It is commonly believed that concepts of power, authority and influence are synonymous. Luthans (1992) suggests that power and authority are separate but related concepts. He identifies power as the ability to get an individual or group to do something, while authority gives the person attempting to wield the power legitimacy and is actually a source of power. Unlike authority, power is not always nor does it need to be legitimate. Theories of power will be discussed and integrated into the final theory. A grounded theory methodology was used to explore the role of a sample of the Directors of Nursing in the Band One Teaching Hospitals in Ireland. In-depth interviews were held with eleven Directors of Nursing. A grounded theory of 'Powerless Responsibility’ was identified. The level of responsibility for keeping the hospital functioning is not commensurate with the level of influence and/or power that Directors of Nursing exert. Directors of Nursing in Band One Hospitals in Ireland have responsibility for patient welfare and for keeping the hospital functioning safely, but have very few opportunities to influence the strategic direction of the hospital or the wider health care system. All of this occurs against a backdrop of working within a health service that is undergoing major structural reforms (Health Service Reform Programme 2004) and which has been identified as being ‘systemically maladministered’ (Travers 2005). The study contributes to the body of knowledge about the role of the Directors of Nursing in Ireland in Band One hospitals, by helping to identify their position of Powerless Responsibility. The substantive theory indicates that Directors of Nursing need to understand power dynamics before they can successfully challenge the status quo. If nursing is to overcome its fixation with repressive power and begin to deconstruct nursing as an apolitical and powerless profession, self awareness of the history of the nursing profession within a feminist and sociological context must occur.