Shared Governance in Nursing

• Shared governance in nursing was a model introduced in 1985 structured to allow a shared responsibility between administrators and staff nurses. 
• Studies show better adherence to policy change if the decisions were made with subordinates’ voices. 
• Those looking to implement a shared governance in nursing model can refer to web sources such as books, blogs, case studies, and personal testimonies on how they implemented this in their facility successfully. 

As a nurse, have you ever felt frustrated that nurses have the answers to questions healthcare administrators are troubled with, but they never asked the opinion of the nurses?  Have you ever had a hospital remodel a nursing unit without ever asking the nurses what they wanted for improvement?  

Shared governance in nursing is a solution.  

In 1985, shared governance began as a model that nurses could share the responsibility and direction for their profession with healthcare administrators and nursing leadership. 

Traditionally, decisions about nursing shifts, policies and procedures were made in a central administration away from bedside nurses, but shared governance offered an opportunity and organized structure to decentralize decision-making by including nurses in decisions that directly affected them. 

How Does Shared Governance in Nursing Work?

The core components to successful shared governance include teamwork, problem-solving, and accountability.  

Nurses are trained in those principles in nursing school and on the job, so it makes sense to include nurses in councils that directly affects our own practice such as nursing practice councils, evidence-based practice councils, department and unit councils, professional development councils and more.  

Nurses, who were traditionally seen as just employees, were finally empowered to use their clinical knowledge and expertise to direct their own professional practice in work settings.  

What seemed logical to nurses, however, was met with resistance by administration and upper management who didn’t want to loosen their grip on control.   

It has been a difficult process but slowly nurses and administrators are working together to find solutions for often complex problems in healthcare. 

How to Create Shared Governance in Nursing

Not all hospitals and healthcare faculties have a formal shared governance policy and practice.  

If your healthcare facility doesn’t have a position on shared governance, you can be the one to make the change.   

Creating any new cultural change is difficult but with effort you can be the catalyst for good. Steps include becoming involved in your organizational leadership by creating a mission statement regarding shared governance.  

Begin to write bylaws on how the structure and committees would work together and define nursing leadership structure.  

Because nurses touch every aspect of patient care, they should be represented at the committee tables that make decisions in those areas of care.  A powerful concept that managers need to know is that when front-line nurses are involved and empowered in the decision-making, they’re more likely to take ownership for their practice and be more engaged and effective at the bedside.   

Why progress in developing shared governance in nursing has been slow also includes the lack of interest and energy by nurses.  

At the end of a physically and emotionally draining 12-hour shift, not many nurses have the energy to push for their own leadership.  Nurses experience burnout and just want to go home after a busy shift.  

The best solution to help nurses become more energized in their work is to involve them in the decisions that define and affect their work.  

It’s kind of like buying something from a business versus owning that business. There is more buy-in emotionally to be engaged and proactive for business owners.  

Nurses who are heard at the decision-making table can become more resourceful and effective at the bedside because they’ve been a part of those decisions and leadership.

Resources for Shared Governance in Nursing

For those who decide shared governance in nursing could be an improvement to their organization, there are many resources to help.  

Books, blogs, online groups, and support from other nurses who have successfully made the transition to shared leadership are available.   

Designing and building a structure to support shared governance has already been done at many other healthcare facilities by nurses.  

Best practices and case studies of hospitals that have succeeded can give you guidance. Interprofessional collaboration will give you an opportunity to network with other units and staff and can increase your confidence to move forward.  

The Bottom Line

If you’re tired of being treated as just an employee with no say in your own nursing practice, you may be interested in becoming involved in creating or contributing to a shared governance in nursing model at your healthcare facility.  

You don’t have to recreate the wheel, as many other nurses have successfully created a shared governance model at their facility and can guide you through the process to uplevel your own nursing leadership.  

Nurses are no longer just “handmaidens for the doctor” but can oversee our own profession, as it should be.

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