1. Understand what empowerment is. And isn’t.

Picture this. A newly expanded cardiology unit seeks to empower its nurses to implement a new staffing model. The unit manager gathers the nurses together and says:

“We have to create a staffing model. We need to have 3 nurses on at 3:00; 5 nurses at 10:00; and 2 nurses at 1:00. Figure it out.”

But what if that conversation went a little differently:

“Here’s our challenge. We have x number of nurses and y number of patients. And we have z number of hours to work with. How would you handle this?”

Quite a difference, huh? The first approach is exactly what empowerment is not. Empowerment is not executing someone else’s plan. It’s about staff members developing and implementing their own plan.

2. Assess the readiness of your staff

How ready is your staff to take on more accountability and be actively engaged in your facility’s culture? This question hints at a bigger question: Is structural empowerment a push or a pull strategy at your facility?

If your staff is actively pulling for empowerment, lucky you! This represents an opportunity to recognize their dedication and to start on the journey together.

A push strategy, on the other hand, looks and feels much different. If you have to push the idea of empowerment, the journey becomes more challenging. In this scenario, it’s critical to communicate with your staff.

3. Prepare to encounter resistance

When it comes to change it’s not uncommon to meet resistance.

“Why are we changing things?”
“This is going to take more time out of my day.”
“Am I going to be held responsible for this?”
“I’m not getting paid for this.”

Empowerment can be scary, especially in healthcare where people’s lives are at stake. Communication is key. Be sure to reinforce what the goal of empowerment is and how this new structure will benefit staff and patients alike.

4. Invest in infrastructure and training

Where do you begin if you’re going from a traditional manager-employee model to one of structural empowerment? Begin by putting an infrastructure in place. One that can be adapted at many different levels. It may be a formal program such as Magnet accreditation or a council that is charged with establishing and enforcing best practice standards.

Asked to construct a hypothetical multidisciplinary CV council, Garavet responded with this “council dream team”:

• Cath lab nurses
• Cath lab radiology technicians
• Medical assistants from pre- and post-op and inpatient
• LPNs from pre- and post-op and inpatient
• Pharmacists
• Inpatient unit nurses, both cardiac ICU and cardiac "step down"
• Someone to gather and analyze data
• Management liaison or coach, whose role is to remove barriers (such as funding or development of policies and procedures) 

5. Start small. Assess. Then move up.

In the beginning, have your staff take on projects that are well defined, have a clear start and finish, include defined measures of success, and are not too challenging politically. A long-term goal may be 360-degree evaluations, where staff members have the opportunity to receive feedback from their teammates.

With each level of engagement, measure its success before proceeding to the next level. How did it go? What did you learn? How did your staff feel about the challenge?

Once your staff has mastered fundamental levels of empowerment, it’s time to introduce more challenging projects. “It’s one thing,” says Garavet, “for staff members to reach a consensus about clinical practice issues. It’s another to agree on interactions involving direct coworkers.”

6. Finally…don’t put empowerment on auto-pilot

If you want empowerment to fail, tell your staff: “OK, you’re empowered now. Call me if you need anything.” Leaders need to offer ongoing support. Remember: empowerment is a shared journey. Don’t abandon your staff simply because they have effectively taken on more responsibility.

In summary, there are many advantages to implementing a structured empowerment program. But doing it right takes commitment from both staff and leadership. It takes deliberate training, clarity of purpose, and lots of communication. But the payoff—moving decision-making from the conference room to the patient’s bedside—is invaluable.

Transforming Care at the Bedside: A Model to Promote Staff Nurse Empowerment and Engagement

By Elizabeth Potratz

White paper from SOPHIA

This white paper reviews literature on empowering and engaging staff in the changing healthcare environment.

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Article from Becker's Hospital Review

This short but enlightening article shares 8 principles to encourage hospital employees to invest in their own development.

6 Myths About Empowering Employees

By David Marquet

Article from Harvard Business Review

This Harvard Business Review article is a perfect way to show how NOT to go about achieving employee engagement.