This chapter focuses on the ethical responsibilities of nurse leaders to advocate for health. A leader who understands how to use power is more likely to be a successful advocate. Building on Foucault’s work, we know that we must look at the relationship between health, power, and diverse populations. In Canada a focus on the Indigenous populations is required if we are to make a difference.
Nurse leaders must also look at the workplace and examine how the presence or absence of structural empowerment and psychological empowerment for care providers impacts patient care. Critical social theory suggests that reflection upon the roles of nurses in health care systems empowers nurses to be effective advocates. Nurse leaders, intent on advocating for health, can join other nurses in political action directed at changing existing health care practices. When no other solution is available to advocate for the health of vulnerable people, whistle-blowing may be employed as a last resort.
After completing this chapter, you should now be able to:
- Identify the importance of ethics to nursing leadership.
- Describe advocacy.
- Compare the advocate approach to the paternalistic approach in addressing health inequities.
- Determine how the nurse leader uses advocacy to introduce change that addresses health inequities.
- Identify the different types of power.
- Recognize the role nurse leaders can have in political action.
- Verbalize your own response to change.
- Pick a shift from one of your most recent clinical rotations. Examine the actions of nurses during your shift and look for examples of the five different types of nursing power. Did you or your fellow nursing students exhibit personal power, expert power, position power, perceived power, or connection power? What types of power did your preceptor exhibit? What about Staff nurses? The charge nurse? Which nurse do you think was the most powerful on your unit? Why?
- Review the CNA’s “June 2016 Environmental Scan Summary” which was discussed in Essential Learning Activity 10.2.1. Select an issue identified in the environmental scan that you believe will have a serious impact on the health of Canadians when you graduate in one to two years. Develop a plan to advocate for the health of Canadians using the advocacy tools provided on the CNA website.
- Read the research article “Exploring confidentiality in the context of nurse whistle blowing: issues for nurse managers” (Jackson et al., 2011) on whistle-blowing (outlined in the Research Note earlier in this chapter). Identify how confidentiality was used to silence and isolate nurses.
- Think of the commonly heard phrase “Nurses eat their young.” What theory explains this phrase? As a graduate nurse, what steps will you take to ensure that people will not describe you as a nurse who “eats her young”?
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