Abstract
The fiduciary relationship between the client and the professional who has been hired to provide a service rarely exists today between nurses and patients, Nurses are employed by the State and operate in organizations where elements of both the bureaucratic and professional models are integrated. This paper discusses nursing's adaptation to the ever-changing health system in the United Kingdom and how this has resulted in the involvement of senior nurses in the political process. The mechanisms which result in policy output are discussed with reference to the power of nurses. It is argued that all nurses have a role in the decision-making process through the use of influence which will result from the development of political awareness.

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