Nursing

History and development of shared governance

Nurse Leader Insider, November 11, 2019

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The concepts of shared governance and shared decision-making are not new ones. Philosophy, education, religion, politics, business and management, and healthcare have all benefited from a variety of shared governance process models implemented in many diverse and creative ways across generations and cultures:

  • Socrates (470-399 BC), an ancient Greek philosopher, integrated shared governance concepts into his philosophies of education. The Socratic Method (answering a question with a question) calls for the teacher to facilitate the student's autonomous learning as the teacher guides him or her through a series of questions. The Socratic Method encourages students to use reason rather than appeal to authority.
  • The government model for the United States was established on the concepts of shared governance-"of the people, by the people, for the people" (from Lincoln's Gettysburg Address, 1863)-wherein the very citizenry is directly responsible for the government on both state and federal levels. Political variations of this model of shared governance can also be seen in the European Union and the United Nations, where individual countries share in the decision-making on joint international matters.
  • Eventually, shared governance found its way into the business and management literature. Organizations began to design formal structures and relationships around their leaders and employees. Positive outcomes emphasized movement from point of service outward. This differed from the more traditional, hierarchical method of moving from the organization downward approach previously used.
  • In the late 1970s and early 1980s, shared governance found its way into the healthcare and nursing arenas as a form of participative management. It engaged self-managed work teams and grew out of the dissatisfaction nurses were experiencing with the institutions in which they practiced.


Source: Book excerpt adapted from
Shared Governance: A Practical Approach to Transforming Professional Nursing Practice, Second Edition, by Diana Swihart, PdD, DMin, MSN, CS, APRN,BC. For more information about the fourth edition of this book, click here.

Looking for more information about shared goverenance? See this free downloadable tool.



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