Understanding the impact of power in organizations.

Although implementation of Shared Governance appears to have failed, it failed primarily on the surface. Many staff nurses actively involved in the Shared Governance movement not only were empowered but were dramatically affected on a professional level. Several council chairpersons were empowered to assume management roles in the transition back to the hierarchial model--a manifestation of their professional growth and development. At the unit level, several units lobbied the new leadership to allow them to continue to do peer review and unit-based council management of unit governance issues. Three councils lobbied to continue to do their work, although in a modified role, in the reestablished hierarchial structure. The three remaining councils were those of Practice, Quality, and Research. If nurse leaders at any level within the organization are to guide their departments forward while in the throes of the current chaos in health care, they must develop and use their power bases, both formal and informal, as individuals and then as leaders. Russell Coile identifies the need for more clinical expertise (expert power) on the executive team of health care organizations. He predicts that 50% of the executive team will be nurses and physicians and that only health care executives with an MBA or financial backgrounds, who also have well-developed informal power bases with skills in relationship development, facilitation, and networking, will be part of the new system. Those with a diversified informal power base will be most successful in guiding their organization to its destination. The future for nursing leaders is in the sharing of information; it is about embracing diversity and recognizing the contributions others can make that are refreshingly different; it is also about clearly defining a balance in life, because balanced leaders who have found a way to nurture and meet their own needs are better positioned to do the same for others. Ultimately, understanding the impact of power in an organization, regardless of organizational structure, begins with understanding and defining your own power base.