Do nurses exercise power in rehabilitation wards?
OBJECTIVE
Nowadays, there is a change in nursing policy. The nurse-centred model is shifting to the patient-centred model. Decision-making is therefore transferred to the customer (Power to the Patient). Data from literature mainly deals with acute care and long-term care facilities. The aim of the study was to evaluate whether: i) a nurse-centred model is still effective in rehabilitation wards; ii) patients' dignity is nevertheless considered; iii) nurses experience role satisfaction in a rehabilitation setting.


METHODS
A cross-sectional design was applied. Forty-eight nurses of our rehabilitation centre were invited to compile -in an anonymous way- a questionnaire developed by Finnish researchers from both acute care and geriatric units. More questions dealt with personal data.


RESULTS
The sum of variables describing the nurses' exercise of power showed that power was most commonly exercised in obligatory daily activities. Power was less in activities necessitated by obligatory daily activities and in voluntary activities. Nurses' power was due to the necessity of organising the individual rehabilitation programs, which are tailored for each patient and require the observance of time-schedules. Nevertheless, patients had a say in many choices and their dignity was maintained. The nurses also answered that work in rehabilitation wards was more stressful than in both medical or surgical acute care. A third of them felt themselves not involved in the rehabilitation of the patients.


CONCLUSIONS
The exercise of power is not a negative phenomenon in situations requiring safety, control, quick decisions, coping with time-contingencies, as it daily happens in rehabilitation wards. However, subject's dignity is compatible with that exercise of power. Rehabilitation staff should be aware of the nurse role, which can be only partially perceived. Better communication between nurses and other components of the rehabilitative staff would improve self-esteem and hasten motivation. Apparently, when the association between the ''experience'' variable and the sum variable was considered, it was found that the group of low clinical experience believed that power was exercised more often.
Giaquinto
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IRCCS San Raffaele Pisana Rehabilitation Center, Rome, Italy. salvatore.giaquinto@sanraffaele.it
D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D003657:Decision Making; D005260:Female; D006801:Humans; D007400:Interprofessional Relations; D007558:Italy; D008297:Male; D008875:Middle Aged; D024802:Nurse's Role; D009726:Nurses; D028701:Patient Rights; D011209:Power, Psychological; D012047:Rehabilitation Centers / Q000458:organization & administration*; D011795:Surveys and Questionnaires