment for nursing practice can be illustrated. During illness people become vulnerable and unsure of their world, it is during this time that they become dis-empowered. It is important for a nurse to understand their patient and to provide care that is centred around the unique needs of that individual (Cox, 2000). The empowering nurse will often spend many hours with a patient building a trusting and collaborative relationship. However empowerment is not easy and is something that has to be worked at particularly in a health care culture where it has been traditionally accepted that patients would relinquish power to those who knew how best to help them (Lutz and Bowers, 2000). Communication and information both facilitate patient empowerment. Faulkner, (2001) states that empowerment is achieved through the provision of information and the upholding of a patient’s right to be involved in the decision making process. A nurse that withholds information from a patient regarding aspects of their care is placing the patient in a position of weakness and reinforces the position of power for the nurse. Davidhizar and Dowd, (1999) state that â€Å"informational power† is about sharing valuable information, in the nursing context it could be about educating a patient or informing them of their rights either verbally or through the provision of educational literature, which is appropriate to the patient’s literacy level. Research shows that patients who become empowered in a particular area of their care have more potential to gain control of many other aspects of their life (Faulkner, 2001). For this reason it is vital for the nurse to remain aware of their patient’s situation and to continue to assist as necessary or as needed. It is interesting and important to note that not all patients see empowerment as being a positive thing. Many patients are happy to relinquish their power to a nurse and find security in this. Faulkner, (2001) cites the example that many aging patients find increased control over situations, activities and health care can in turn lead to their increased concern and may cause the patient undue stress and worry about their future. For many patients in this category the feeling of being ‘totally cared for’ provides a sense of comfort and security from the overwhelming reality of life (Gould, 1990). Gould (1990) goes on to say that some patients hold nurses in such high esteem that they feel inadequate and willingly relinquish their power to the nurse seeing him/her as the expert in relation to their health care needs. There are many barriers to empowerment, some totally outside of the nurse’s control that may in effect stand to dis-empower the nurse. Things such as budget constraints, environmental culture and simply a lack of time may all have an impact upon the empowerment of the nurse, thus effecting his/her ability to effectively empower the patient. Aoki, (2002) states that often a nurse needs to learn how to empower him/herself in order to empower their patient. Empowerment in a general nursing context is far from a simple matter of encouraging a patient to take control of their life. In all cases it is important that an individual approach be taken and consideration given to social, physical and cultural constraints both in relation to the nurse and the patient. However one thing does appear clear that in order for a nurse to empower a patient they must develop a collaborative and trusting relationship that aims to provide the patient with accessible information according to individual needs. Reference List: Aoki, Y. (2002). Reflections on empowerment. Nursing Older People, Feb 2002, 17-22. Cox, C. (2000). Response to Patient Centered Care: Understanding Its Interpretation and Implementation in Health Care. Nursing Reasearch, 45, 183-187. Davidhizar, R. Dowd, B. (1999). Benevolent Power. The Journal of Practical Nursing, March 1999, 34-31. Falk-Rafael, A. (2001). Empowerment as a process of evolving consciousness: A model of empowered caring. Advances in Nursing Science, 24, 1-6. Faulkner, M. (2001). Employment Disempowerment and The Care of Older People. Nursing Older People, July 2001, 18-22. Gould, D. (1990). Empathy: A review of the literature with suggestions for an alternative research strategy. Journal of Advanced Nursing, 15, 1167-1174. Grace, V. (1991). The marketing of empowerment and the construction of the health consumer. International Journal of Health Services, 21, 329-343. Kuokkanen, L. and Leino-Kilpi, H. (2000). Power and empowerment in nursing: three theoretical approaches. Journal of Advanced Nursing, 31, 275-241. Lutz, J. Bowers, J. (2000). Patient centered care: Understanding it’s interpretation and implementation in health care. Nursing Reasearch, 45, 165-182. Melville, M. (1997). Do patients have power in health care? British Journal of Nursing, June 1997, 337-340.