Empowerment in nursing: paternalism or maternalism?

Abstract

The aim of this article is to explore whether patient empowerment flourishes in the wake of current health reforms or if there is a power struggle between nursing and medicine as to what is in the patients' best interest. Shifting the balance of power from healthcare professionals to patients has become a key element of healthcare policy in England. The RCN's definition of nursing places patient empowerment as a central remit of nurses. However, achieving genuine patient empowerment is not easy and requires individuals and organizations to alter their beliefs, values and behaviours. To empower patients nurses must be in a position to share power and this may require a realignment of the traditional power base within health care. Although empowerment is often viewed on a one-to-one level between professionals and patients, for true patient empowerment to occur, issues of power and control must also be addressed at a national and political level.

Concept Analysis of Empowerment From Survivor and Nurse Perspectives Within the Context of Cancer Survivorship

“…Power-over can either be used to exert control over the patient such as in a paternalistic relationship or can be used to increase the patient's power-from-within in an empowering provider-patient relationship. Power-from-within develops internally in patients because of a sense of confidence or strength, and is demonstrated when patients start to sense an opportunity for control over their lives (Rissel, 1994) and begin using knowledge as a tool of power (Christensen & Hewitt-Taylor, 2006). Therefore, in an empowerment model, the provider uses power-over to share expert knowledge in an interactive process where the patient uses power-from-within to assert personal goals, circumstances, beliefs, and solutions.…”

Empowerment in medicine: An analysis of publication trends 1980–2005

“…The aim of community empowerment is to strengthen the patient's voice, to create an environment of group support and to promote solidarity. Programs aimed at promoting community empowerment often focus on sharing knowledge among patients and to promote a more coherent voice for patients [5,20].…”

“…Nurse empowerment applications in the literature concentrated on expanding nurses' education, leadership skills and management effectiveness, with the aim of enhancing nursing commitment in the workplace, professional competence and job satisfaction [5]. At the same time the role of nurses in the processes of patient empowerment is broadly discussed.…”

“…At the same time the role of nurses in the processes of patient empowerment is broadly discussed. This literature focused on a shared power position and a realignment of the traditional power base within health care systems away from the physicians control, towards a nurse/ patient dyad [5].…”

“…In recent years the term 'empowerment' has become a catchphrase in academic medicine and the concept has been applied to a range of populations and settings [1][2][3][4][5][6][7][8][9][10]. Empowerment has been studied in the context of quality improvement, health care policy reform, health care ethics, consumerism, philosophy, partnerships, psychology, and information imbalance [11].…”