Seeking Connectivity: An Analysis of Relationships of Power from Staff Nurses' Perspectives

Nurse empowerment is a well-researched area of nursing practice yet the quality of work environments continue to be eroded, and interactions between nurses and nurse managers continue to be fragile. Power is integral to empowerment, yet the exercise of power between nurses and their managers have been under-investigated in the nurse empowerment literature. To advance our knowledge in the empowerment literature, the study explored the process of how power is exercised in nurse-manager relationships in the hospital setting. Strauss and Corbin’s (1998) grounded theory methodology informed the study. Multiple qualitative fieldwork methods were utilized to collect data on staff nurses about how the manager’s role affected their ability to do their work. The researcher conducted semi-structured interviews and participant observations with 26 participants on three units within a tertiary hospital in Western Canada. Seeking connectivity was the basic social process in which nurses strive to connect with their manager to create a workable partnership in the provision of quality patient care while responding to the demands in the organizational context. Conditions, actions, and consequences formed the theory of seeking connectivity as an extension of nurse empowerment theory. The overarching finding is that the manager plays a critical role in modifying the work environment for nurses and as such, nurses seek connection with their manager to accomplish their work. Institutional policies and practices combined in various ways to influence nurses’ thinking and shaped their actions. The first pattern of the process was characterized by the absence of meaningful engagement with the manager. Power was held over nurses restricting discussions with the manager, and nurses employed a variety of resistance strategies. In the second pattern of the process when managers provided guidance, advocated for nurses, and engaged nurses as collaborators, nurses were better able to problem solve and make decisions with the manager to positively influence patient outcomes. The theory of seeking connectivity is the explanatory framework emerging from the study that reveals how power is exercised in social relations between nurses and managers. Seeking connectivity is a recursive process that continues to evolve. The results of this study advance nurse empowerment primarily from a structural perspective and secondarily from a critical social perspective, suggesting nurses’ perceptions and abilities shape their work role and are foundational to promoting change through collective action. Study implications for research, practice and policy are addressed.Ph