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Boost Nurse Responsibility with Shared Governance

Rebecca Hendren, for HealthLeaders Media, May 31, 2011

But getting to a true and functional system of shared governance is tricky. Many organizations start down the road only to find difficulties in identifying exactly what shared governance should look like in their organizations, what it entails to implement, and how to achieve the final result.

Organizations may also be hampered by transactional leaders who are unwilling or unable to release any control, hesitant, experienced nurses who do not trust the initiative is genuine, or by concerned direct-care nurses fearful of yet another change that will pull them or their peers away from patient care.

If organizations are willing to invest resources and time and commit to establish and sustain a culture of shared governance, these problems can be resolved equitably.

Swihart identifies four elements that are essential to the successful implementation of shared governance in the earliest stages of process development:

1.      A committed nurse executive who is invested in nurse empowerment and willing to undertake the efforts and energy necessary to implement shared governance

2.      A strong management team that is committed to each other, to nursing, to the organization, and to building the structure and implementing the processes

1 | 2 | 3 | 4

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3 comments on "Boost Nurse Responsibility with Shared Governance"


rebekah hall (6/3/2011 at 11:51 PM)
I agree with Carol! Girl you hit the nail on the head there!!I have recently lived this situation and it cost me my job and most of my self esteem.

Carol Johns (6/2/2011 at 6:50 PM)
The problem with this idea is contained in Swihart's comment, "It makes every employee FEEL like he or she is part owner with a personal stake in the success of the organization" [emphasis added]. Employees eventually figure out they've been duped by organization lip-speak when they are encouraged to embrace a plan that pretends to benefit employees. If nurses actually WERE part owners of the organization (sharing in the profits) and were engaged in cost-cutting decisions, etc., then we'd have something to talk about. Letting nurses sit at the table with the big boys is fine until the nurses realize the meetings are designed to make them FEEL like they have a say when they really don't. When nurses really ARE the big boys at the table it will work.

Julia Weinberg RN (6/1/2011 at 12:35 PM)
I am very skeptical: The key points here I think in the article shared: first: is commitment from the top by more than words and theroy written as a plan on paper. Second: Trust and respect of "real" shared decision making and "real" letting go of control by managers and upper mangement too. As a staff nurse over 25 years, I have only my own observations and experience as well others I have been associated with who are also staff nurses who work elsewhere. What this article shares with readers and what my own experience is this "letting go of control" it is to hard, for those who have been and are now in control to really let go especially for the long term. Many times when my own employers have tried, it is so short term that end results do not have the time to have imporvements and dollars saved be realized. Giving decision making control to frontline RNs and others of the healthcare team to really be the decision makers of the thought out plans to be tried and failed and revisited and tried again as well then be accountable for the outcomes realized for our patients and the care given and dollars saved, then these same teams be given recognition for job well done. I have to say again it takes a serious commitment from the top administration including boards and shareholders to really have their action match their words and written plans. In the places I have and I am working it sounds and could be so good, what is described here in the article, however, my experience tells me this is not reality. As much as Administrators and top managers "say" they want to do this, meerly only "words" with out serious actions to back these words up. Reality has got to be seen as serious commitment demonstrated and carried out for the long-term. Matching these same "words", Talk and written theroy on paper with the real committed action. Without the commitment to continue on for the long term, this has been my own experience which I have demonstrated whatever the "fad" "idea" that year, taken on full throttle ahead, only when maybe it begins to be seen that maybe the work done maybe making a difference, the plug is pulled and end results not ever fully realized. Then it is on to something else. For those who this article speaks too and you are still doing this in your workplaces; is this truely working as stated in this article? Has the shared decison making really been your reality? As frontline staff RNs and other healthcare frontline workers, can you tell me and others; How is it really working for you? I would really like to know what is the truth with facts and places that this being done and is stated in this article. Is this really if being done as stated in this article really making a difference for patients and frontline RN's and all members of your healthcare teams? Please let us know.