CPNRE® Comprehensive Review Series: Part 8





In yesterday’s post, we talked about the elusive concept of empathy. Today, we’re introducing the concept of power in nursing and what it means to give power away. It’s part 8 in the serialization of the CPNRE Comprehensive Review eBook. If you want a re-fresher, here’s part 1, part 2, part 3, part 4, part 5, part 6 and part 7.

Nurse-client interactions: Power

Power is a challenging concept for a lot of us, especially women. There’s a part in each of us who wants to be told what to do and be cared for by others – but there’s also a part of us that is afraid of being powerless.

When we talk about power in health care, we often think about ‘power-over’. Power-over is defined as the ability of a person or group of people to exert control over others. In health care, this means that nurses and physicians and other professionals have more authority, more knowledge, more skills, more influence and more leverage than clients do.

One of the greatest problems with power-over in our health care system is that ‘health’ has been defined in our society so often that people usually believe we – as in health care professionals – are the experts of their health and they should do what we say.

The truth is, clients are the experts of their health because they know what’s best for them. We just don’t often realize that – or help clients realize it themselves.

To overcome the inherent asymmetrical power in health care, and in nursing, we have to create and give away power. Instead of telling clients what to do, we can partner with them – and help them make decisions if they want to change something.

In order for clients to make changes in their health and manage the problems they face, we have to empower them with the skills and knowledge they need to change their behaviours if they want to. We know that when clients are involved in their care and making decisions affecting their health, the better off they are.

Question: Which column of statements below is the most empowering?  

You should get dressed now

When would you like to get dressed?

You should walk to the mall every day

Let’s talk about activities you’d like to do

You must follow your meal plan

What would you like to eat instead?

You have to wash your hands

Let’s review ways you can prevent spread of infection

You need to quit smoking

How can I help you quit smoking?

Answer: the right column

By helping clients identify and build upon their preferences, strengths, and weaknesses, we’re empowering them to take responsibility and become more independent in managing their health.

We can empower clients by:

  • Providing them  with the relevant information they need to manage their health
  • Including them in planning their care
  • Supporting them to evaluate their care and give feedback
  • Listening to their concerns, questions, preferences, values and beliefs
  • Giving choices and allowing capable people to make their own decisions

Exam tactic

It’s a sign you’re being tested about the concept of power on the CPNRE® if you see a question asking you to choose something like:

  • How can the practical nurse encourage the client to take responsibility for his/her health?
  • How can the practical nurse promote the client’s independence?
  • How can the practical nurse involve the client in planning his/her care?
  • How can the practical nurse implement a plan of care the client will agree with?
  • How can the practical nurse understand the client’s health care needs?

When you see questions like these on the CPNRE®, you should think about the above ways in which practical nurses could give people power. Choose the one answer option involving the practical nurse empowering someone to have more control over his or her health or care. Although hard to do, it’s always better to let capable people decide for themselves than for us to make decisions for them.