Power Dynamics

Table of Contents

Power Dynamics

The purpose of this application is to provide the opportunity to critically appraise a selected power dynamic (demonstrating the application of legitimate or illegitimate power) affecting a potential health policy outcome. DOES NOT MATTER WHICH HEALTH POLICY IS CHOSEN…..


Introduction Introduces the purpose of the paper and addresses all background information elements of the power dynamic and its practice situation.
Description of the Power Dynamic Individually addresses potential impacts of legitimate and illegitimate power from the perspectives of sociopolitical factors, stakeholders, and interested parties on the power dynamic.

Use examples from the practice situation to support your assertions.
Reflection on the Power Dynamic, Individually critiques driving forces and restraining factors that impact the power of nursing to advocate for change at macro, meso, and microsystem levels of healthcare. Summarize your critique using examples from the practice situation to support your assertions.
Conclusion An effective conclusion identifies the main ideas and major conclusions from the body of your manuscript.

Minor details are left out. Summarize the benefits of the selected power analysis to advanced practice nursing.
Clarity of writing Use of standard English grammar and sentence structure. No spelling errors or typographical errors. Organized around the required components using appropriate headers.
APA format All information taken from another source, even if summarized, must be appropriately cited in the manuscript and listed in the references using APA (6th ed.) format.
1. Document setup;
2. Title and reference pages; and
3. Citations in the text and references.

(20 points) Excellent introduction of selected power dynamic. Rationale is well-presented and purpose fully developed.
17–20 points Basic understanding and/or limited use of original explanation and/or inappropriate emphasis on an area.

13–16 points Little or very general introduction of power dynamic. Little to no original explanation;
Description of the Power Dynamic
(50 points) Excellent discussion of selected power dynamic. Discussion of required subtopics supported with examples.
42-50 points Basic discussion of selected power dynamic. Discussion of required subtopics not supported with examples.
36-41 points Little or very general discussion of selected power dynamic. Little or no application to practice situation or subtopics not supported with examples.
0–37 points

Reflection on the Power Dynamic
(50 points) Excellent discussion of all required subtopics. Reflection on power dynamic is supported with practice situation examples.
42-50 points Basic discussion of all required subtopics and/or reflection on power dynamic not supported with practice situation examples.
36-41 points Little or very general discussion of all required subtopics, or missing one or more of required subtopics. Little or no reflection on power dynamic and/or practice situation examples.
0–37 points

(10 points) Excellent understanding of power dynamic. Conclusions are well-evidenced and fully developed.
7-10 points Basic understanding and/or limited use of original explanation and/or inappropriate emphasis on an area.
4-6 points Little understanding of power dynamic. Little to no original explanation; inappropriate emphasis on an area.
0–3 points

Clarity of writing
(20 points) Excellent use of standard English showing original thought. No spelling or grammar errors. Well-organized with proper flow of meaning.
17-20 points Some evidence of own expression and competent use of language. No more than three spelling or grammar errors. Well-organized thoughts and concepts.
13-16 points Language needs development. Four or more spelling and/or grammar errors. Poorly organized thoughts and concepts.
0–12 points
APA format
(25 points) APA format correct with no more than one to two minor errors.
22–25 points Three to five errors in APA format and/or one to two citations are missing.
18-20 points APA formatting contains multiple errors and/or several citations are missing.
0–19 points


Power Dynamics

Power dynamics in the case of healthcare is power distribution as used in the health sector (Lunenburg, 2012). Healthcare policies have been long influenced by the changes in power as these have been among the top and influential topics during most of the crucial debates such as the United States presidential debate. One of the health policies that are controversial currently is the insurance policy as thousands of Americans are not insured.

The effects of the American’s lack of insurance is felt daily beyond the fact of just being uninsured. The problem is felt in emergency rooms, when health insurance premiums rise, when health departments are overtaxed and the community resources continue to diminish such that the healthcare services become hard to administer. This paper explores the changing role of power dynamics as the health policies continues to affect the life of Americans as the medical practice advances in America.

People are permitted to use other health insurance services that cover for other issues that are not accounted for in the normal health insurance, thus resulting in a total health cover insurance. In essence, a person holding private insurance may still have the payments that are not catered for by insurance, since most of the services offered in the private departments are all the same expensive and may go beyond the scope of the insurance.

The American health system has evolved over the years and so has the health insurance system. The insurance system of USA relies mostly on private insurance and about 61% of them have insurance according to CDPC (Short, Graefe & Schoen, 2003). Private insurance came to a bill of 12.2 million in 2011. At the same time, public programs such as Medicare provide a bulk of the insurance for low-income families and senior citizens in America today.

Some states, however, have programs for low-income families and individuals (Lillie-Blanton & Hoffman, 2005). The problem in the insurance sector therefore presents itself in this aspect, and therefore, needs advocacy for the necessary improvements to happen as should be. The healthcare staff, together with influential individuals play a crucial part in improving healthcare and ensuring that the concerned families get the right care through the use of their power and advocacy skills.

This is where health advocacy come in too, they are important as they play an integral part in ensuring that the citizens are given appropriate care and advocate for fair rates. The American public is therefore made aware of the issue at hand and how it can be improved through various interventions by the health policy experts. It is important to understand the role of medical advocacy in the healthcare of individuals beyond just emergencies and into actual treatment and normal running of the life of an individual as it directly affects them.

Impacts of legitimate and illegitimate power from various stakeholders on the issue at hand


Nurses have the power and are in a position to asume leadership and advocacy role at the grassroot level. Nurses can take care of daily medical issues, turning them from a problem into policy issues that need to be addressed at a national level.

As they are providers of clinical care and play the role of advocating for specific policies. Acting in the role of policy advocates as nurses can help bring effective changes to policy matters which can offer rewarding benefits to the healthcare systems as it is.

Nurses can be political advocates especially in the matter of health insurance as this is an issue that widely affects Americans. Pioneer nurses such as Lilian Ward and Florence Nightingale used their power as nurses to develop policies which stand central to today’s health system. Their methgods and tactics have shown today’s nurses how they can use their influence to move a policy through the political system.

Despite living in a male dominated world, the nurses perservered and were able to revolutionize a system. Through their role in political advocacy exemplifies how nurses can educate the public and change policies. Nightingale advocated for sanitation to reduce infection while Lilian Ward,was able to advocate for a school for the nurses. Through the advocacy of such pioneers, nurses are able to bring their expert power to the filed of nursing and help in the treatment of patients in the hospital organization.


Doctors in the healthcare syatem also have their expert and legitimate power through their physiscian associations.  Through the healthcare associations, doctors have been able to help in broadening the population that has been insured through their role in major health policy changes in both the private and public health care center.

The doctors have also influenced the expansion of the healthcare providers that consumers can choose from and have been able to improve the healthcare quality and give more healthcare to patients.

Power, Policy and Politics

Politics by definition is the processs through which groups make decisions that can influence events. While the word politics can have a negative connotation when mentioned, it is through politics that policies such as the public health can be made better through advocacy (Patel & Rushefsky, 2014).

President Bush was able to use his legitimate power as President of the United States to sign into law the Medicare Prescription, Improvement and Modernization Act which was beneficial for the elderly and disabled among the Americans (Baicker & Chandra, 2004). Through the influence of power and politics, this act heralded a new beginning in healthcare reforms.

In 2008, healthcare was a crucial part of the presidential debate, with both candidates offering their positions on matters of healthcare. Mc Cain as one of the presidential candidates focused on tax credits. The plan was $2500 per individual and $5000 families that did not have health care access through their employers. For those who were not covered by insurance, he proposed collaboration with the states to create the Guarateed Access Plan.

His Opponent Obama proposed universal health care which aied from for the creation of National Health Insurance exchange that would cover both Medicare and private insurance. This plan meant that coverage was guaranteed despite of the health status of the person and premiums would not vary on the health status. Parents could take insurance for their children although adults were not required to buy insurance.

Restraining factors that impact the power of nursing to advocate for change at macro, micro and meso systems of healthcare.

The Macro level of healthcare is where the program exists conceptually. The visionaries are the ones who are working on the policy and funding the scheme that is directly related to addressing the second-generation gap in the face of bigger national infrastructure (Kulikowsky, 2002).

Nurses at this stage of healthcare are not in direct contact with the policy makers and are therefore not central in the decision-making process. This is critical for the nurses as they may not be able to understand key concepts in the decision-making process.

The meso level is where the policy begins to take shape as part of the larger program. The policy then becomes a high-level concept and is negotiated into a program with specific deliverables and a specific scope. This is however not smooth as this is the stage where most misunderstanding occurs.

This is the transformative stage of the policy and therefore, it means that there is a great potential for misinterpretation of the aims and objectives of a project. This can be dangerous as misunderstandings can have grave effects.

Even among nurses, there have been disagreements over the validity of patient advocacy. Most of the disagreements arise especially in the process of implementation as nurses cannot agree on how the advocacy should be implemented.  Nurses believe that advocating for patients is important for professional practice but they say that they would not be in the best position to act in the best interest of the patient always.

Nurses therefore do not agree to the role of advocacy being professionalized. If they had the right to advocate on behalf of the patient, then inter-personal conflicts may intensify among them and cause strife among the nurses. Nurses are better as careers while doctors are meant to make the final decisions and in that way, carry the main role of advocacy. Despite the slight disagreements among nurses, they agree that patients sometimes need an advocate and as the caretakers, they might be in the best position to advocate on their behalf.

Nurses are also viewed as not being able to be in an advocacy position because they have to work by internalizing the views of dominant powers such as the employing institution and sometimes the doctors and thus cannot be the advocates for patients in the nursing scenario.

Furthermore, the nurses’ role in advocacy cannot be professionalized because the nurses’ education is insufficient in preparing them for an advocacy role and therefore, they do not have the impartiality to acting as patient advocates. Furthermore, different needs by different patients may cause ethical conflicts for the nurses. The nursing profession can therefore be advocates for patients on a non-professional level only as appropriate.


This paper focuses on the use of power and the role of politics in changing the legislature to suit the needs of the healthcare system. Through the continuous advocacy of nurses, doctors and even politicians, the American health system has evolved into the current healthcare system. The paper discusses the role of pioneer nurses such as Florence Nightingale and Lilian Ward and the role of doctors and their professional associations.

The paper also addresses the use of legitimate and illegitimate power in the quest to help the healthcare system get better for both the patients and the nursing profession. It goes deeper into some of the aspects of the nursing and advocacy that may pause challenges. In this area, we find out that the role of advocacy should not be left entirely to the nursing profession but is better suited for the doctors as the nurses are the primary care givers.



Baicker, K., & Chandra, A. (2004). Medicare spending, the physician workforce, and beneficiaries’ quality of care. HEALTH AFFAIRS-MILLWOOD VA THEN BETHESDA MA-, 23(3), 291-291.

Kulikowski, C. A. (2002). The micro-macro spectrum of medical informatics challenges: from molecular medicine to transforming health care in a globalizing society. Methods of information in medicine, 41(1), 20-24.

Lillie-Blanton, M., & Hoffman, C. (2005). The role of health insurance coverage in reducing racial/ethnic disparities in health care. Health Affairs, 24(2), 398-408.

Lunenburg, F. C. (2012). Power and leadership: an influence process. International journal of management, business, and administration, 15(1), 1-9.

Patel, K., & Rushefsky, M. E. (2014). Healthcare Politics and Policy in America. Public Integrity, 17(1), 94-96.

Short, P. F., Graefe, D. R., & Schoen, C. (2003). Chrun, Churn, Churn: How Instability of Health Insurance Shapes America’s Uninsured Problem. New York: Commonwealth Fund.


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