A surreal illustration symbolizing the balance of power and knowledge in the nurse-patient relationship.

Unveiling the Power Dynamics: How Nurses Impact Patient Care

Theo Raines in Health & Wellness June 2025 • 4 min read.

"Explore the subtle yet significant ways nurses' knowledge and authority shape patient experiences in healthcare settings."

In the intricate world of healthcare, the relationship between nurses and patients is a cornerstone of effective treatment and compassionate care. Governed by regulations and ethical codes, nursing practice extends beyond the administration of medicine and the monitoring of vital signs. It encompasses a dynamic interplay of power, knowledge, and trust.

This relationship, while intended to be supportive, is often influenced by the inherent power imbalance between healthcare providers and patients. Nurses, armed with specialized knowledge and acting as intermediaries within complex medical systems, wield considerable influence over patient experiences. Understanding this power dynamic is crucial for fostering a healthcare environment that respects patient autonomy while delivering high-quality care.

Michel Foucault’s theories on power and knowledge provide a valuable framework for analyzing these dynamics. Foucault argued that power is not simply a top-down force, but a pervasive element in all social relationships. In the context of nursing, power is manifested through the nurse’s expertise, their control over treatment decisions, and their ability to shape a patient's understanding of their own health.

Decoding Power Dynamics: Knowledge as a Cornerstone of Nursing Authority

A surreal illustration symbolizing the balance of power and knowledge in the nurse-patient relationship.

Nurses possess a distinct body of knowledge acquired through education, training, and experience. This knowledge base includes understanding of anatomy, physiology, pharmacology, and disease processes, as well as the practical skills needed to perform medical procedures and provide direct patient care. Because of their specialized knowledge, nurses often have the authority to make decisions about a patient's care, such as administering medications, implementing treatment plans, and educating patients about their conditions.

This authority, however, can inadvertently lead to a power imbalance if not exercised with sensitivity and respect. Patients may feel intimidated by the nurse's expertise, hesitant to ask questions, or reluctant to challenge treatment decisions. Therefore, it’s essential for nurses to be aware of this potential dynamic and actively work to create a more equitable and collaborative relationship with their patients. This entails:

Transparency: Clearly explaining medical information and treatment options in a way that patients can easily understand.
Empowerment: Encouraging patients to actively participate in decision-making processes related to their care.
Respect: Valuing patients' perspectives, beliefs, and preferences, and incorporating them into the care plan.
Communication: Fostering open and honest communication, creating a safe space for patients to voice their concerns and ask questions.

When nurses prioritize transparency, empowerment, respect and open communication, it can help mitigate the power imbalance and foster a more collaborative partnership. This enhances trust, increases patient satisfaction, and ultimately leads to better health outcomes. Conversely, when technical knowledge is valued over patient needs, the care can become impersonal, negatively affecting the patient’s recovery and perception of the overall experience.

Ethical Considerations: Balancing Power and Promoting Patient Well-being

The power dynamics inherent in the nurse-patient relationship necessitate a strong ethical framework that prioritizes patient well-being and autonomy. Nurses must adhere to ethical principles such as beneficence (acting in the patient's best interest), non-maleficence (avoiding harm), and respect for autonomy (honoring the patient's right to make their own decisions). By upholding these principles, nurses can navigate the power dynamics in a way that promotes trust, collaboration, and ultimately, the best possible outcomes for their patients. This requires ongoing self-reflection, ethical education, and a commitment to creating a healthcare environment where patient voices are truly heard and valued.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1590/2177-9465-ean-2017-0064, Alternate LINK

Title: The Patient And The Relation Between Power-Knowledge And Care By Nursing Professionals

Subject: General Nursing

Journal: Escola Anna Nery

Publisher: FapUNIFESP (SciELO)

Authors: Marina Kelly Santos Baptista, Regina Maria Dos Santos, Sebastião Junior Henrique Duarte, Isabel Comassetto, Maria Cristina Soares Figueiredo Trezza

Published: 2017-08-07

Everything You Need To Know

What does the term power dynamic mean in the context of healthcare?

The power dynamic in healthcare refers to the influence that nurses have over patients due to their specialized knowledge, authority in treatment decisions, and ability to shape a patient's understanding of their health. This power isn't just a top-down force but exists in the relationship between nurses and patients. It is significant because it affects patient autonomy, trust, and overall care quality. If not handled carefully, this imbalance can lead to patients feeling intimidated or hesitant to participate in their treatment.

What kind of knowledge and authority do nurses have, and why is this important?

Nurses possess a deep understanding of anatomy, physiology, pharmacology, and disease processes, along with practical skills for medical procedures and patient care. This knowledge provides nurses the authority to make key decisions about a patient’s care, such as administering medications and implementing treatment plans. This is important because while knowledge enables effective care, it can inadvertently create a power imbalance. Nurses must be transparent in explaining information, empower patients to participate in decisions, and respect patient beliefs and preferences to mitigate this.

What are transparency, empowerment, respect and communication, and why are they important?

Transparency involves clearly explaining medical information and treatment options so patients can easily understand. Empowerment means encouraging patients to actively participate in decisions about their care. Respect requires valuing patients' perspectives, beliefs, and preferences, and incorporating them into the care plan. Communication entails fostering open and honest dialogue, creating a safe space for patients to voice concerns and ask questions. These elements are vital to balance power dynamics, enhance trust, and improve patient outcomes.

What role do ethical principles play in the nurse-patient relationship?

Ethical principles such as beneficence, non-maleficence, and respect for autonomy are crucial in nursing. Beneficence means acting in the patient's best interest. Non-maleficence involves avoiding harm. Respect for autonomy honors the patient’s right to make their own decisions. Upholding these principles helps nurses navigate power dynamics ethically, promoting trust and collaboration. It requires self-reflection, ethical education, and a commitment to valuing patient voices.

How do Michel Foucault’s theories relate to power dynamics in nursing?

Michel Foucault’s theories explain that power is not just a top-down force but exists pervasively in all social relationships. In nursing, power is seen through expertise, control over treatment decisions, and the shaping of a patient's understanding of their health. This is significant because it highlights how power operates within the nurse-patient relationship, influencing patient experiences and autonomy. Awareness of these dynamics is important for fostering a healthcare environment that is respectful and collaborative.