Nursing: empowerment and the problem of power

The concept of empowerment is one which is often invoked in discussions over the nature of nursing practice in a range of health and welfare services. A short excursion through the Cumulative Index to Nursing and Allied Health Literature reveals that over the last 10 years 378 papers are identified which list empowerment as one of the topics discussed. In 1993, the number is 55. These papers cover a diverse range of health related issues: health promotion and HIV; breast feeding; mental health; management and leadership; change, training and education; feminism and women's issues; sexual abuse and violence; advocacy and working with immigrants; professionalism; and nursing theory. However, few of these papers discuss the relationship between empowerment and the notion of power itself. This gives rise to particular problems for nursing practice, for without a clear conceptualization of what is meant by power it is difficult to convincingly argue that one form of practice is more or less empowering than another. Alternatively, this dilemma may be stated in the following question: how do we work to empower others when we have no clear notion of what power is? This paper demonstrates that the concept of power demands a very specific consideration. In order to illustrate this it briefly identifies problems within two models of power which are drawn upon in nursing. It also demonstrates the way in which the work of Michel Foucault can be drawn upon to inform nursing in the analysis of the relationship between power and health.