Seven types of power in nursing leadership

Leadership plays a crucial role in all workforce settings including nursing. A nurse in a leadership role performs such duties as training, motivation, communication, assessment, supervision, counselling and conflict resolution. Leadership is a continuous process involving many aspects, so training and regular evaluation of leaders in the nursing field is detrimental. Not all leadership is good leadership, so knowing what leadership power and strategies are being used within an organisation is a sound practice.

Organizations such as hospitals, nursing homes, home health agencies and assisted living programs have nursing programs which include managers. At least one manager must be available to keep nursing practices and organisation in good practice due to state and federal oversight of health-care programs. Besides oversight by regulating agencies, bad management leads to costly mistakes and in nursing, can lead to injury to patients. Lining up the right type of power and management tools with the nurse supervisors lessens the chance of fault.

Seven types of power exist in nursing leadership that a nurse manager may utilise in supervising of subordinates. They are personal, positional, reward, coercive, legitimate, referent and expert power.

Personal power is used when there are personal relationships built through experience or age.

Positional power solely lies on the fact that the nurse is titled a manager or supervisor and therefore must conceive this role.

Reward power is created by the ability of the nurse supervisor to offer rewards for specific behaviour desired. Rewards given should never be for normal job duties but for extra exertion or exceptional emergency response.

Coercive power is the understanding that the nurse manager can and will take away privileges or impose penalties if subordinates' work does not meet required standards.

Legitimate power carries the position that subordinates believe the manager has the "right" to power. Legitimate and positional power are very similar in nature.

Referent power is formulated by how the subordinates feel about the manager. Subordinates that look up to the personality and qualities of the manager have a sense of longing to perform similarly.

Expert power is the ability to manage others because of expert status on specific subjects. Someone who has expert power often may not even be in a management role, but because of their expertise in something they receive a power role.

Power roles are often mixed and can send different messages to different people. Nurse managers themselves may feel they have positional power, but subordinates may look at the manager as an expert or role model, therefore adding a separate role of power. During annual or biannual evaluations of a nurse supervisor or leader, the director may address these issues and create a plan to allow the manager to effectively supervise and enhance these roles.

Power roles can be dangerous when taken out of context or not performed appropriately. This can happen with reward or coercive power. The option of reward giving can lose its power when the rewards become too frequent and lose their bargaining power. Coercive power works well, but if the power is mishandled, the relationship between the manager and subordinates can falter. Employees may begin to view the manager as stringent and unapproachable, which will lead to high turnover or burnout rates.