The circumstances and impact of powerlessness in psychiatric nursing.

Nurses comprise the largest professional group in healthcare; yet, they do not possess a degree o f power compatible with their numbers. Nursing, being a predominantly female profession, suffers many o f the same oppressive forces imposed on women in a patriarchal society. In addition, nurses suffer the oppression inherent in the hierarchical healthcare structure. A sense of powerlessness may compromise nurses' competency, and this is o f particular importance in the mental health field where nurses' ability to advocate for patients can significantly impact the care given. The aim o f this study was to explore the situations in which acute care psychiatric nurses feel most powerless, and the impact this has on them, both personally and professionally. A qualitative research design was used, and data were collected through four focus groups with four to five nurses in each group. Three groups were conducted in lower mainland hospitals, and one group took place in an interior British Columbia hospital. Four common situations in which psychiatric nurses feel powerless, emerged from the data. These include (a) those related to medicine's dominance and control; (b) when nurses feel they are in a no-win situation; (c) when there is a lack o f communication and support; and (d) when there are system problems. The personal and professional impact o f feeling powerless is explored. Implications for both nursing and counselling are discussed.