Embracing Empowerment in the Healthcare of the United States

doi:10.4236/ojl.2013.24013

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Open Journal of Leadership

2013. Vol.2, No.4, 85-86

Published Online December 2013 in SciRes (http://www.scirp.org/journal/ojl) http://dx.doi.org/10.4236/ojl.2013.24013

Open Access 85

Embracing Empowerment in the Healthcare

of the United States

Bozena Padykula1*, Karen Wexell2,3,4

1Department of Nursing, Western Connecticut State Universit y, Danbury, USA

2Poison Control, Farmington, USA

3UConn School of Nursi n g, Storrs, USA

4Sacred Heart University, Fairfield, USA

Email: *[email protected]

Received August 2nd, 2013; revised September 5th, 2013; accepted September 18th, 2013

Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium,

provided the origina l w o rk is properly cited.

The United States experiences an economic and healthcare crisis that calls for change. Transformational

leadership model by Kouzes and Posner (2003) defines traits that are important to embrace by today’s

healthcare leaders in promoting organizational change. To promote growth, engaging and empowering all

members in the organization opens the door for collaborative work intentionally establishing sustainable

healthcare outcomes. Since nurses play a significant role in US and global healthcare systems, healthcare

organizations demand empowered nursing leaders that have an equal voice. The significance of this re-

view to the future is to awaken nursing leaders to step away from a dependent mode and to step forward

to an empowered mode.

Keywords: Nursing Leadership; Empowering Nursing Leaders; Kouzes and Posner Transformational

Leadership; Collaborative Healthcare

Introduction

The United States experiences an economic and healthcare

crisis that calls for change. The healthcare system in the United

States needs leaders that influence an organization’s capacity to

change dedicated to “get involved in something that you care so

much about that you want to make it the greatest it can possibly

be, not because of what you will get, but just because it can be

done” (Collins, 2001: p. 209). Transformational leadership

model by Kouzes and Posner (2003) defines traits that are im-

portant to embrace by today’s healthcare leaders in promoting

organizational change.

Kouzes and Posner-Transformational

Leadership

Kouzes and Posner’s (2003) transformational leadership

model focuses on establishing a caring relationship between the

leader with his followers. This form of professional relationship

promotes leadership that “will be wholly dependent upon the

capacity to build and sustain those human relationships that

enable people to get extraordinary things done on a regular

basis” (Kouzes & Posner, 2003: p. 3). In their model, Kouzes

and Posner (2003) introduced 5 fundamental practices of ex-

emplary leadership that motivate extraordinary performance.

These 5 practices require leaders to: “1) challenge the process;

2) inspire a shared vision; 3) model the way; 4) enable others

to act; [and] 5) encourage the heart” (p. 3).

To challenge the process, leaders seek and explore “opportu-

nities to innovate, grow, and improve” (Kouzes & Posner, 2003:

p. 6). Based on their knowledge and expertise, they investigate

new ideas and consider applying the initiative in practice. To

inspire a shared vision, leaders envision clearly what they plan

to accomplish and reach acceptance of this vision with follow-

ers. To model the way, leaders develop their own individual

voice after clarifying personal and professional values. This

independent voice represents their distinct beliefs that they need

to stand for and express. To enable others to act, leaders estab-

lish trust that promotes collaboration and engagement. These

essential components further create an enabling environment

that embraces choice, accountability, and interest to share and

eliminate “hoarding the power ... by giving it away” (p. 8).

Lastly, to encourage the heart, all constituents need to feel that

their contributions are appreciated and valued; and they are mo-

tivated to dedicate time and energy to work on common goals.

The leaders are like captains on a ship accountable to sail

with the wind and anchor the future of the organization on the

paradise island. Everything starts with the leader, who he is and

where his heart is. The leader according to Kouzes and Posner,

needs to model the way, challenge the process, and inspire

shared vision. To model the way, the leader needs to start with

individual self-awareness; who he is representing professionally

and personally. To challenge the process, the leader’s knowl-

edge contributes to how much he will be able to invest in

transforming opportunities. Once the leader is confident in

selected opportunities, the ideas and possibilities need to be

inspired in followers.

*Corresponding author.

B. PADYKULA, K. WEXELL

Kouzes and Posner, in the practice of enabling others to act,

focus on creating an environment where trust, collaboration and

accountability are valued and acknowledge the significance of

encouraging the heart. When followers gain a sense of appre-

ciation, they establish full dedication to common goals of the

organization. Kouzes and Posner reinforce the value of rela-

tionships with followers as the primary source of creating

prosperous future for the organization.

Value of Empowerment

According to Kouzes and Posner (2003), one of the charac-

teristics of exemplary leaders is to empower others to act. Many

organizations support this vision but the healthcare system,

nationally and globally requires significant improvement in

empowerment of others to act (Coonan, 2008; Dossey &

Keegan, 2013; Hurley & Linsley, 2007; Neera, Anjanee, &

Shoma, 2010; Patrick, Spence, Wong, & Finegan, 2011; Tho-

mas, 2005; Thompson, 2012).

The healthcare system, nationally and globally, undergoes

many changes to meet the needs of every community. Nurses

play significant roles as healthcare providers globally (Dossey

& Keegan, 2013). The role of nurses shifted drastically in the

last 10 years however, “historically, nursing culture is grounded

in dependent role delineated attitudes” (Hurley & Linsley, 2007:

p. 751). As reminded by Hurley and Linsley, based on the bu-

reaucratic management structure in healthcare organizations,

nurses still are not taking active participation in organizational

decisions and report being a victims of managerial hierarchy.

Globally, nurses in the twenty first century envision functioning

in the empowered collaborative role with other members of

healthcare organizations. Nurses are self-determined to build

partnership with “equitable power manifested through shared

decision-making, effective senior leadership and interpersonal

constructs of mutual respect, trust and authenticity toward

shared goals and visions” (p. 751). This sense of victimization

is present when nursing leaders are considered irrelevant by

other medical professionals. Inclusion of nursing leaders with

medical professionals creates the initial step forward for nurses

to build an equal voice in the decision making process. As sug-

gested by Hurley and Linsley, nursing leaders are challenged to

“empower staff, fuse enthusiasm, and instill confidence” (p.

752).

The authors Hurley and Linsley (2007) highlight four factors

that contribute to improving the value of nursing leaders in the

hierarchy of healthcare organizations: 1) self-awareness with

courage to know individual strengths & weaknesses; 2) human-

istic principles-autonomy, empathy, creativity, social skills; 3)

open to collaborate with different disciplines; and 4) flexibility.

When nursing leaders embrace these principles in building a

reputation for themselves in healthcare organizations, they cre-

ate an opportunity to advocate and thus empower every nurse to

gain their own voice in the profession.

Hurley and Linsley (2007) remind that “nursing leadership

remains caged in a multiplicity of boundaries, many self-im-

posed” and the above concepts are the cornerstone to align

nurses toward a collaborative role. The authors conclude, that it

is the responsibility of nursing leadership to support “fluidity

and an increasing realization that each nurse is, leader” (p.

754).

Conclusion

To thrive in the 21st century, each organization must con-

tinuously be open to change and growth. To promote growth,

engaging and empowering all members in the organization

opens the door for collaborative work intentionally establishing

sustainable healthcare outcomes. Since nurses play a significant

role in US and global healthcare systems, healthcare organiza-

tions demand empowered nursing leaders that have an equal

voice.

The significance of this review to the future is to awaken

nursing leaders to step away from a dependent mode (Hurley &

Linsley, 2007) and to step forward to an empowered mode

(Kouzes & Posner, 2003). Further, this new empowered voice

in nursing leaders invites nurses to collaborative work opportu-

nities with other healthcare members.

In agreement with Kouzes and Posner (2003), transforma-

tional leaders who create a compelling relationship with fol-

lowers capture their interest and motivate them to work toward

a common vision. Hurley and Linsley (2007) describe nursing

leaders with self-awareness model personal humanistic qualities

and attributes such as creativity and flexibility and inspire oth-

ers to the same. When leaders align with leadership attributes

according to Kouzes and Posner, they inspire and empower

followers to engage in collaborative work.

In conclusion, the fundamental purpose of this paper is to in-

troduce the value of the transformational leadership model by

Kouzes and Posner (2003) to healthcare leaders. These leaders

influence an organization’s capacity to change and ability to

thrive amid the demands of our changing world. Therefore in

order to create a sustainable future in every organization, “we

need leaders who can unite us and ignite us” (Kouzes & Posner,

2003: p. xiii).

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