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How can I explain shared governance to direct-care nurses?


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Direct-care nurses can be suspicious of shared governance if they do not understand what it is. Tell your nurses that developing a shared governance structure can empower direct care nurses to make decisions about their practice and take more responsibility. It has been shown to increase retention and employee satisfaction, improve safety and patient satisfaction, reduce lengths of stay, and result in a more robust bottom line.

Every nurse wants to work in an organization that has a healthy work environment, where team members work collaboratively and collegially, and where nurses make decisions about the way nursing care is practiced, delivered, and measured for continuous improvement.

Ensuring such an environment is simpler if organizations adopt a formal shared governance structure that empowers direct care nurses-and other healthcare workers-to be involved in decision making around patient care in all practice settings.

The model of shared governance engages shared decision-making to result in shared leadership based on the principles of partnership, equity, accountability, and ownership at the point of service. This infrastructure can provide safe, effective, and efficient patient care necessary to facilitate nursing excellence at all levels of practice.

Developing a shared governance structure can empower direct care nurses to make decisions about their practice rather than following those handed down or mandated from above. It brings nurses back into alignment with their interprofessional partners, physicians, and pharmacists, and also promotes safer, more effective patient care.

-- Diana Swihart, PhD, DMin, MSN, CS, RN-BC


(June 2011)