Ph.D. Candidate: Olalekan Agunbiade
Project funding source: Self-funded
Primary supervisor: Professor Martin McNamara
Co-supervisor: Dr. Wayne Thompson
Given the emphasis on adopting a collaborative, multidisciplinary approach to clinical practice in healthcare (Rogers et al., 2020; Anjara et al., 2021), it is timely and important to analyse power relationships and dynamics in health systems and how nurses among other healthcare professionals make sense of and experience them. The term power relates to perceptions and meanings that are determined by values, beliefs, culture, individuals’ experiences and especially the context in which the term is used (Seenandan-Sookdeo, 2012). Health systems globally often operate within a hierarchical model in which power is exerted by those at the top of the pile - superordinates, on the individuals and professionals at the base - subordinates (Griscti et al., 2017; Rogers et al., 2020; Morrow, Gustavson and Jones, 2016). While structures and hierarchies come with organisational benefits, the model, among other concerns, has been described as fostering oppression (Maner and Mead, 2010; Morrow et al., 2016).
This study is concerned with describing and analysing how and under what conditions existing power relations in nurses’ practice contexts enable or constrain their capacity to practice to the full extent of their education, training, and experience (Cohen Konrad et al., 2019). Using the interpretive phenomenological approach and the Oshry’s Organic Systems Framework Oshry (2019), the study will explore strategies for strengthening enabling conditions and for addressing disabling conditions so that nurses can better realise their potential to contribute to collaborative care and treatment to improve patient and health system outcomes (McNamara and Teeling, 2021). A conceptual and empirical inquiry into how nurses in Irish acute hospitals think about and experience power in health systems will make power relations and dynamics explicit; enable exploration of their impact on nursing practice, and help to identify strategies to enable nurses to optimise their contribution to health systems.
Project Outputs (to date):
Anjara, S. et al. (2021) 'Teamworking in Healthcare during the COVID-19 Pandemic: A Mixed-Method Study', International Journal of Environmental Research and Public Health, 18(19), pp. 10371.
Cohen Konrad, S. et al. (2019) 'Theories of power in interprofessional research – developing the field', Journal of Interprofessional Care, 33(5), pp. 401-405.
Griscti, O. et al. (2017) 'Power and resistance within the hospital's hierarchical system: the experiences of chronically ill patients', Journal of Clinical Nursing, 26(1-2), pp. 238-247.
Maner, J. K. and Mead, N. L. (2010) 'The essential tension between leadership and power: when leaders sacrifice group goals for the sake of self-interest', Journal of personality and social psychology, 99(3), pp. 482.
McNamara, M. and Teeling, S. P. (2021) 'Introducing health care professionals to systems thinking through an integrated curriculum for leading in health systems', Journal of Nursing Management, 29(8), pp. 2325-2328.
Morrow, K. J., Gustavson, A. M. and Jones, J. (2016) 'Speaking up behaviours (safety voices) of healthcare workers: A metasynthesis of qualitative research studies', International Journal of Nursing Studies, 64, pp. 42-51.
Oshry, B. (2019) The organic systems framework : a new paradigm for understanding and intervening in organizational life. Axminster, England: Triarchy Press.
Rogers, L. et al. (2020) 'The micropolitics of implementation; a qualitative study exploring the impact of power, authority, and influence when implementing change in healthcare teams', BMC Health Services Research, 20(1), pp. 1059.
Seenandan-Sookdeo, K.-A. I. (2012) 'The Influence of Power in the Canadian Healthcare System', Clinical Nurse Specialist, 26(2), pp. 107-112.