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of being central and relevant to the orga- nization. When individuals have formal and informal power, they are more likely to have access to empowering structures to help them achieve organizational goals.
The structures include supports, resources, information, and opportunities to develop and learn.
Research fi ndings demonstrate that empowerment has been applied to stu- dent and faculty populations in both the classroom- and practice-based context.
Empowerment has been assessed from the organizational, personal development, and emancipatory perspectives. Empowerment of self and others intersects among social, cultural, and political factors and appears to be instrumental in student professional development as well as a possible infl uenc- ing factor in nurse educators’ intentions to remain in the role.
RECOMMENDATIONS
Educators and students need to have a strong sense of empowerment, including how empowerment impacts practice and learning processes. When nurse educators develop and implement empowering teach- ing behaviors, students tend to envision that person as a role model and incorporate those behaviors in a similar way of being into their own sense of self as a soon-to-be nurse (Babenko-Mould et al., 2012). Integrating the concept of empowerment into nursing education could support the enactment of empowerment as a core element of practice in academic and in professional practice settings.
Babenko-Mould, Y., Iwasiw, C., Andrusyszyn, M. A., Laschinger, H. K. S., & Weston, W. (2012). Effects of clinical practice environments on clinical teacher and nursing student outcomes. Journal of Nursing Education, 51(4), 217–225.
doi:10.3928/01484834–20120323-06
Bradbury-Jones, C., Irvine, F., & Sambrook, S.
(2010). Empowerment of nursing students in clinical practice: Spheres of infl uence.
psychological empowerment, decreased incivility and burnout (Laschinger, Grau, Finegan, & Wilk, 2010); increased organi- zational citizenship (Gilbert, Laschinger,
& Leiter, 2010); increased recruitment and retention (Laschinger, Leiter, Day, & Gilin, 2009); and patient satisfaction (Purdy, Laschinger, Finegan, Kerr, & Olivera, 2010).
Clinical instructor and student empower- ment have been associated with student self-effi cacy in acute care settings (Babenko- Mould, Iwasiw, Andrusyszyn, Laschinger,
& Weston, 2012). Structural empowerment was associated with psychological empow- erment among students in a problem-based learning program; psychological empow- erment was positively associated with mentoring quality and job satisfaction and negatively related to job stress among nursing faculty (Chung & Kowalski, 2012).
Empowerment was positively associated with teachers’ perceptions of their own use of empowering teaching behaviors and students’ perceptions of those same behav- iors (Babenko-Mould et al., 2012). Student empowerment was evident when practice environments consisted of a positive culture and where mentoring relationships sup- ported students’ knowledge and confi dence (Bradbury-Jones et al., 2010).
SYNOPSIS
A foundational concept analysis of the term empowerment has resulted in the term being conceptualized from an organizational, personal development, and emancipatory perspective (Kuokkanen & Leino-Kilpi, 2000, 2007). According to Kanter’s (1977, 1993) theory of structural power in orga- nizations, power relates to an individual’s ability to achieve goals by mobilizing human and material resources. To do so, individuals need to have informal and for- mal power (Kanter, 1993). Informal power results from connections in the organiza- tion such as peers, employees, and men- tors. Formal power is developed as a result of being engaged in a role that provides autonomy and fl exibility to support feelings
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Effects of work environments on nurse and patient outcomes. Journal of Nursing Management, 18, 901–913.
doi:10.1111/j.1365–2834.2010.01172x Spreitzer, G. M. (1995). An empirical test of
a comprehensive model of intrapersonal empowerment in the workplace. American Journal of Community Psychology, 23(5), 601–629.
Yolanda Babenko-Mould
E
NGAGEMENTDEFINITION
Engagement is the way in which people feel connected in a strongly positive manner. The term can also be defi ned by types of people and work settings where there is an ongoing positive feeling. Faculty are expected to be committed to engagement in order to help students attain the goals of learning and be prepared as professional nurses who work directly with patients and other staff.
The Center for Advancing Health (2010, p. 2) defi nes engagement from the patient perspective as “actions individuals must take to obtain the greatest benefi t from the health care services available to them.” This defi nition can also be applied to engage- ment of professional nurses, nurse educa- tors, and student learners. The Commission on Community-Engaged Scholarship in the Healthcare Professions (n.d.) defi nes com- munity engagement as “the application of institutional resources to address and solve challenges facing communities through col- laboration with these communities” (p. 12).
APPLICATION
Several studies have focused on work engagement in Magnet hospitals. Nurses who work in Magnet hospitals are more engaged than those who work in non-Mag- net organizations.
Journal of Advanced Nursing, 66(9), 2061–
2070. doi:10.1111/j.1365–2648.2010.05351.x Bradbury-Jones, C., Sambrook, S., & Irvine, F.
(2007). The meaning of empowerment for nursing students: A critical incident study.
Journal of Advanced Nursing, 59(4), 342–351.
doi:10.1111/j.1365–2648.2007.04331.x Chung, C., & Kowalski, S. (2012). Job stress,
mentoring, psychological empowerment, and job satisfaction among nursing faculty.
Journal of Nursing Education, 51(7), 381–388.
doi:10.3928/01484834–20120509-03
Conger, J. A., & Kanungo, R. N. (1988). The empowerment process: Integrating the- ory and practice. Academy of Management Review, 13, 471–482.
Gilbert, S., Laschinger, H. K. S., & Leiter, M. (2010). The mediating effect of burnout on the relationship between structural empowerment and organi- zational citizenship behaviours. Journal of Nursing Management, 18, 339–348.
doi:10.1111/j.1365–2834.2010.01074.x Kanter, R. M. (1977). Men and women of the cor-
poration. New York, NY: Basic Books.
Kanter, R. M. (1993). Men and women of the corporation (2nd ed.). New York: NY: Basic Books.
Kuokkanen, L., & Leino-Kilpi, H. (2000).
Power and empowerment in nursing:
Three theoretical approaches. Journal of Advanced Nursing, 31, 235–241.
Kuokkanen, L., & Leino-Kilpi, H. (2007).
Organizational change and work related empowerment. Journal of Nursing Management, 15, 500–507.
Laschinger, H. K. S., Grau, A., Finegan, J., & Wilk, P. (2010). New graduate nurses’ experiences of bullying and burnout in hospital settings. Journal of Advanced Nursing, 66(12), 2732–2742.
doi:10.1111/j.1365–2648.2010.05420x
Laschinger, H. K. S., Leiter, M., Day, A., &
Gilin, D. (2009). Workplace empowerment, incivility, and burnout: Impact on staff nurse recruitment and retention outcomes.
Journal of Nursing Management, 17, 302–311.
doi:10.1111/j.1365–2834.2009.00999.x Purdy, N., Laschinger, H. K. S., Finegan,
J., Kerr, M., & Olivera, F. (2010).
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collaboration, accountability, shared deci- sion making, competent leadership, qualifi ed nurses, expert practitioners, and recognition of the value of nursing’s meaningful contri- bution to practice.
Recommendations from the Institute of Medicine’s (IOM) The Future of Nursing (2010) have compelled schools of nursing to redesign undergraduate nursing curricula to include judgment, inquiry, engagement, and voice (D’Antonio, Brennan, & Curley, 2013). In their work, Educating Nurses: A Call for Radical Transformation, Benner, Sutphen, Leonard, and Day (2010) described an urgent need to restructure nursing curricula so they actively engage learners and promote clinical reason- ing. Engaging students in the classroom and clinical setting allows students to envision themselves as nurses. Activities that foster student engagement in interprofessional col- laboration and communication in practice settings help students to develop confi dence levels. Strategies to facilitate student and new graduate nurse engagement in interprofes- sional collaboration suggest better patient outcomes (Pfaff, Baxter, Jack, & Ploeg, 2013;
Pollard, 2009).
RECOMMENDATIONS
Learners, faculty, direct care nurses, advanced practice nurses, and nurse lead- ers have the opportunity and the obligation to work to improve places where nurses work, with the goal of well-engaged nurses.
Although little research has been done in nursing and health care as compared to some other fi elds, gaining an increased understanding of engagement can lead to professional maturity.
Benner, P., Sutphen, M., Leonard, V., & Day, L. (2010). Educating nurses: A call for radical transformation. San Francisco, CA: Jossey Bass.
Carter, M. R., & Tourangeau, A. E. (2012).
Staying in nursing: What factors deter- mine whether nurses intend to remain employed? Journal of Advanced Nursing, 68(7), 1589–1600.
Highly engaged nurses are described as more effective than disengaged nurses.
In addition, engaged nurses have a good relationship with nursing management, a supportive work environment, a sense of empowerment, and a good work–life bal- ance. Furthermore, they participate in deci- sion making and professional development (Carter & Tourangeau, 2012; Fasoli, 2010) as engaged practitioners.
Factors contributing to the perception of engagement nurses have in the workplace are workload, control, reward, fairness, community, and value. Positive practice environments that infl uence engagement were found to have the following aspects:
an empowering work environment; a shared governance structure; leadership support;
adequate numbers and skill mix of staff;
and value autonomy, professional develop- ment, and collegial relationships (Twigg &
McCullough, 2014).
Palmer, Griffi n, Reed, and Fitzpatrick (2010) studied a group of acute care nurses and found that engagement associated posi- tively with self-transcendence. Thus, when nurses are fully engaged in their personal and professional lives, it can be concluded that their growth, development, and becom- ing as a person will be enhanced. In another study, a signifi cant determinant of feeling engaged was the perception that one’s work is important (Rivera, Fitzpatrick, & Boyle, 2011).
Therefore, the experience of being engaged in one’s work is when one fi nds meaning in his or her work.
SYNOPSIS
Engagement is a complex concept that has a variety of meanings from various perspec- tives. Reports of literature in nursing and other fi elds indicate a relationship between productivity and engagement, such that the more engaged—the more productive.
Practices defi ned in a document by the American Organizations of Nurse Executives provide the underpinnings of an environ- ment where nurses experience self as being engaged to the fullest. The practices are
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Journal of Nursing Studies, 51(1), 85–92.
doi:10.1016/j.ijnurstu.2013.05.015
Patricia S. Yoder-Wise Kathryn S. Whitcomb