NURSING DIAGNOSIS: Powerlessness

related to:
  1. physical limitations and/or prescribed activity restrictions;
  2. dependence on others to meet basic needs;
  3. alterations in roles, relationships, and future plans.
Desired Outcome
The client will demonstrate increased feelings of control over his/her situation as evidenced by:
  1. verbalization of same
  2. active participation in planning of care
  3. participation in self-care activities within physical limitations and prescribed activity restrictions.
Nursing Actions and Selected Purposes/Rationales
  1. Assess for behaviors that may indicate feelings of powerlessness (e.g. verbalization of lack of control over self-care or current situation, anger, irritability, passivity, lack of participation in self-care or care planning).
  2. Obtain information from client and significant others regarding client's usual response to situations in which he/she has had limited control (e.g. loss of job, financial stress).
  3. Evaluate client's perception of current situation, strengths, weaknesses, expectations, and parts of current situation that are under his/her control. Correct misinformation and inaccurate perceptions and encourage discussion of feelings about areas in which there is a perceived lack of control.
  4. Reinforce physician's explanations about the disease or injury and treatment plan. Clarify misconceptions.
  5. Support realistic hope about probability of future independence and ability to resume usual roles and lifestyle.
  6. Assist client to meet spiritual needs (e.g. arrange for a visit from clergy if desired by client).
  7. Remind client of the right to ask questions about condition and treatment regimen.
  8. Support client's efforts to increase knowledge of and control over condition. Provide relevant pamphlets and audiovisual materials.
  9. Include client in the planning of care, encourage maximum participation in the treatment plan, and allow choices whenever possible to promote a sense of control.
  10. Consult physical and/or occupational therapists if indicated about assistive devices and environmental modifications that would allow client more independence in performing activities of daily living.
  11. Inform client of scheduled procedures and tests so that he/she knows what to expect, which promotes a sense of control.
  12. Encourage significant others to allow client to do as much as he/she is able so that a feeling of independence can be maintained.
  13. Assist client to establish realistic short- and long-term goals.
  14. Encourage client's participation in support groups if indicated.