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Strategies for a Successful Shared Governance

Erin A. Avery

School of Nursing, James Madison University

NSG 462: Issues in Contemporary Nursing Practice

Dr. Kile

November 5, 2023
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Strategies for a Successful Shared Governance

Healthcare companies worldwide continuously seek ways to improve patient satisfaction

and outcomes. Nursing directors and leaders strive to promote optimal working environments for

nurses by encouraging employee engagement and fulfillment. Implementing shared governance

within an organization allows for bedside nursing staff to be a part of the decision making that

was once left up to the sole discretion of nurse leaders (McKnight & Moore, 2022). Since its

development several decades ago, shared governance has morphed into a professional

governance where bedside nurses function as peers within their corporation. Nurses who

participate in their shared (or professional) governance have the ability to directly affect decision

making and transform their practice, which contributes to both the nursing profession and their

community (Black, 2020). This paper will explore evidence-based recommendations and

strategies to improve an organization’s shared governance.

Nurse Autonomy and Professional Development

Nurses desire a workplace that supports professional development, allows for autonomy,

and encourages their involvement in decisions that affect their practice and influence patient care

(Bailey & Cardin, 2018). Autonomy in the nursing practice allows the nurse to provide patient

centered care that utilizes their expertise and independent judgement within the scope of their

nursing practice. Research shows that a culture that empowers their nurses to act autonomously

sees its benefits reflected in patient outcomes, specifically lower mortality rates and fewer failure

to rescue events (Bailey & Cardin, 2018). Rather than being micromanaged, this empowerment,

respect and support from nurse leadership improves nurse retention and productivity (Duru &

Hammoud, 2022). Shared governance allows a space for nurses to grow professionally and have

input in various stages of the decision-making process.

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Interprofessional Collaboration and Communication

In order to have a successful shared governance, clear and effective communication

amongst all staff is vital (McKnight & Moore, 2022). Communication that is consistent, open,

direct and respectful is essential for fostering patient safety, building trust, and promoting

teamwork. The shared governance entity should also be well defined and supported by a

leadership that actively participates in its process (Al-Ruzzieh et al., 2022). From the start,

leadership must involve bedside nurses, provide education on and promote shared governance

within their organization. It is recommended that those involved in shared governance have

frequent pulse checks to determine status, ensure items are being addressed, and that there is a

group consensus (McKnight & Moore, 2022).

Participation and Employee Engagement

Shared governance relies heavily on bedside nurse participation. Studies show that the

more a staff is involved with their shared governance, the more effective and beneficial it is for

their workplace (Al-Ruzzieh et al., 2022). Achieving a work life balance in general is difficult,

but a nurse in today’s world typically works a 12-hour shift, is completing continuing education,

working multiple jobs, and has a family at home. How can an organization encourage bedside

nurses’ participation in something extra at work, like shared governance? Leadership can attempt

to hold meetings at times that are most convenient for the staff and could offer them remotely. It

is important that shared governance includes perspectives from those who work varying shifts,

such as overnight and weekends. Engagement in nursing shared governance provides a sense of

belonging and loyalty within the organization. This increases morale, nurse productivity and

helps nurses gain an insight on the bigger picture (McKnight & Moore, 2022). The satisfaction
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of seeing an idea or suggestion come to fruition shows that one can make a difference,

decreasing burnout and aiding in retention.

Shared governance is a platform that allows nurses the opportunity to have an open forum

and discuss concerns regarding patient care and advocate for change (Al-Ruzzieh et al., 2022).

Organizations that have a strong shared governance council with staff buy in have decreased

incidences of hospital-acquired pressure ulcers, infections, and falls (McKnight & Moore, 2022).

Statistics like the above are proof that an actively engaged shared governance makes positive

changes within an organization.

Conclusion

Shared governance allows a more collaborative work environment compared to the top-

down decision-making style that once was (McKnight & Moore, 2022). Forming a strong shared

governance within a healthcare organization can be difficult for nurses and administration, but its

benefits are unmatched. An organization that empowers their nurses to work autonomously have

more satisfied employees and better patient outcomes. Nurses that are encouraged to act more

autonomously will have more opportunity to direct change in their workplace through shared

governance. Providing an environment for interprofessional collaboration and effective

communication is important for shared governance success. Leadership and bedside nurse

participation is imperative to achieve a more positive and inclusive work environment. A shared

governance whose members are actively engaged in participating have better patient outcomes

and higher job satisfaction (McKnight & Moore, 2022). An organization with a successful shared

governance requires change in culture, long-term commitment, and active participation from

bedside nurses and leadership (Quaid, 2023).

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References

Al-Ruzzieh, M., Ayaad, O., Hess, R. (2022). The role of participation in and effectiveness of

shared governance councils in the nurses’ perception of a professional practice work

environment. The Journal of Nursing Administration, 52(1), 51-56.

https://search.ebscohost.com/login.aspx?

direct=true&AuthType=cookie,ip,shib&db=rzh&AN=154198387&site=ehost-

live&scope=site&custid=s8863137

Bailey, D., Cardin, S. (2018). Engagement in nursing: One organization’s success. Nursing

Administration Quarterly, 42(3), 223-230. https://search.ebscohost.com/login.aspx?

direct=true&AuthType=cookie,ip,shib&db=rzh&AN=130143024&site=ehost-

live&scope=site&custid=s8863137

Black, B. P. (2020). Professional nursing: Concepts & challenges (9th ed.). Elsevier.

Duru, D., Hammoud, S. (2022). Identifying effective retention strategies for front-line nurses.

Nursing Management, 29(1), 17-24. https://pubmed.ncbi.nlm.nih.gov/34490763/

McKnight, H., Moore, S. Nursing shared governance. National Library of Medicine.

https://www.ncbi.nlm.nih.gov/books/NBK549862/

Quaid, M., (2023). The ELEVATE study: Evaluating the impact of educational professional

governance workshop of nurse’ perceptions of shared decision-making. The Journal of

Nursing Administration, 53(10), 540-546. https://search.ebscohost.com/login.aspx?

direct=true&AuthType=cookie,ip,shib&db=rzh&AN=172997635&site=ehost-

live&scope=site&custid=s8863137