Legitimate power, otherwise dubbed positional power, is a form of power granted to an individual based on their relative duties and position within the organization. As seen in the discussion, legitimate power has historical roots in nursing. The concept serves to protect the recruitment and retention interests of registered nurses in practice. The legitimacy arises from both formal credentials upon certification and organizational structure. In essence, the DNP-prepared nurse’s legitimate power comes from their legal authorization to coordinate care given the licensure of their specialty. This paper compares the influence of legitimate power on micro-, meso, and macro-levels of healthcare in shaping nursing practice.
The micro-level clinical environment explains behavior and actions at the most basic personal level. Caldwell and Mays (2012) state that it recognizes the intentional and habitual actions and their considerable effects on systems and processes in the work environment. The perspective includes ascription to a moral responsibility, awareness of behavioral consequences, behavioral control, and subjective norms. Micro-level healthcare focuses on how individuals, as well as clinical settings, balance their duties and identities in service delivery (Caldwell and Mays, 2012).
Second, the meso-level perspective studies the group-based experiences as well as various forms of interaction in a team environment. The concept describes the extent to which individuals in a team set up transact among themselves and with other groups. Ideally, the contemporary workplace exists in an environment where teams and organizations are dependent on each other in a system. Thus, visible rigidity and fluidness in interaction would explain the boundaries that exist in group-level environments (Valentijn, Schepman, Opheij, and Bruijnzeels, 2013).
Lastly, the macro-level perspective analyzes the interactions that happen on a broad level, such as inter-state and international interactions. Researchers that compare such environments attempt to define similarities, differences, and shifts in policy and practice. Macro-level healthcare practices recognize the essence of socio-political environments in influencing service delivery. The approach concentrates on healthcare policy interactions between states, countries, and regions (Caldwell and Mays, 2012).
References
Abood, S. (2007). Influencing Health Care in the Legislative Arena. OJIN: The Online Journal of Issues in Nursing, 12 (1). doi:10.3912/OJIN.Vol12No01Man02
Bartos, C., Fridsma, D., Butler, B., Penrod, L., Becich, M., & Crowley, R. (2008). Development of an Instrument for Measuring Clinicians’ Power Perceptions in the Workplace. Journal of Biomedical Informatics, 41 (6), 1041-1049.
Caldwell, S., & Mays, N. (2012). Studying policy implementation using a macro, meso and micro frame analysis: the case of the Collaboration for Leadership in Applied Health Research & Care. Health Research Policy and Systems, 10. doi:10.1186/1478-4505-10-32
Valentijn, P., Schepman, S., Opheij, W., & Bruijnzeels, M. (2013). Understanding integrated care: a comprehensive conceptual framework based on the integrative functions of primary care. International Journal of Integrated Care, 13, 1-12.
