The Meaning of Empowerment and How We’re Listening

June 2, 2022 by

by James Nataro, MD PhD MBA, Chair, Department of Pediatrics

Read the introduction to this project from January 2022

Empowerment has been variously defined as the authority or power given to someone to do something or, perhaps better, the process of becoming stronger and more confident, especially in controlling one’s life and claiming one’s rights. Most of us know that UVA faculty and staff do not consider themselves to be highly empowered in questionnaires stretching back years. In a questionnaire I circulated last fall, I was similarly disappointed at low empowerment ratings by Children’s Hospital doctors, nurses, and staff.

When a large number of people voice a similar negative sentiment leadership takes note and seeks to effect change. The problem in this area is that not only are there multiple definitions of empowerment, and lack thereof, but being empowered is a sentiment very much in the eye of the beholder. But this makes it more important to address, not less.

Over the last several months, I have had innumerable discussions with you all seeking to understand what you mean when you say you don’t feel empowered. I believe the root cause of it comes down to two things: lack of ability to effect meaningful change in your working environment and lack of transparency regarding how things get done and the allocation of resources. Although I received many specific examples of changes people would like to make, and ways in which they felt disempowered, I believe these two general concepts best capture the prevailing feelings.

So where do we go? At the level of the department, I have tried to address both overarching concepts. We have begun efforts to share department finances and decision-making with the faculty generally and in certain specific cases. In some situations of resource allocation we have engaged the faculty directly in allocation decisions – the disbursement of funds from the Fortify Children’s Health CIN is a specific example.

How do people become empowered to effect change in the workplace? I think the answer is genuine listening from an open and nonjudgmental perspective. One challenge we have is that all of our workplaces involve multiple people with different perspectives, so empowering just one person to effect change may be unfair to many others. In response, Children’s Hospital leadership led by Karin Skeen and Billy Petersen have begun pilot programs to improve clinical operations, while engaging individuals at the point of care. These change efforts are aimed to directly empower providers and clinical staff to address their own working conditions, improve efficiency, and take better care of patients. The results of these efforts will be more broadly applied, but more importantly, the ethic of engaging and listening to individuals who directly deliver care will be reinforced as the norm.

I believe that the most powerful way to move the needle on empowerment is to present an honest willingness to listen. When it’s impossible to bring about the change that people seek, the best response is open communication, an explanation, not silence. It is unfortunately all too easy, and perhaps too common, to simply not respond when the hill is too steep to climb.

Empowerment is the word of the year. We are still working on it and want to hear from you. Please send us an email anytime at And thanks for being so committed to the welfare of children.

Filed Under: Features