From the staff development bookshelf: Nurses as partners in whole-system shared governance implementation

Staff Development Weekly: Insight on Evidence-Based Practice in Education, March 2, 2012

Nursing's role in whole-systems shared governance is multifaceted, occurring within multiple levels of the organization (i.e., macro-, meso-, and microsystems):

  • Shared governance is a universal process structure or model. It can be applied in any setting. As it emerges in one division, it begins to affect other services, departments, and disciplines who want to participate in decisions that affect their future and roles, and want to be involved to the fullest extent possible as shared decision-making applies to them. That is be expected and anticipated.
  • Other departments and disciplines should be implemented when they are ready. Although nurses generally lead the process change, shared governance will vary in terms of organizational application. When other departments are ready, nursing must be ready to assist, to encourage, and to act as role models, sharing the information and experiences gathered in their own implementation process. Allow the shared governance process model to materialize in the divisions, disciplines, and departments that seek it.
  • Structure corporate and organizational integration into the shared governance process. Nursing support provides an opportunity for the organization to integrate everyone's growth in shared governance. Healthcare can only manage to change strategically if the whole organization joins nursing's efforts and they collectively undertake the necessary structures for change together. Shared governance needs to be incorporated so that it becomes an organizational imperative and continues to grow across the organization.

Many organizations have developed institutional process models (Porter-O'Grady, 1991), where all disciplines and departments have some role in making decisions that affect the direction and the operation of the organization. As individual disciplines do their work, they integrate with this larger process model. All employees play a role in the organization as a whole, participating as part of the organization in the directions, policies, decisions, and objectives that set the organization on a course for its own future. Nursing has an opportunity to lead their respective organizations into that future through shared governance.

Book excerpt adapted from
Shared Governance: A Practical Approach to Transform Professional Nursing Practice by Diana Swihart, PhD, DMin, MSN, CS, RN-BC.

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