Ian Hodgson

UOB.GIF (1974 bytes)

Bradford, UK

Nurses and professional power

Health and Social Policy Module

The Nurse as a Political Innovator

Some issues for consideration

Webplaced: 22nd February 2001

Author: Ian Hodgson

Outline of session

  • define political influence in relation to nursing
  • discuss current status of nursing as a political force
  • examine types of ‘power’
  • focus upon the making of policy


  • Politics: the study of influence and the influential
  • ‘who gets what, when and how’ Laswell, 1936
  • politicians are involved in policy making, within a framework of disagreement [and tolerance]; negotiation; and a return to order [or policy]

Factors determining the political function of the nurse

  • gender inequalities
  • role of nurse in health care - no unitary or generic definition of a nurse
  • carers vs. curers - conflict between power bases
  • public image
  • adherence to altruism - leading to exclusion from policy making; divided loyalties

Special Interest Groups in Nursing

  • Generalists - accept hierarchy; more ‘practical’; steer away from theoretical base
  • Specialists - keen on professionalism and qualifications - seek to increase power and authority
  • Managers - budget holders etc.; seek control

NB: all groups have different aims, values and strategies

White, 1988

Models of Nurses

  • Unitary (‘natural state’) - seeks consensus; suppresses conflict; ‘conservative’; settles at lowest common denominator
  • Pluralist (to have influence) - encourages conflict; accepts conflict as natural phenomena; is truly political; avoids the status quo

Bases of power

  • reward - eg. employer giving wage rise
  • coercive - negative sanctions
  • legitimate - bestowed by status
  • referent - networking; identifying with other people who have power
  • expert - knowledge base
  • informational - control of communication
  • charisma - personal ‘attractiveness’

Influencing a Social System

  • Need resource of power
  • Need will, time and energy
  • Need political skill

……in order to have an affect

Mintzberg, 1983

References and bibliography


Antrobus, S. (1997) - An analysis of nursing in context: the effects of current health policy. Journal of Advanced Nursing, 25, pp 447-453
Clay, T. (1987) - Nurses: Power and Politics. Heinemann, Oxford
Keen, J. & Malby, R. (1992) - Nursing, power and practice in the United Kingdom. Journal of Advanced Nursing, 17,  pp 863-870
McPhail, G. (1997) - Managament of change: an essential skill for nursing in the 1990s. Journal of Nursing Management, 5, pp 199-205
Mintzberg, H. (1983) - Power in and Around Organisations. Prentice Hall
Robinson, J. (1992) - Problems and paradigms in the nursing profession. Journal of Advanced Nursing, 17,  pp 632 - 638
Salvage, J. (1985) - The Politics of Nursing. Heinemann, Oxford
Steppe, H. (1997) - Nursing under totalitarian regimes: the case of National Socialism. In: A. Rafferty, J. Robinson & R. Elkan (ed) - Nursing History and the Politics of Welfare. London, Routledge.
White, R. (ed) (1988) - Political issues in nursing: past, present and future. Chichester, Wiley.
Wiley, E. (1987) - Acquiring and using power effectively. Journal of Continuing Education in Nursing, 18 (1),  pp 25-27
Young, A. (1997) - Competing ideologies in health care: a personal perspective. Nursing Ethics, 4 (3), pp 191-201

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