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Vol. 23, No. 10, OCTOBER 2006

Powered by Insight: Power and Influence: Missed Opportunities

By Mary Fran Tracy, RN, PhD, CCNS, CCRN, FAAN

Power and Influence. We often associate these commanding words with business and politics, rarely with our practice as nurses. Bernice Buresh and Suzanne Gordon have been instrumental in raising the clarion call for nursing. In their compelling book, From Silence to Voice, just reissued in a new edition, they show us how to use our voices boldly to raise awareness about critical issues and to bring about essential change. This call resonates with many of us. Yet we struggle when we try to use our power and influence effectively at work or in other professional activities.

How do they differ?
Power and influence are familiar forces to Eleanor Sullivan as a former nursing school dean and writer of mystery books that feature a critical care nurse sleuth. Sullivan pinpoints the difference between power and influence in her very practical book, Becoming Influential: A Guide for Nurses.
Power is the ability to influence. Influence is actually using that power. Individual nurses and the profession at large have immense power. But we don’t often recognize it or use it to influence and that makes me wonder about my own influencing. To gain insight, I applied my two familiar filter questions: What am I doing well? What could I do better? In this instance, I asked myself: Where do I have power? Do I use it to influence? Am I effective?

Personal Insights
After mulling over these questions, I have become aware that my power comes from many sources. Access to information. Expertise. Credibility. Connections with influential people. Reputation. And formal position which may, in fact, be the least common source, as I think of the nursing assistant or unit coordinator who effortlessly mobilizes an arthritic bureaucracy because he or she has access to information, connections and credibility. I also now recognize that when I fail to identify my personal power or do not use it to influence others, I have, at the very least, missed a valuable opportunity. At worst, I am being unethical.

“When you fail to use the power you have by virtue of your position, your expertise, or your access to information, you miss opportunities for yourself, your patients and your profession.”
—Eleanor Sullivan

We often find it easier to exert influence when something affects patient care; less so when it benefits the nursing profession or us as individuals. Think of a nurse who possesses key perspectives and information yet chooses to remain silent during group dialogue, perhaps during a discussion about new nurse orientation or a talk on how to raise awareness about specialty certification. Could you be that nurse? Influencing on behalf of ourselves and our profession—using our voice to advocate for improvements such as radical changes in our work systems—directly benefits our patients by facilitating our work and removing obstacles.

Why do we hesitate to use our power and influence? Using influence means taking risks. This requires being confident about the value of our knowledge and perspective. It means becoming visible and engaged, perhaps leaving our comfort zone. And with endless daily change already depleting our energy, the commitment to using our power and influence can seem overwhelming because it means being open to success and failure equally as we explore solutions to difficult problems.

A Skill to Develop
Being influential is a skill that must be learned and developed. Scan your environment. How do successful influencers do so? What blocks those who are ineffective? For example, look at how nurses interact with physicians. Do they actively engage as peers by offering valuable perspectives and information during interdisciplinary rounds and patient care conferences? Or do they wait to be invited or simply choose to avoid interaction?

Engage successful influencers as your coaches. Watch them in action. Inquire extensively about how they influence. Listen intently to the answers. Stick your toe in the water with their support.

Learning Beyond Our Sphere
One more suggestion I’d like you to consider. Optimizing our influence depends on building trusting relationships within and beyond our familiar spheres. This requires knowing more than our own familiar sphere so that our use of power and influence is appropriately matched to a situation. So explore an area outside your sphere that you know little or nothing about. For example, find out more about medical education. How are today’s physicians educated? How different is it from nursing? Are there similarities that can enhance your influencing ability?

Let me know where these insights take you. Share your examples of influence with me. Or tell me about missed opportunities where you wish you had used your influence to make a difference. Write to me at insights@aacn.org.

What Do You See?

See something a new way and you’ll never see it the old way again. Each of my columns this year will feature a different graphic so we can share a different dimension of seeking insights.—MFT

Starting from the left, you can read A B C. Starting from the top you can read 12, 13 and 14. So the meaning of the middle character depends on where you start reading.
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