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Chapter 3:

Organizational Power and Politics

Overview

  • Power and politics—differing perspectives on use in organizations
  • Power relationships in the workplace—sources of power of actors in units/departments
  • Positive and negative perceptions of power and politics in workplace
  • Organizational structures that empower employees
  • Organizational groups that exert power and how power operates
  • How politics plays out in organizations
  • Strategies and games used in health care organizations
  • Types of situations that give rise to use of power and politics

LEARNING OBJECTIVE 1

Define power and politics and describe differing perspectives on their use in organizations.

CONCEPTS FOR LECTURE

  1. Power
  2. “The ability to exert actions that either directly or indirectly cause change in the behaviour and/or attitudes of another individual or group”
  3. In an organization—“the ability to mobilize resources (human and material) to get things done”
  4. Five bases of power that are most common:
  5. Reward power—ability of person in senior position to provide rewards (pay increases, promotions, privileges etc.)
  6. Coercive power—power to apply punishment or withhold rewards (termination)
  7. Legitimate power—formal position of someone and perception that this person has the right to exert influence and expect compliance
  8. Referent power—based on personal attractive qualities. Those influenced by this power would like to be associated with him/her. Sometimes referred to as charisma.
  9. Expert power—perceived extent of a person’s knowledge or expertise.

  1. Politics
  2. Tactical activities or strategies a person takes to influence the decisions or actions of others
  3. More likely to evoke a negative image than power
  4. Has been seen in organizations as essentially illegitimate, and has been compared to an illness

QUESTIONS FOR LECTURE DISCUSSION

  1. Discuss the benefits of power in an organization.
  2. What do you see as the negative aspects of power and politics in health care? Have you seen any examples?

SUGGESTIONS FOR LECTURE ACTIVITIES

  1. Have students explore any form of media (print, radio, social) by searching the month prior for any political issues concerning healthcare. Is there rebuttal from opposing parties? Have students debate the issues presented from both a pro and a con position.

LEARNING OBJECTIVE 2

Analyze power relationships in the workplace and the sources of power of the actors or units/departments of an organization.

CONCEPTS FOR LECTURE

  1. Multiple factors affect power relations in an organization
  2. Three groups of people in an organization
  3. Those who are naïve about power and influence in organization
  4. Those who are cynics
  5. Those who are in between
  6. Diversity or difference among people around goals, values, and perspectives
  7. Cultural, professional
  8. People are interdependent—two or more actors are dependent on each other to some degree, and therefore have power over each other.
  9. When few people are involved in a situation (low interdependence) and when differences between them are few (low diversity), conflict is easier to resolve.
  10. Many health care teams now draw on wide range of health care disciplines to ensure that health care recipients benefit from the knowledge and skills of experts who may have differing perspectives on how health care should be delivered or what the priorities of the organization should be.

QUESTIONS FOR LECTURE DISCUSSION

  1. In the health care organization where you are currently doing clinical placement, can you identify job titles that would fall under each of the following?
  2. Top management
  3. Operators
  4. Line managers
  5. Analysts
  6. Support staff
  7. How does one influence over the other? What do you see as the power relationship?

SUGGESTIONS FOR LECTURE ACTIVITIES

  1. Have students interview a person in a position of authority at the health care organization where they are doing their clinical placement. Ask the to plot the individual’s position on an organizational chart. Have them explore what this influence this individual will have on their work as a nurse, directly and indirectly.

LEARNING OBJECTIVE 3

Debate the positive and negative perceptions of power and politics in the workplace.

CONCEPTS FOR LECTURE

  1. Power
  1. Negative perceptions:
  2. Dominance over others
  3. Hold-over from pre-democratic periods where leader was cruel tyrant
  4. Social inequality, abuse and rule by elites
  5. Westerners showed a negative association between power and cooperation
  6. Differing cultural views of power may lead to differing psychological and behavioural consequences in the workplace
  7. Positive perceptions:
  8. Contribute to order and effectiveness
  9. Westerners showed positive association between power and reward
  1. Politics
  1. Negative perceptions
  1. “A domain of activity in which participants attempt to influence organizational decisions and activities in ways that are not sanctioned by either the formal authority system of the organization, its accepted ideology or certified expertise”
  2. Competing interests and goals, jockeying for a favourable position, or approval of one over another
  3. When politics becomes the dominant force in an organization, it affects legitimate power.
  1. Positive perceptions
  1. The constructive reconciliation of competing causes—by which diverse interests and views can be sorted out in a just way.

QUESTIONS FOR LECTURE DISCUSSION

  1. Describe situations from your past where power and politics may have affected you in a negative way.
  2. How might power and politics at higher levels of administration in the hospital affect the work environment of all employees?

SUGGESTIONS FOR LECTURE ACTIVITIES

  1. Have students review the interview with Dr. Judith Shamian and write an opinion piece, discussing each of her answers.

LEARNING OBJECTIVE 4

Discuss how an organization may be structured to empower employees.

CONCEPTS FOR LECTURE

  1. Empowerment
  1. Workplace factors that give employees a sense of power and more influence in the organization
  2. Factors include the ability to act and to make decisions in their positions
  3. Requires support (supplies, resources, education and information) and delegation to the employee
  1. Types of power used in organizations to empower employees
  1. Expert power
  2. Reward power
  3. Referent power

  1. How organizational factors contribute to power or powerlessness (see Table 3.1):

QUESTIONS FOR LECTURE DISCUSSION

  1. How are student nurses empowered in the clinical practice area? In their academic work?
  2. Review the factors in Table 3.1 (above) and provide examples of situations you may have seen in the clinical practice area that demonstrates each.

SUGGESTIONS FOR LECTURE ACTIVITIES

  1. Have a hospital administrator, or a person from another leadership role, speak to the students about perceived power of their role and the powerlessness/lack of authority for other aspects of their role.

LEARNING OBJECTIVE 5

Describe the groups in organizations who can exert power and ways in which power can operate.

CONCEPTS FOR LECTURE

  1. Three groups have been described as being powerful or influential in hospital decision-making:
  2. Board of trustees or directors
  3. Senior administration of the hospital
  4. Senior physician
  5. Systems of influence in organizations
  1. Internal coalition
  2. Top management
  3. Operators
  4. Line managers
  5. Analysts
  6. Support staff
  7. System of Authority
  8. Formal power that accrues to the holder of an official position, e.g., CEO
  9. They establish and design the hierarchy or chain of authority
  10. System of Ideology
  11. Beliefs about the organization that integrate personal and institutional goals
  12. Involves a sense of mission and shared goals, traditions, identification, socialization, and loyalty
  13. System of Expertise
  14. Relies on professionals for the complex work required in the organization
  15. Relies on less bureaucratic form of organization
  16. System of Politics
  17. Employees have delegated power that gives them discretion to make decisions at some level.
  18. Discretion in work makes the use of political power possible

QUESTIONS FOR LECTURE DISCUSSION

  1. In each of the following agencies, identify which groups may exert power? How would it manifest?
  • Acute care hospital
  • Long-term care facility
  • Home care

  • ER
  • Operating room
  • Medical-surgical nursing unit

SUGGESTIONS FOR LECTURE ACTIVITIES

  1. A hospital has announced that 20 full-time nursing positions will be cut for the upcoming fiscal year. Discuss the implications of the following, using a negative and positive perspective and how the situation may be managed:
  • Personal attributes
  • Personal behaviour
  • Personal actions
  • Formal position
  • Control over resources
  • Control of decision processes
  • Control over access to knowledge and information
  • Ability to cope with uncertainty
  • Being central in communication networks

LEARNING OBJECTIVE 6

Discuss how politics plays out in organizations and the strategies and games that can be used in health care organizations.

CONCEPTS FOR LECTURE

  1. Political strategies
  1. Ways in which people develop and use power to their advantage to influence a decision and/or achieve goals
  2. Actors in political process consider their own sources of power and that of others to develop strategies
  3. Push strategies—threaten or force others to change behaviour through assertiveness, sanctions, or blocking through non-cooperation
  4. Pull strategies—positive motivation to influence behaviour through recognition, benefits, or the satisfaction of needs and goals
  5. Persuasion strategies—appeal to logical reasoning or convincing others about behaviour in relation to goals
  6. Preventive strategies—designed to prevent an issue from arising and may involve focusing attention elsewhere, avoiding a topic, or leaving it off an agenda
  7. Preparatory strategies—aimed at preparing the ground or creating the conditions favourable to other strategies and range from the way in which someone dresses to create an impression, to ordering the agenda in a favourable way, to simply pouring on the charm
  1. Political games
  1. Patterns of behaviours engaged in by political actors who attempt to achieve their own ends, rather than the overall good of the whole organization
  2. “Game” is used because the pattern reflects a set of rules that may or may not be explicit
  3. Involves positions and moves by the players who set out with similar bases of power as they seek to “win”
  4. Example: Budget—when annual budget is developed, key actors, usually managers, present their budgets, make their cases, and bargain with others in an effort to get what they want to achieve their goals.

QUESTIONS FOR LECTURE DISCUSSION

  1. Give an example of each of the following strategies
  1. Push strategies
  2. Pull strategies
  3. Persuasion strategies
  4. Preventive strategies
  5. Preparatory strategies

SUGGESTIONS FOR LECTURE ACTIVITIES

  1. Use a video clip from the legislative assembly to demonstrate the political debate regarding health care issues.

LEARNING OBJECTIVE 7

Identify the types of situations in health care organizations that give rise to use of power and politics.

CONCEPTS FOR LECTURE

  1. It is likely that you will engage in the exercise of power and politics. Certain conditions and events are more apt to give rise to political behaviour.
  2. Some situations in health care organizations might be:
  1. Strategic planning processes
  2. Budgeting processes (capital and equipment)
  3. Periods of constrained resources in health care “downsizing”
  4. Leadership change

  1. Implementation of a change in work, reorganization, re-engineering
  2. Any process involving allocation of resources, such as space and equipment

QUESTIONS FOR LECTURE DISCUSSION

  1. Discuss how nurses are involved in the power and politics in healthcare organizations.
  2. What can nurses do to ensure their interests are recognized and voices are heard?

SUGGESTIONS FOR LECTURE ACTIVITIES

  1. Have both the local nursing union president/representative and a hospital HR person discuss politics and/or power in the workplace.

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