NURS 623 Week 8 Discussion Board Forum 3 on Power, Politics and the Nurse Administrator Example

Discussion Board Forum 3: Power, Politics and Influence in Nursing Administration

NURS 623 Nursing Administration I: The Role of the Nurse Administrator, Discussion Board Forum 3

Thread by [Student Name]

The hospital, the budget request and the classmates replied to are composites written for a model discussion.

Last fall, the nurse manager of the neurology unit at my practicum hospital brought a request to the budget committee for funding to replace one-to-one sitters with a mix of video monitoring and two dedicated safety companions on nights. Her proposal was well built. It showed the unit's fall rate, the cost of agency sitters and two published evaluations of video monitoring. The committee tabled it in eleven minutes. Afterward, the chief financial officer told her privately that he would have supported it if he had seen it before the meeting, and the director of facilities said nobody had asked whether the cameras could be mounted in the older wing. My argument in this thread is that political astuteness, the skill of reading where power sits in an organization and working through it ethically, is a core administrative competency, not a personality trait, and that the manager's proposal failed for political reasons rather than clinical ones.

Roussel (2018) describes power as the capacity to influence the decisions and behavior of others and politics as the process by which that influence is exercised over the allocation of scarce resources. Seen that way, a budget committee is a political arena whether or not anyone uses the word. The manager had expert power from her data but had not built the relationships, or done the early consultation, that turn expertise into a decision. She had treated the committee meeting as the place where the decision would be made, when in practice most of it had been made in the conversations that came before, and she had not been part of any of them.

Evidence suggests that many nurse leaders are underprepared for this. O'Hanlon Curry and Fitzpatrick (2024) surveyed 101 members of the American Organization for Nursing Leadership and found that half showed only slight political astuteness; executives such as chief nursing officers scored higher than directors and managers, and the authors recommended formal education in political and legislative processes. Muswede and Matahela (2026) analyzed 24 sources and named the defining attributes of political astuteness in nurse leadership as strategic awareness, policy acumen, advocacy, stakeholder engagement and ethical reasoning, with emotional intelligence and exposure to governance among its antecedents. If political astuteness has antecedents that can be supplied, then organizations that leave their managers to learn it by failing in committee are choosing not to teach it.

Three habits follow for administrators. First, map the stakeholders for any request before writing it, including those who control space, money and information. Second, consult early and privately, so that objections surface while the proposal can still change. Third, keep advocacy honest by sharing the same data with every audience, and by naming the costs as plainly as the benefits, because influence built on selective numbers lasts only until someone checks them. Daniel served in the court of a foreign king, yet he consulted the official in charge of him before acting and proposed a ten-day test of his request (English Standard Version Bible, 2001/2016, Daniel 1:8-14). He combined conviction with respect for the people who held authority, which is political astuteness in a form any Christian administrator can practice.

Reply to Gabriela

Gabriela, your point that many nurses hear the word politics and think of manipulation is fair, and I think it explains why some excellent clinicians avoid the committee rooms where staffing and budgets are decided. Research suggests that political skill actually pushes leaders toward more cooperative behavior, not less. One study measured political skill and negotiation behavior in 100 frontline nursing managers at two hospitals, using the Political Skill Inventory and a negotiation self-assessment, and found strong positive correlations between political skill and both collaboration and accommodation, along with strong negative correlations between political skill and both avoidance and competition (Higazee & Gab Allah, 2022). The managers relied most on compromise, which was negatively related to political skill. If those patterns hold more widely, the politically skilled manager is the one who looks for solutions that work for both sides rather than the one who wins at others' expense. Paul's instruction to the Philippians points the same way: each believer should attend to what others need and not only to personal advantage (English Standard Version Bible, 2001/2016, Philippians 2:4). The study was correlational and limited to two hospitals, so it cannot say that training in political skill would change how managers negotiate. Still, it offers a reply to colleagues who fear that politics will make them less ethical, and it suggests that the nurse who avoids every hard conversation may be the least politically skilled person in the room rather than the most principled. Would you say the managers you have observed in your practicum avoid conflict more often than they compete?

Reply to Andre

Andre, you argued that political astuteness belongs mostly to executives, since chief nursing officers are the ones who sit with the board and the finance team. I agree the stakes are highest at that level, but I would push back on leaving it there, because the frontline manager is often where a good idea dies first. Liou et al. (2022) asked nurse managers at three levels in Taiwan to rate the importance of 23 leadership and management competencies for their current jobs. Effective communication was rated highest at every level, while political astuteness was rated lowest, with a mean of 3.92 on a five-point scale compared with 4.88 for communication, and managerial level predicted how important managers considered each competency. If managers do not see political astuteness as part of their work, they are unlikely to build it before they are promoted into roles that depend on it. That gap matches what happened to the neurology manager in my thread, whose clinical case was strong but whose groundwork was missing. One practical answer would be to let managers shadow their director through one budget cycle, sitting in on the conversations that happen before the committee meets, so that they learn who must be consulted and in what order. A second answer would be to add political astuteness to the manager's annual evaluation, so that it is coached and discussed rather than left to chance. Do you think your organization would let a manager observe those early budget conversations, or are they kept at the executive level?

References

English Standard Version Bible. (2016). Crossway. (Original work published 2001)

Higazee, M. Z. A., & Gab Allah, A. R. (2022). The relationship between the political skills and negotiation behaviors of front-line nursing managers. Nursing Forum, 57(6), 1240-1248. https://doi.org/10.1111/nuf.12772

Liou, Y. F., Lin, P. F., Chang, Y. C., & Liaw, J. J. (2022). Perceived importance of competencies by nurse managers at all levels: A cross-sectional study. Journal of Nursing Management, 30(3), 633-642. https://doi.org/10.1111/jonm.13545

Muswede, N. J., & Matahela, V. E. (2026). Political astuteness in nurse leadership: A concept analysis. Journal of Nursing Management, 2026(1), Article e7258276. https://doi.org/10.1155/jonm/7258276

O'Hanlon Curry, J., & Fitzpatrick, J. J. (2024). The level of political astuteness in nursing leaders: A baseline assessment. The Journal of Nursing Administration, 54(3), 172-176. https://doi.org/10.1097/NNA.0000000000001403

Roussel, L. (2018). Management and leadership for nurse administrators (8th ed.). Jones & Bartlett Learning.