Ten Ways for Nurses to Build Power at Work

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shutterstock_80614225Nurses don’t talk about power much.  That needs to change.

We talk about want we need or want, our goals, our gripes and problems. We talk about what we do, and how we struggle and suffer getting it done.

What is power, really? Nurses owe it to themselves to pay this topic some attention. The less you know about it, the attention you pay to it, the less power you’ll have. It’s a bad place to put yourself: choosing weakness over strength.

Power is just the ability to get things done, make things happen. No more, no less. If you can flip a switch and light up your bedroom, that’s power. Money is power: it convinces people to give you goods and services you want. If you ask someone for a favor and they grant it, that too is power.

We nurses work with lots of people. We ask them to do things, and ask them to let us do lots of other things to them. We exert power all the time to get the job done, whether we think of it that way or not. We have no other choice. Here’s my central point for today: the more power you have, the easier your work, the less struggle and frustration. Let’s get us more.

How can you enjoy more power? All it takes is a little knowledge, applied.

Let me tell you about Reciprocity.

I wrote about it in general terms last year, in Make work better, easier, FUN! Reciprocity. Here I’ll fill in some details I left out last time around.

For those who missed it, Reciprocity is a powerful, wonderful phenomenon if you know how to make best use of it. It applies everywhere there are people: it’s universal.

Reciprocity is a crucial driver of many human decisions, in fact one of the most powerful and universal social norms in human history. It basically says: “… we should try to repay…. what another person has provided us.” Whenever you offer someone a gift or favor, it triggers a deep, powerful instinct to pay you back in kind, somehow. To reciprocate!

Here’s how to make this powerful instinct work for you at work:

You can’t offer a deal, like “ If you do what I say, I’ll give you ice cream.”

That’s not reciprocity, that’s bribery. Bribes work sometimes in the short run, I suppose, but they generate no reciprocity, no benefit over time. They might even make things WORSE by building expectations for more bribes in the future.

Reciprocity involves an exchange of gifts, not business deals. You freely offer gifts, no strings attached, and it generates a sense of debt automatically, by instinct. Think of it as a bank account, but instead of money, you’re building up good will and coöperation.

Later,  when you ask for something, “Yes” has become far more likely. When reciprocity acts, it’s like magic: “Yes” without struggle, delay, or argument. It’s wonderful! Extensive research and practice have confirmed it works, and that it works better than bribery. Talk about evidence-based care! 

Notice the power this approach gives you: you choose the gifts to offer, when and what, and you can also choose the payback. You can set the agenda when you need to, take charge, without needing to say so. You don’t need to tell someone they owe you anything back. The instinct of reciprocity will do it for you, wordlessly.

In nursing work, that payback often amounts to things like accepting your care, trusting you, listening, cooperating. You earn all the little things that work work easier, smoother, quicker, more pleasant. Reciprocity makes it so.

In this post, I’ll offer various ways to earn Reciprocity, build up that account. Busy nurses need ways to earn the most reciprocity with the least time or effort. That way you come out ahead: you save time and energy, as your reciprocity investments pay off. In fact, you save more time and energy than you invested, and you generate lots of goodwill at the same time. In short, you win, all by doing good. No tricks, no manipulation: just gifts.

What gifts? There are countless options. I’ll offer a few:

1) Time: Obviously busy nurses have little to spend. Remember, the goal for our purposes here is to save time. Still, wise investments can do just that. Unwisely trying to cut corners to “save time” often backfires badly, costing far more time than it saves. It takes some practice to find the best balance on this point. Here are some ways to improve your odds:

– Avoid rushing people. It often backfires. I’ve actually found that saying “There’s no rush” tends to speed people up.

– Sit with patients. It’s great for your feet, it makes you seem less overbearing, and costs little time at all. Every second you sit with a patient seems to them longer than the same second you spend standing. It provides a credible sense of commitment, of being “with” them. More reciprocity per second!

thumbnail2) Politeness and Respect: the oils that keep the social machine from breaking down and bursting into flames. That’s why humans came up with such rituals! You can prevent lots of hard feeling this way, avoid many unpleasant interactions, and save lots of time. How much do “Hello,” “Good morning,” “Please” and the like cost you? They pay off far more than they cost.

3) Attitude. What does it  cost you to offer someone a little warmth in a cold environment? Show eagerness to help, express it as often as possible. Don’t lie: fake fails. Learn to feel it yourself, to believe it. It helps you too, makes the day pass faster and more pleasantly.

4) Your apology. If the hospital food stinks, apologize! Don’t try to sell an obvious lie, and don’t protect yourself. Obviously the food isn’t your fault, but you gain absolutely nothing arguing the point. Express your regrets, do what you can about it, and make sure they know you’re doing it. The interpersonal response makes it a solid investment. The same applies with your own mistakes and shortcomings. Learn to apologize up front and readily and focus on fixing it, not defending yourself. It gets much less painful with practice, and it saves much grief.

5) Empathy. People treat empathy as a skill or a task. It’s actually a process. Our early guesses are often inaccurate, and we need to test them, ask questions, reassess, and so one to develop anything useful, Empathy allows us to ask the right questions, offer the right services. It shows respect, it shows people you value them, and it helps you to cause fewer costly misunderstandings and get your work done easier.

6) Listening. Show some eye contact. Ask questions to show you’re paying attention, and to confirm you understand what they’re saying. People find a “good listener” very flattering.

7) Acceptance. Voice it, show it in how you act and speak.

8) Trivial Gestures. Sometimes I help someone buy a snack when I’m running an errand. People don’t soon forget minor bits of help outside of your “duties.” Even trivial choices are also a great option:


9) Information. Patients are desperately ignorant about most everything in a hospital. It’s rather frightening, and any little lessons you can teach them make a strong impression. Show off your knowledge, and show them you’re an expert.

10) Compliments. I compliments patients’ smiles, or things they say, or special clothes they wear, jokes they tell, stories, whatever I can find. I look for things I can honestly appreciate: it makes the day more pleasant, and people appreciate the way it makes them feel important.

It’s as much of a mindset and habit as anything, a way of thinking. I’m always looking for little ways to give a little bit more, ways that I can afford to offer and don’t interfere with my essential work. I build my Reciprocity accounts, over and over, and they give me a positive reputation as a nurse to trust, one who cares, one of the “good” ones. Partly reputation, partly substance: both are matter.

What goes around comes around. So it goes in life, so too in nursing. In many ways, doing right pays for itself and more.


  1. Power is a critical concept for nurses, because we could wield a great deal of it (since there are so many of us, and we are absolutely essential), but we squander it. We squander it every time we introduce ourselves as “Judy”, as if we as individuals don’t matter and are interchangeable with the next “girl” (no physician would do that!); when we allow petty jealousies and competition to run the unit rather than potent cooperation; when we fail to realize that all the unwritten rules of business apply to us as much as they apply to bankers and politicians. Eleanor J. Sullivan, PhD, RN, FAAN has written an excellent book, “Becoming Influential: A Guide for Nurses” that will make each of you look at your professional life in a completely different way.


  2. Loved this post! As an almost grad I can say that this is one of the topics we are getting taught. That empowerment doesn’t mean we are better, but shows that we have the strength and knowledge of what we are doing. It helps us advocate for the patient. Working in a hospital I see all different kinds of nurses, but this post made me smile and will probably mention it to a couple that they embrace some of your suggestions. Great post thank you 🙂


    1. It’s a topic impoortant to everyone, yet rarely discussed or even noticed. There is a tremendous literature on it, yet few people see any of it. Too bad – power is everything that gets anything done. Thanks for your kind support, and feel free to suggest other topics. I find suggestions useful: otherwise I’m lieft to the usual: wild guesses… Thanks again – Greg


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