INTRODUCTION:

Capacity building for nursing faculty empowerment:

Capacity building is a methodical process to ameliorate personnel’s knowledge, skills, understanding, values, attitudes, motivation and capacity building influences organizational revenue, competitiveness and performance. Victorious planning is a significant component of the event of capacity building. Capacity building contemplates faithfulness to quality enhancement and designates a learning organization (Senge, 1991).¹Knowledge and enhanced practice fortify research capacity but it needs more consciousness towards better medical practices to research itself with supplementation of mentorship by senior nurse leaders. (Me Phee et al, 2011).²

Capacity building is defined ‘as promoting an environment that increases the protentional of individuals, organizations and communities to receive and possess knowledge and skills as well as to become qualified in planning, developing, implementing and sustaining health -related activities according to changing or emerging needs’. (OECD, 2006)³

Capacity building of nurse educators is highly significant in order to be assured that the quality of nursing education is facilitated, thus, resulting in quality patient care. There are a few regulations for building capacity for nurse educators. They are given below ⁴:

· Construct capacity on trust, interactive reciprocation and norms of action.

· Choose predominant concern in nursing and nursing education.

· Invigorate collaboration among colleagues in nursing practice and education.

· Determine contribution to establish the human and social capital.

· Organize capacity building according to the existing capacity, local expertise and knowledge.

Need for capacity building in nurse education⁵

· Substandard educational tracking and governance at state level

· Acute shortage of faculty members

· Inadequate physical infrastructure

· Inadequate resources in particular with clinical skills teaching

· Deficiency of continuing education programs for faculty

· Deficiency of opportunities for faculty promotion

· Disarranged curriculum

· Reliance on didactic teaching approaches

· Substandard hostel for students

· No liaison between educational organizations and hospitals

· Insufficient clinical experience for students

Nurses’ education, experience, continuous professional development, autonomy, individual features, encouragement, work contentment and the evaluation of quality of nursing care have been recognized as factors related with nursing competency. (Shargi, Alanri, Khosravan, et al, 2015).⁶ Building educational capacity by continuous nursing faculty programs have been suggested as one of the various strategies to solve the nursing man-power problems and the implementation and outcome of nursing education too. The current nursing curriculum entails revision so as to furnish nurses adequately to control the learning experience, to dispense faculty with the independence and inspiration to be creative. (Evans, Razia and Cook, 2013).⁷

Administrators and nursing faculty at colleges are accountable to produce nurses who are qualified and capable to ponder critically, foster change and create innovative problem- solving approaches. Study findings illustrated that nursing faculty members in colleges of nursing reexamine their depth of participation in decision making measures in order to produce a learning environment that is conducive for themselves and students as well.⁸

Capacity building for nursing empowerment:

Research evidence related to capacity building of nurse educators/students:

Kerstin Erlandsson et al, (2019)⁹ evaluated a model for capacity building of midwifery educators in Bangladesh. Results demonstrated that educators were expected to become more amicable with technology. And hoped that they would equip with pedagogical and other skills that would foster them to support the students’ progress in learning and thought they might acquaint skills to authorize their students as human beings. The study participants self reported that these ambitions, allocating the masters program with assisting them permit them to be accountable for their own teaching and learning, displaying them how to enhance their students learning and how to foster reflective and critical thinking among them.

The reviewed articles revealed the essence of nursing educators’ abilities to empower students by building rapport relationship, supporting them, and facilitating learning opportunities. The classroom and clinical learning are important concomitantly. The learning placement performs a strong role to provide learning experience for nursing students. It will have optimistic impression on their holistic clinical skills, decision making, self- esteem, problem- solving skills, and hands on patients care. (Al Niarat TF, 2019)¹⁰

A grounded theory approach was utilized for analysing the participants’ experiences, their perceptions and strategies influencing empowerment. A total of 44 participants in 12 series of observation were done. Three main categories were emerged. They were personal empowerment, collective empowerment and structure of organization and the culture. From the participants’ frame of mind, empowerment is a ‘dynamic process that results from mutual interaction between personal and collective traits of nurses and the culture and the structure of the organization’.¹¹

Model of empowerment:

Professional empowerment is an energetic process that happens by association at the personal, professional cultural and organizational levels. The existence of expert nurses is significant for empowerment. Additionally, the strength of the profession and the public’s image of nursing can influence nurses self confidence for illustrating their entire competencies. The personal and professional power of nurses is created by their own knowledge, action and behaviour.¹² The same is depicted in figure 1.

Figure 1: Model of empowerment

A model – nursing capacity building in developing countries:

Enhancing the quality and quantity of nurses and nursing care necessitate both capacity building of individual faculty members and at both nursing institutions and health care organizations where clinical teaching happens. To accomplish these two demands the application of both edges – pulling and bottom up strategies and quality improvement (Fig. 2). The edge pulling strategies relate to leader development and bottom up strategies correspond to enhancing quality improvement of nursing faculty members and nursing professionals. It should also be fortified with midterm and long term strategic planning to create and establish spirit in the workplace. ¹³

Figure 2: Model-Nursing capacity building in developing countries

Nursing empowerment for quality improvement:

Power is authority over others. Empowerment is the power knowingly shared with another. Thus, power and empowerment are different. Nursing empowerment means the ability to successfully encourage and prepare one and others to achieve positive result in nursing practice. The patient quality care and nurses empowerment are considered as two sides of the same coin. The empowered team affects staff morale, productivity, staff retention and associated costs, patient care quality and patient safety (Fig.3).¹⁴

Figure 3: Model of nursing empowerment for quality improvement

A systematic review on effectiveness of capacity building interventions appropriate to public health practice was conducted. The review identified six intervention types. They were internal based instruction, training and work place, technical assistance, education using self-directed training, communities of practice, and multi strategy interventions. Capacity building interventions can facilitate knowledge, skill, self – efficacy, changes in practice or policies, behaviour change, application and system level capacity. Nevertheless, while applying available evidence, organizations should consider the outcomes of the highest priority, selecting interventions that would result in accomplishment of the outcomes.¹⁵

The empowerment of nurse educators is important to the effective execution of quality programs and the successful usage of teaching methodologies that enhance proficiencies for nursing students.¹⁶In these circumstances, nursing faculty require to emphasize on factors or behaviours that enhance their level of empowerment, so that they will be more dedicated in the implementation of their activities. According to Thorndike and colleagues, faculty empowerment is significant for the reason it advances academic realization.¹⁷ As a result, the chances should be rendered to faculty members to affect and influence the nursing programs and produce collaboration in the academic success.¹⁸

Types of empowerment:

• Structural Empowerment: means execution of organizational strategies that hold up shared team governance, open leadership communication, and supportive and empathetic nursing team relationships. It has a constructive effect on individual nurse empowerment by accelerating the clinical nurses’ positive insight of empowerment at their working environment. This inspires the nurses and boosts their job satisfaction. (Kramer M, 2010)¹⁹

• Professional Empowerment: is the same as discussed in the model of empowerment. This creates trustworthiness and encounters a sense of empowerment among nurses. (Adib HM, 2004)¹²

• Psychological Empowerment: Empowerment can encourage an individual to work with enthusiasm and productively in accomplishing the goals of the organization [Spreitzer GM, 1995].²⁰Spreitzer defined psychological empowerment ‘as the cognition state resulted from the subjective positive transformation of perceptions, and an individual starts to work with full dedication and fully immersed in the work environment’. Psychological empowerment comprises of four structural processes namely meaning, competence, self-determination, and impact.

· Meaning - The value of a work purpose and/or goal in relation to an individual’s own ideals/standards

· Competence- An individual’s belief in their capability to implement activities with skill

· Self- determination - An individual’s sense of owning choice in initiating and regulating actions

· Impact - The level to which an individual can affect strategic, administrative or operating outcomes in the working environment

Use factors contributing to nurse empowerment are:

The factors contributing to nurse empowerment²¹ are depicted in fig.4. Nursing empowerment becomes an inevitable component to achieve quality improvement in any health care setting.

Figure 4: Factors contributing to nurse empowerment

Empowering behaviors:

The interactive process of empowerment requires open communication, mutual goal setting and decision making and the use of empowering behaviors. Empowerment of faculty should promote the use of empowering teaching behaviors in an organization.

Gorman and Clark determined four categories of empowering behaviours²²

Empowering Behaviors	Empowering Teaching Behaviors
Analytic nursing: activities that improve a person’s ability to understand	Utilizing clinical experiences as situations for group analysis of problems and encouragement of the analysis of health care providers roles in bureaucratic settings
Change activities: remove barriers to practice, enhanced organizational visibility and extended professional networks.	Motivating student attendance at meetings organized by nursing services and having students take rotations in the leadership role of group projects
Collegiality: Strategies provided dialogue for learning, aided in identifying and accessing resources, facilitate social cohesion, and invigorating cooperation	Redirecting students questions to other students and discussing feedback from teacher’s evaluation with the students
Sponsorship: Measures provided access to resources, information, and support systems and expanded role relationships	Encouraging student to find an experienced nurse for guidance and discussing the importance of participating in organizational decision making.

Common piece of work to enhance the ability to be empowered¹⁴:

Enhancing leadership skills:

Nurses should be motivated to involve in leadership and management internship programs. Several health care organizational committees that make decisions and create policies influence nursing job responsibilities and practice to a larger extent. These programs permit nurses to facilitate comprehensive view of leadership styles, establish a rapport with organizational leaders, and achieve awareness into how the organization operates.

Be a positive agent:

Examine the workplace to explore areas for improvements that will enhance the efficiency of the environment and intensify job role satisfaction. Consider establishing a committee. Workgroups permit nurses to associate to achieve specific tasks, such as formulating a new protocol for a procedure that will improve patient safety and systems efficiency and so on.

Get certified:

Certification reflects level of expertise particularly in a specialized area. Create a study group with co-workers for specialty certification exams. Research has demonstrated that when hospitals are equipped with baccalaureate prepared nurses who hold speciality certification, 30-day patient mortality is dramatically lower.

Be an Evidence Based Practice (EBP) cheer leader:

When nurses implement EBP and research councils into their practice, patient care outcomes are heightened and patient satisfaction as well. Nurses must improve their knowledge base by completing continuing- education courses or by attending workshops and /or conferences regularly.

Confidence:

Collaborate trust and confidence. Ensure psychological safety by the following strategies:

· Encourage input from entire team members

· Motivate team members to contribute

· Enhance active listening and learning from each other

· Make sure that all team members are accessible

· Recognize the limits of current knowledge.

Communication:

Stimulate two-way communication between management and staff. Provide a separate place for all staff to display their achievements.

CONCLUSION:

Empowerment is important for improving nurses’ role, building up professional image and invariably improving the health care system nationally and internationally. Restructuring nursing services will remove obstacles to poor quality nursing care, inadequate educational preparation, role ambiguity and low self esteem among nurses. Enhanced communication, courtesy, honesty, mutual respect, cooperation, mutual goal setting and decision making makes nursing institutions better places for students, faculty and administrators. The preparation of nurses who are empowered and able to think critically, promote change and generate creative problem-solving approaches will advance the future of nursing.

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Received on 28.12.2022 Modified on 23.01.2023

Int. J. of Advances in Nur. Management. 2023; 11(2):127-131.

DOI: 10.52711/2454-2652.2023.00031