New Zealand Mental Health Nurses' Perceptions of Structural and Psychological Empowerment

Abstract

Purpose Tue pmpose of this quantitative study was to investigate structmal and psychological empowerment among registered nurses providing direct care in New Zealand mental health and addiction services. Background Nurses' perceptions of sti-uctural and psychological empowerment have been extensively investigated, led mainly by Laschinger who bas expanded on Kanter's structural empowerment theory. Nurses can be empowered to practise professionally if they have access to structural empowerment factors, that is; opportunity, support, information, resources, infonnal power and formal power in their work environment. Nmses can also feel psychologically empowered by their work environments in that they may feel a sense of meaning, scJf-determination, impact and competence about the work they do. Methods A non-experimental descriptive correlational survey design was used to examine the levels of structural and psychological empowerment and relationships between these two variables. A convenience sample of 306 registered nurses who were members of the Public Service Association, New Zealand Nurses Organisation or Te Ao Maramatanga New Zealand College of Mental Health Nurses Inc. participated. Nurses who held formal management positions were excluded. A web-based anonymous questionnaire which included the Conditions of Work Effectiveness Questionnaire II, Psychological Empowe1ment Scale and a demographic questiomiaire was used to collect data. Data were analysed using the IBM Statistical Package for the Social Sciences version 21 programme. Data were also analysed using descriptive statistics and Spearman rank-order correlation methods. Results Three hundred and eighty nine nurses responded to the online survey. However, only 306 smveys were usable. More than half were female and in the 45-59 age group. Most identified as New Zealand European/Pakeha and most were community-based nurses. Similar to other studies, nurses in this study perceived they had only moderate levels of structural and psychological empowerment. Overall nurses felt they had most access to opportunities to learn and grow and least access to the resources needed to do their job. Furthermore, nurses in this study felt most strongly that they had a personal connection to their work; that is, a sense of meaning, and least strongly that they made an impact in their work environment. A significant relationship between structural and psychological empowerment was also found (r = .366, p < .000). Overall structural empowerment was most strongly related to sclfdetermination (the feeling of having control over yotrr work). Overall, psychological empowerment was most strongly related to informal power (alliances with others). Conclusion 1he moderate level of workplace empowerment suggests that improvements in mental health and addiction nursing work environments are needed to better support optimal nursing practice, and to attract and retain nurses. The main areas \.Vhcrc improvements are needed are the provision of support and resources by managers and the development of organisational processes that increase mrrses' self-determination and identify the impact that nursing work has on organisational outcomes. The relationship between structural and psychological empowerment amongst registered nurses practising in New Zealand mental health and addiction services gives fmther support for Laschinger's theory by finding a similar relationship in a previously unstudied group. Main implication Managers and leaders of nurses must make every effort to enhance workplace empowerment for nurses in order to fully optimise the significant contribution nurses working at the point of care make to achieving organisational goals, and in order to attract and retain a sufficient supply of nurses to deliver services.