KANTER’S THEORY OF STRUCTURAL EMPOWERMENT
Empowerment of nurses in various forms equips them to perform their responsibilities in a manner that positively affects their service delivery to patients. In this study, Kanter’s Theory of Structural Empowerment will be used to focus on the empowerment of registered nurses. The Theory of Structural Empowerment was developed by Rosabeth Moss Kanter. She believes that access to empowerment structures is enhanced by specific job characteristics and interpersonal relationships that foster effective communication (Laschinger et al 2009:229). Managers in charge of clinical practices should ensure that the following job characteristics are available to facilitate the empowerment of employees in the workplace. The job characteristics include autonomy, required interaction, optional interactions, knowledge and required skills. In clinical practice, an employee who has a high need for autonomy would perceive involvement in decision-making differently than an employee who has a low need for autonomy (Ivancevich et al 2008:160) .Kanter’s Theory of Structural Empowerment emphasises the importance of giving power to employees in order for them to accomplish their tasks (Lucas et al 2008:965). Power is viewed as having the ability to create, get, and use resources to achieve one’s goals (Kelly 2008:689). Power is necessary in order to be able to influence an individual or group. Nurses need power to influence patients, physicians, and other health care professionals, as well as each other. Powerless nurses are ineffective and less satisfied with their jobs (Manojilovich 2007:2).According to Lucas et al (2008:965), Kanter’s Theory of Structural Empowerment is divided into three components. Component one is concerned with structural empowerment, which includes the dimensions of opportunity, information, support, resources, formal power and informal power. Component two is concerned with psychological empowerment, which includes meaning, confidence, autonomy and impact as sub-components. Component three is concerned with positive work behaviours and attitudes and includes job satisfaction, commitment, low stress and low burnout as dimensions.Manojlovich (2007:3) states that empowerment arises from social structures in the workplace, which enable employees to be satisfied and more effective on the job. Organisations need to have empowerment strategies in place before employees can feel empowered. These empowerment strategies include participative management, job enrichment, meaningful organisational goals, less bureaucracy, and involving staff in decision-making (Manojlovich 2007:6). Managers in charge of wards/units can facilitate empowerment of nurses by delegating assignments to provide learning opportunities for less experienced staff, for example delegating a registered nurse to assist a doctor during the doctor’s ward rounds based on the scope of practice of the nurse (Marquis & Huston 2012:288).
The study deals with empowerment of registered nurses in the workplace. Kanter’s Theory of Structural Empowerment contains 14 dimensions under the three key components as illustrated in Table 2.1; it does not include a dimension on‘empowerment’ as such. Kanter’s Theory deals with empowerment, but this concept is not included as one of the dimensions of this theory. It must however be reviewed in the literature and be tested by means of the data collection instrument. Attention will be given to empowerment in the literature review after the discussion of Kanter’s Theory has been concluded, and it is included in the questionnaire under section B.
Generally, an organisation needs to have empowering structures in place to facilitate achievement of its organisational goals. Without these structures, it might not be possible for the organisation to meet the needs of its customers. This section includes the discussion of each aspect of Kanter’s Theory of Structural Empowerment. Williamson (2007:133) conducted a study on nurses’ perceptions of empowerment, the study suggests that empowerment is linked to autonomy, job satisfaction, retention, power, professional growth and development. This study further indicates that nurse managers have the responsibility of structuring work environments, so that they promote the empowerment of nurses. For example, in the wards/units the nurse manager can practise shared governance by involving registered nurses in participative decision-making, especially when taking decisions that are related to patient care (Williamson 2007:142).In this section, structural empowerment will be discussed based on the following subtopics/dimensions: opportunity, information, support, resources, formal and informal power.
According to the Longman Dictionary of Contemporary English for Advanced Learners (2009:1226), opportunity refers to a chance to do something, or it could be an occasion when it is easy for a particular person to do something. Quick and Nelson (2013:4) indicate that opportunity refers to favourable times or chances for progress or advancement in an organisation. According to Quick and Nelson (2013:367), opportunity also means participating in decision-making in the form of choice, for example, allowing employees to make off duty requests to their supervisors which offers employees the opportunity to have a voice in the compilation of ward/unit off duties. Orgmbidez-Ramos and Borrego-Ales (2014:30) view opportunity as referring to the possibility for growth and movement within the organisation as well as the opportunity to increase knowledge and skills. Organisations need to be sensitive and responsive to changes, for example, managers need to create opportunities for nurses in order to train them on how to use the new technology by providing training for basic computer skills and on how to access the internet to improve quality patient care. Managers can facilitate the empowerment of nurses by letting those closest to the situation make decisions regarding the area of their responsibilities and create opportunities for employees to perform their duties (Marriner-Tomey 2009:125). An opportunity to perform refers to the absence of obstacles that constrain the employee (Robbins et al 2010:180). Managers can enhance the opportunity to perform by coaching subordinates in clinical practice by the clarification of goals and by providing guidance during the provision of patient care when an employee is uncertain about how to carry out a certain nursing procedure (Roussel 2013:666), for example checking a patient’s blood pressure, thus removing obstacles to satisfactory performance.Nurse managers should create opportunities for employees to learn new skills and perform challenging tasks (Ivancevich et al 2014:114). An opportunity represents a situation in which there are possibilities to do things that lead to results that exceed goals and expectations of delegated responsibilities (Kinicki & Fugate 2012:253). Employees lacking opportunities feel stuck in their jobs, and have low job expectations and organisational commitment (Lucas et al 2008:965).Other opportunities that managers could make available to their employees are access to challenges, rewards, and professional development such as allowing nurses to attend job-related seminars and workshops. Ning, Zhong, Libo and Qiujie (2009:2643) suggest that ways to increase their clinical practice knowledge and skills are through participation on committees, task forces and interdepartmental work groups that give them an opportunity to work with people in other areas of the organisation. The opportunity to perform is enabled by a working climate which provides the necessary support so that employees can achieve their full potential. This support should pertain to both the formal and informal structures of the organisation and include factors such as the quality of resources and the availability of channels for influencing management decisions (Wilton 2011:50). Managers of organisations should ensure that the Skills Development Act no 97 of 1998 is implemented in order to create opportunities for the development of employees. Skills development in the workplace plays a major role in improving the quality of life of workers, it facilitates an active learning environment, and helps in assisting employees with the opportunity to acquire new skills that are necessary for the achievement of the organisation’s goals (South Africa1998:26).Application to Kanter’s Theory Orgmbidez-Ramos and Borrego-Ales (2014:30), view opportunity as referring to the possibility for growth and movement within the organisation as well as the opportunity to increase knowledge and skills. The definition of Orgmbidez-Ramos and Borrego-Ales (2014:30), indicates that managers should create opportunities for empowering employees to develop and grow in the workplace by creating a working climate that supports employees to increase knowledge and skills, and by involving employees in decision-making related to their jobs to allow them to reach their full potential in meeting organisational goals (Wilton 2011:50). The creation of opportunities for employees in the workplace is in line with Kanter’s Theory which indicates that access to opportunities means enabling employees to learn and grow in their jobs and to participate in decisionmaking so that they do not feel stuck in their jobs (Lucas et al 2008:965).
According to the Longman Dictionary of Contemporary English for Advanced Learners (2009:903), information can be facts or details that tell someone something about a situation, person, or event. Lucas et al (2008:965) state that information refers to having informal and formal knowledge that is needed to be productive in the workplace, not only technical knowledge, but also an understanding of the organisation’s processes. Information is power and comes from knowledge. It is a source of power when others need the information (Marriner-Tomey 2009:120). Leaders should not hoard information, but should impart information and help to empower future leaders to learn (Ulrich & Smallwood 2007:191). For example in clinical practice nurse managers are expected to share information such as protocols, policies, their experiences, expertise and job descriptions with employees in order to provide them with information which could enable and enhance performance.A job description is a summary statement of what an employee does on the job (Ivancevich 2014:553). The information in job descriptions should be specific and relevant rather than being vague and should avoid generalisation (Marriner-Tomey 2009:346).According to Marriner-Tomey (2009:228), policies and procedures are means to accomplishing goals and objectives and serve as guides that define the general course and scope of activities that help to accomplish organisational goals. Marriner-Tomey (2009:230) states that information related to policy statements should be communicated to all nurses verbally, by letters, bulletin boards, incident reports, policy manuals and meetings to explain new policies to personnel affected by the policies (Meyer et al 2009:269). Marquis and Huston (2012:425) indicate that information should flow downward, upward, horizontally and diagonally to ensure that all employees receive the required information related to their work.For example, in clinical practice the ward/unit nurse managers give information to employees related to their performance through feedback. Feedback refers to the degree to which carrying out the work activities required by a job results in the individual obtaining direct and clear information about the effectiveness of their performance (Robbins, Judge & Campbell 2010:174). Quick and Nelson (2013:736) state that feedback refers to information exchange, which completes a two-way communication process. Employees do better when they get feedback on how well they are progressing toward their goals because feedback helps to identify discrepancies between what they have achieved and what was expected; feedback therefore guides behaviour (Robbins et al 2010:149). Feedback should be given regularly such as daily or weekly to produce more consistent effects and to facilitate carrying out of delegated duties (Roussel 2013:665). Feedback also determines whether understanding has been achieved or not (Robbins et al 2010:290).Nurse managers need to obtain information from colleagues, subordinates and department heads, and from outside stakeholders in order to make sound job-related decisions (Smit et al 2011:14). Participative decision-making should be practised by nurse managers by involving all the staff affected by a decision, by giving staff the opportunity to voice their opinion or give input on issues related to their jobs, and by treating all staff involved equally in the decision-making process (Meyer et al 2009:240). Members who want to contribute to decision-making need sufficient information in order to make good decisions; even those members who do not want to contribute to decision-making still need to have information about the organisation beyond their tasks, as information may include job-related knowledge and skills that are compulsory and important for their performance (Abraiz, Tabassum, Raja & Jawad 2012:394). Organisations should ensure that nurses have access to the internet so that they can access accurate and up-to-date information which they need to carry out their work, and to ensure that quality care is provided to patients (Kelly 2008:144).Application to Kanter’s Theory The possession of information means knowing the formal and informal happenings in the organisation (Gilbert et al 2010:340). The provision of information to employees is supported by Kanter’s Theory which indicates that access to information enables employees to be productive, to understand organisational processes and to access correct sources that could provide them with relevant information to make appropriate work-related decisions (Lucas et al 2008:965). In clinical practice managers should empower employees by providing employees with the relevant protocols, policies, work procedures and job descriptions as sources of information that employees could utilise to carry out their delegated responsibilities in their nursing units (Meyer et al 2009:268).
Lucas et al (2008:965) define support as receiving feedback and guidance from sponsors, peers and subordinates. Support encourages original thinking, risk-taking behaviour and autonomous decision-making. Wagner et al (2010:449) support the views of Lucas et al (2008:965) but indicate that support is also available in the form of feedback and guidance received from superiors, peers and subordinates. Jooste (2011:407) views support as the degree to which employees believe the organisation values their contribution and cares about their well-being and personal needs for instance when an employee has a child or transport problem (Robbins et al 2010:64). The manager can show support in the nursing unit by listening to the needs of staff, assist in problem-solving and by encouraging reflection and self-awareness (Jooste 2011:407). When managers support employees they promote cooperation by giving timely and specific feedback, acknowledging the employees’ viewpoints and needs and recognising their efforts and accomplishments (Marriner-Tomey 2009:6).Sullivan (2013:258) proposes that managers should ask employees for suggestions, allow employees to use their analytic skills to solve their own work-related problems, and they should also listen openly in order to understand the employees’ perspective. In clinical practice managers are expected to delegate responsibilities to subordinates. The manager should be supportive of delegated tasks by giving a clear description of what it is that an employee is expected to do and describe the overall scope and background of the current task in order to enable the subordinate to carry out the delegated task (Grohar-Murray & Langan 2011:175). Supporting employees also focuses on subordinates’ needs and well-being and on promoting a friendly work climate (Schermerhorn et al 2012:300).Managers can facilitate support in their organisations by developing supportive networks. Support networks provide strength and promote sharing of problems and ways of improving the organisation’s outcomes (Whitehead, Weiss & Tappen 2007:223). Affiliation to groups provides an opportunity for people to network with others both inside and outside their own social groups and allows them to become empowered (Bhengu 2010:10). Generally, in practice, registered nurses can network with other registered nurses by affiliating to professional organisations, such as the Democratic Nursing Organisation of South Africa (DENOSA).This body (DENOSA) informs nurses about conferences and workshops, for example in the Nursing Update of September 2015 a conference scheduled to take place in February 2016 is advertised. During conferences and workshops registered nurses are able to network and share knowledge and skills that are necessary for clinical practice. Supervisors can also support employees by giving hands-on assistance where nurses are faced with challenging health needs of patients. This is an indication that the supervisor is willing to guide and support (Ning et al 2009:2643).Application to Kanter’s Theory According to Lucas et al (2008:965), support refers to receiving feedback and guidance from sponsors, peers and subordinates. Support includes giving a clear description of the work to be carried out by an employee on delegated duties (Grohar-Murray & Langan 2011:175), as well as giving hands-on assistance to employees during the execution of their duties to empower them in the workplace (Ning et al 2009:2643). The giving of support to employees is in line with Kanter’s Theory which postulates that access to support includes receiving feedback and guidance from sponsors, peers and subordinates (Lucas et al 2008:965). Feedback by supervisors enhances the empowerment of employees in the workplace (Faulkner et al 2008:215).
The term ‘resources’ refers to money, property and skills that are available for use when they are needed (Longman Dictionary of Contemporary English for Advanced Learners 2009:1487). Organisations need resources in order to achieve their goals. Managers have the responsibility of bringing resources together and deciding which resources are needed in order to achieve the organisation’s mission and goals; and managers are also responsible for the success and sustainability of their organisations (Smit et al 2011:4). Organisational resources are divided into financial resources (money), physical resources (raw material), equipment and supplies, technology and human resources (Smit et al 2011:4).Apart from management’s responsibility to ensure that adequate and sufficient resources of all kinds are available for organisational functioning, the availability or lack of resources has a definite effect on the ease with which employees or practitioners perform their duties. Seeking to deliver quality patient care without the necessary resources leads to frustration and a sense of helplessness in reaching one’s patient care objectives.
The term ‘finances’, refers to money (Longman Dictionary of Contemporary English for Advanced Learners 2009:643). Managers of institutions need to ensure that they have all the required resources in sufficient quantities in place in order to be able to carry out the plans to achieve their organisation’s goals, but this can only be achieved if they budget for resources and acquire the necessary funding (Smit et al 2011:142). A budget is a detailed financial plan for carrying out the activities of an organisation or unit (Motacki & Burke 2011:169). In clinical practice it is important for nurse managers to involve employees when drawing up the institution’s nursing budget. Nurse managers can obtain suggestions or inputs from subordinates who do the functional work, the doctors involved, as well as from other team members such as the pharmacists and technicians. This will help the nurse manager to be aware of the needs of units and departments (Jooste 2011:392). The major types of budgets that organisations use include an operating budget, a capital expenditure budget and cash budget (Yoder-Wise 2007:230).Operating budget: An operating budget is the financial plan for the day-to-day activities of the organisation. The operating budget consists of a personnel budget and a supply and expense budget for each cost centre. The organisational unit that allows costs to be identified and managed is known as a cost centre (Yoder-Wise 2007:230). This budget applies to and makes provision for developmental opportunities, information technology and all forms of resources which are important components of structural empowerment as the availability of these aspects, or the lack thereof, has a direct influence on the ease with which staff members perform their duties and the satisfaction they may experience in the work environment.Capital expenditure budget: A capital expenditure budget reflects expenses related to the purchase of major capital items such as equipment. Items on this budget should have a useful lifespan of more than one year and must not exceed a cost level specified by the organisation (Yoder-Wise 2007:232). A capital expenditure budget includes land and fixed and movable items (Muller et al 2011:451).
CHAPTER 1 RATIONALE AND OVERVIEW OF THE STUDY
1.2 BACKGROUND TO THE PROBLEM
1.3 PROBLEM STATEMENT
1.4 PURPOSE OF THE STUDY
1.6 THEORETICAL FRAMEWORK
1.7 SIGNIFICANCE OF THE STUDY
1.8 DEFINITIONS OF KEY CONCEPTS
1.9 RESEARCH METHODOLOGY
1.10 ETHICAL PRINCIPLES
1.12 STRUCTURE OF THE THESIS
CHAPTER 2 LITERATURE REVIEW
2.2 THEORETICAL FRAMEWORK
2.3 KANTER’S THEORY OF STRUCTURAL EMPOWERMENT
3.2 PURPOSE OF THE STUDY
3.3 OBJECTIVES OF THE STUDY
3.4 RESEARCH METHOD
3.7 DATA COLLECTION
3.8 PRE-TESTING OF THE INSTRUMENT
3.9 DATA COLLECTION AND MANAGEMENT
3.10 DATA ANALYSIS
3.11 ACQUIRING PERMISSION
3.12 ETHICAL PRINCIPLES
CHAPTER 4 RESEARCH RESULTS
4.2 PURPOSE OF THE STUDY
4.3 RESPONSE RATE
4.4 DATA ANALYSIS
4.5 BIOGRAPHICAL PROFILE
4.6 DIMENSIONS PERTAINING TO KANTER’S THEORY OF STRUCTURA EMPOWERMENT
4.7 DIMENSIONS PERTAINING TO KANTER’S THEORY OF STRUCTURAL EMPOWERMENT
4.8 ORGANISATIONAL STRUCTURE
4.9 ASSESSMENT OF THE DIFFERENCES BETWEEN THE EMPOWERMENT DIMENSIONS
4.10 COMPARING INDIVIDUAL DIMENSIONS BY MEANS OF ANALYSIS Of VARIANCE
CHAPTER 5 SUMMARY, CONCLUSIONS AND DEVELOPMENT OF GUIDELINES
5.3 SUMMARY OF CHAPTERS
5.4 SUMMARY OF EMPIRICAL FINDINGS
5.5 SUMMARY OF EMPIRICAL FINDINGS BASED ON INFERENTIAL STATISTICS
5.6 GENERAL CONCLUSIONS REGARDING THE RESEARCH FINDINGS
5.7 DEVELOPMENT OF EMPOWERMENT GUIDELINES
5.8 VALIDATION OF THE GUIDELINES
5.9 RECOMMENDATION FOR FURTHER RESEARCH
5.10 LIMITATION OF THE STUDY
GET THE COMPLETE PROJECT
GUIDELINES FOR THE EMPOWERMENT OF PROFESSIONAL NURSES IN THE PUBLIC HOSPITALS OF ONE DISTRICT IN THE MPUMALANGA PROVINCE