NURS FPX 8010 Assessment 1 Political Landscape Analysis

Formal and Informal Lines of Power

Politics in organizations is crucial, as personnel utilize their position to obtain an edge and affect results. It entails formal and informal authority. Formal power refers to a person’s authority within an official model with a predefined hierarchy (Kovach, 2020). The organization formal power levels entail the Chief Executive Officer (CEO), who has supreme power, the Chief Medical Officer (CMO), or upper management. The previous physician-centric paradigm granted enormous control to the clinical personnel, notably the CMO. Inside the formal political structure, nurse leaders cannot impact organizational activities because of physicians’ power. It is shown by the periodic resignation of the Chief Nursing Officer (CNO). 

Informal power allows an individual to display reference or expert influence without official control in a company’s hierarchy (Kovach, 2020). The hospitalist group’s desire to incorporate a limited partnership exemplifies the hospital’s informal power dynamics. The CMO holds informal power dynamics owing to his long occupation and involvement in the community, allowing him to lead major campaigns such as the transfer of Advanced Practice Registered Nurses (APRN) to the hospitalist team. The organization contains several power sources, like  coercion, reputation, authority, competence.

NURS FPX 8010 Assessment 1 Political Landscape Analysis

The CEO is the power source in the firm, the CMO holds authority among clinical staff. CMOs and CEO hold personal power built on respect and appreciation that someone garnered from others with time during his job (Kovach, 2020). Expertise is related to the understanding or abilities in specific fields, as CMO shows through the growth of orthopedics as a profitable service area. The use of coercion to induce APRNs to join the hospitalist group is a form of power. Coercive practices affect teamwork or communication when physicians are prioritized on nurses’ concerns. Kovach (2020), stated that coercive power hinders staff’s willingness to perform positively. The power hierarchies affect company culture, regulations, and communications.

The physician-centric culture has led to policies and altered decision-making practices that value physician input, neglecting nurses’ opinions. It forms a segmented culture where communication is centralized, and nurses are ignored. Organizations must boost power balance and cooperation to attain positive results. The new CNO must address these concerns. Samuel et al. (2025) advocated fostering active listening, open interaction, and an inclusive setting integrating stakeholder input or open discussion to boost results. Addressing power dynamic through effective practices can improve teamwork and the hospital’s efficacy.

Organizational Power Influences on Executive-Level Decision-Making

Being a CNO necessitates a strategic approach to addressing the concerns of the APRNs, considering the organization’s power dynamics. Recognizing the physician-centric culture and the informal power held by the physician leadership, the effective evidence-based approach is to adopt a shared governance structure that supports APRNs by including their perspectives in decision-making processes. The scope is that it recognizes APRNs’ informal authority through their clinical skills and dealing with patients while correcting the formal power imbalance that has typically favored physicians. The purpose is to assist organizations in fostering a culture of respect and teamwork by establishing interdisciplinary committees where APRNs can give input to policy creation. According to McKnight and Moore (2022), shared governance promotes active collaboration across the medical team, resulting in better patient results. 

Another approach is to negotiate a collaborative hybrid model. It will allow APRNs to continue their relationship with the nursing unit while collaborating with the hospitalist team. Thi scope of this method is to encourage multidisciplinary cooperation on common aims. According to Abkenar et al. (2024), such partnership enhances care access, and patient satisfaction lowers care costs and hospitalization. Underlying assumptions include empowering APRNs, improving patient results and organizational productivity. Further assumption on positive effects of interprofessional teamwork and negotiating power imbalance, lobbying for nurses; concerns. A balanced approach is critical to meeting APRN’s desires and patients’ needs. 

The Impact of Power on Organizational Policy

The planned policy of shifting APRNs from the medical unit to hospitalist organizations and withholding medical rights of staff, refusing to join is impacted by power imbalance inside the setting. The structure has been physician-focused, with the CMO retaining substantial power and esteem inside the institution owing to his lengthy job duration and prominence in the communities.

This power dynamic caused challenges for the nurses unit, including an elevated turnover of CNOs and the demise of Magnet accreditation. This implies that power may be utilized to favor the interests of a certain team over others, resulting in poor cooperation and more conflicts. According to Ziemianski (2022), misuse of power can lead to ignoring subordinates input, and a hierarchical, uncooperative setting. Further, the suggested move of APRNs from the nursing unit demonstrates the potential influence of power on policy. The strong CMO and clinicians executives are taking this decision, and having severe impact on APRNs’ level of practice and incentives.

It demonstrates that power can be utilized to modify policies that do not necessarily correspond with the priorities of other parties. Further, the push from the organization authority to achieve Magnet status, indicates that power may be utilized to apply outside influence on corporate policy, impacting the hospital’s operations. Power relations can affect inclusivity, as less powerful staff have less effect in crafting policies, causing disparity. It causes clashes, miscommunication, and injustice (Ziemianski, 2022). Resolving power concerns is critical for an open policymaking process that benefits all stakeholders.

Sources of Power

Expert power is the most appropriate power source for the CNO to accomplish its primary strategic objective, improving care provision. Leveraging expert power across disciplines boosts decision-making, skill development, and knowledge base, ensuring long-term success, operational stability, and organizational growth (Kovach, 2020). The CNO’s expert power comes from how deeply CNOs know the best practices for nursing, evidence-based approaches, and the benefits of collaboration on patient outcomes.

Using this power allows the CNO to successfully advocate for policies that will maintain the autonomy and scope of APRNs while meeting the organization’s broader goals. Demonstrating expertise and being a collaborator will allow the CNO to negotiate solutions that support the interests of all involved parties and align with ethical leadership. It creates respect and confidence among the team, promoting a healthy work atmosphere (Ahmed & Khan, 2023).

Considering staff, notably nurses’ autonomy and ensuring justice are ethical values while applying power during decision-making. Further, being a CNO can employ coercion power. However, this power source can cause resentful disagreements, resulting in inferior patient results and staff satisfaction. Kovach (2020), stated that adopting coercive power in work settings can lead to negative effects, like stress and team discontent. Coercion can achieve short-term goals, but it destroys trust and damages the staff’s wellness, impacting service quality. However, expert power and interprofessional cooperation promote compassion, encouraging positive patient, staff, and organization outcomes.

Conclusion

Community organizations feature complex power relations because of the physicians’ dominant authority. To traverse the intricacies of organizational power relations, the CNO must carefully examine informal and formal powers and their effect on workplace culture and interaction. By adopting a shared governance approach, the concerns of APRNs can be resolved. Applying expert power and collaboration supports CNO in boosting patient and hospital results.

References

Abkenar, K. F., Salimi, S., & Pourghane, P. (2024). “Interprofessional collaboration” among pharmacists, physicians, and nurses: A hybrid concept analysis. Iranian Journal of Nursing and Midwifery Research, 29(2), 238–244. https://doi.org/10.4103/ijnmr.ijnmr_336_22

Ahmed, M., & Khan, M. I. (2023). Beyond the universal perception: Unveiling the paradoxical impact of ethical leadership on employees’ unethical pro-organizational behavior. Heliyon, 9(11), e21618. https://doi.org/10.1016/j.heliyon.2023.e21618

Kovach, M. (2020). Leader influence: A research review of French & Raven’s (1959) power dynamics. The Journal of Values-Based Leadership, 13(2), 15. https://doi.org/10.22543/0733.132.1312

McKnight, H., & Moore, S. M. (2022). Nursing shared governance. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK549862/#:~:text=%5B1%5D%20This%20shared%20process%20allows,inclusion%2C%20which%20benefits%20job%20satisfaction

NURS FPX 8010 Assessment 1 Political Landscape Analysis

Samuel, H. S., Etim, E. E., Nweke-Maraizu, U., & Okibe, G. (2025). Building collaborative and interdisciplinary teams: Strategies for effective talent management. In Cultivating Creativity and Navigating Talent Management in Academia (pp. 23-38). IGI Global Scientific Publishing. https://doi.org/10.4018/979-8-3693-6880-0.ch002

Ziemianski, P. (2022). Identifying and mitigating the negative effects of power in organizations. Journal of Applied Social Science, 16(1), 140-159. https://doi.org/10.1177/19367244211014789

NURS FPX 8010 Assessment 1 Political Landscape Analysis