Abstract
There is an argument that a prerequisite to empowering others, is to be empowered ourselves (Bradbury-Jones et al., 2008). Indirectly therefore, studies that investigate the empowerment of nurses have potential to increase our understanding of how to empower those in our care. The extensive work of Laschinger and colleagues has been particularly useful in generating knowledge about the empowerment of registered nurses from an organisational perspective. A considerable amount of Laschinger’s work is based on Kanter’s (1993) theory of structural empowerment. Kanter proposed four conditions for organisational empowerment: opportunity for advancement; access to information; access to support; and access to resources.
The reviewed paper reports on a study regarding the empowerment of graduate nurses. Theoretically underpinned by the work of Kanter, the research was a secondary analysis of data from an earlier study by Laschinger and colleagues. It tested a combined model of theories: empowerment; psychological capital (a positive motivational and psychological state that can impact individual performance) and work engagement (a positive work-related state of mind that persists over time). The results highlighted the importance of work empowerment and psychological capital in promoting new graduate nurses’ work engagement.
The authors conclude that nurses’ work environment is known to contribute significantly to the shortage in nursing, by influencing job turnover. They suggest that empowering work conditions and development of graduate nurses’ psychological capacities will have an impact on their work engagement. They argue that in turn, graduate transition is likely to be successful resulting in less attrition and sustainability of the nursing workforce. The paper therefore highlights the importance of empowerment, work engagement and retention in nursing. A useful extension of the discussion, however, may have been to consider why these issues are important. Recent events in the UK may illustrate this clearly.
In 2013, Francis published a report following his public inquiry into care failings at Stafford Hospital in England. Among a catalogue of failings, Francis identified negative culture, acceptance of poor standards and failure to put patients first. Poor staffing levels were identified as a significant contributing factor. The inquiry highlighted the effects of a disempowered workforce as one in which voices are silenced, and speaking out about concerns over care does not happen. Thus, Francis showed how a disempowering health care environment is one in which patients are at risk of neglect, maltreatment and death. The UK Government has announced how it plans to tackle the 290 recommendations put forward by Francis. Empowerment features highly, with emphasis on strong and stable leadership (Department of Health, 2013).
The paper by Boamah and Laschinger is a timely and salient contribution to nursing research. Its focus on graduate nurses’ empowerment is important, but it should not be seen as the telos – an end in its own right. If it really is the case that empowering others is dependant upon our own empowerment, then the empowerment of nurses can be viewed as an essential means through which those for whom we care are also empowered. The corollary is an empowered culture of health care as advocated by Francis, where patients receive high quality, respectful and safe nursing care.