Shared Governance and Retention

The main argument against the practice of delegating nursing responsibilities is that organizational structures often fail to ensure that the people receiving the delegated responsibilities are qualified to accept the delegation. Resha (2010) discussed this to some extent, but believed that the practice on the whole was worthy. However, it could be argued that by its very nature, delegation creates a discrepancy between the person performing a nursing action and the person responsible for that action. This could have negative consequences on quality of care, because if a nurse isn 't responsible for her own actions, then she may perform her role less effectively than she would if she had to take responsibility for her performance. As Reising and Allen (2007) write, delegation may be encouraged as a way to decrease costs and deal with low staffing levels, but it can also put the organization at increased risk for law suits if carried out improperly. Both aspects of this warning are instructive. First, Reising and Allen seem to suggest that delegation primarily emerges as a result of practical considerations

Caramanica, L. (2004). Shared Governance: Hartford Hospital’s Experience. The Online Journal of Issues in Nursing, Vol. 9. Retrieved from http://www.nursingworld.org/mainmenucatefories/ANAmarketplace/ANAperiodicals/OJIN/tableofcontents/volume92004/No1Jan04/HartfordHospitalsExperience.aspx

One mistake that new nurse leaders make is that they believe that the only way to get things accomplished, is to be direct and autocratic (Kerfoot, 2008.) The new leader’s fear of failing can influence them to take on the autocratic role to try and earn respect from their employees. However, this is not considered to be very effective among staff. When the professional nurse takes on the autocratic leadership trait and uses it on a daily basis, employees feel micromanaged. When a manager micromanages their employees they take the risk of lowering morale, and losing good workers (North, 2011.) Nurses have a lot of autonomy in their profession. They work independently and take responsibility for their actions. When they become micromanaged by their nurse leader, it takes away that autonomy and creates a work environment that is very low in morale, and can hurt the relationship between manager and employee. Often managers are experiencing a substantial amount of stress from the administration concerning budgets, deadlines, and high performance issues, but this does not justify micromanaging employees (North, 2011.) It is important to give your staff some independence; this lets them know you trust their judgment (North, 2011.) A nurse leader may also change their leadership style depending on if they are dealing with an inexperienced new graduate nurse, or an experienced veteran nurse.

Nurses should be full partners, with physicians and other health professionals, in regarding health care in the United States(Institute of Medicine, 2011).Nurses should be full partners because who knows nursing and what nurses need better than a nurses themselves? In care environments, being a full partner involves taking responsibility for identifying problems and areas of waste, devising and implementing a plan for improvement, tracking improvement over time, and making necessary adjustments to realize established goals (Institute of Medicine, 2011).The expense of certain supplies and equipment could be decreased over time if nurses had more say in their environment and resources. On many floors in hospitals, certain supplies are not needed

Nurses are crucial in providing quality care in the health care industry. It is imperative to maintain the proper staffing ratio to ensure that nurses can maintain high quality care for their patients. Studies have shown that the increasing workload of nurses can be linked to increased patient deaths, medical errors, hospital-acquired infections, longer hospital stays, and many other complications. (National Nurses United n.d. ) Leaders and managers play a vital role in developing

The four major components of nursing leadership are decision-making ability, influencing and directing others, facilitating process and relationship building (Paul, Day, & Williams, 2016).Very closely associated with leadership is the concept of management and though many people use the two terms interchangeably, it’s very important to know that leading is one of the key functions of management; the others are planning, organizing and controlling activities to pursue

Shared governance is defined as a professional practice model, inspired by the ideology of equity, partnership, accountability and ownership that will assist in the formation of a work structure that will allow sustainable and responsible decisions by an interdisciplinary plan to excel in patient care (Vanderbilt University Medical Center. (2013). Allowing this type of affiliation promotes collaboration, collective decision making and responsibility for quality of care of patients. Instead of having practices completely controlled by senior executives, shared governance permits nurses to have more power and be more independent in their field (Crow & French, 2015). Shared governance allows nurses to plan, make decisions and take actions with

The work of Green and Jordan (2004) reports that the future of health care is dependent upon the identification of "strategies that provide support for nurses as they take on the challenges of the new century." (p.1) Shared governance is reported as a strategy that has been effective in enabling autonomy and supporting the nurse in possessing more control over their nursing practice. More recently, a strategy has been devised that is effective at local, state and national level and that strategy involves advocacy in the workplace. Workplace advocacy is a principle constructed upon the "common denominators found in shared governance…" (Green and Jordan, 2004, p.1) The challenges faced by the professional nurse are inclusive of "long history of struggling to deliver patient care against multiple barriers, including dwindling resources." (Green and Jordan, 2004, p.1) It is reported that this struggle "his struggle affects not only individual nurses, but also patients, organizations, and the nursing profession. Nurses' strong

Finkelman, A. (2012). Leadership and management for nurses: Core competencies for quality care (2nd ed.). Boston, MA:

Buy-in is very difficult in nursing today because of all the changes required in response to internal and external threats and opportunities. As we know if our nurses are a part of the decision making when creating the change, they are more likely to support the change. This will in turn lead to successful and sustainable outcomes. This is not easy to do even in a culture of shared governance which allows our nurses to have greater control and autonomy over their practice. Our facility promotes a culture of shared governance but unfortunately some nurses are satisfied with sitting back and playing a passive role. This makes it very difficult. Achieving buy-in does require time, accurate and credible communication and an understanding of what

As an employee at Houston Methodist Willowbrook, I actively participated in the unit-based shared governance. Now at CHI Baylor St. Luke's Health I am part of the hospital-wide Staff Nurse Professional Practice Council. There I am able to give input on new policies, practices, and represent individual unit representation. I also helped re-establish shared governance in our unit and serve as a mentor for individual committees.

A roll out date with ‘super users’ available to troubleshoot and maintain staff productivity and compliance would be beneficial. The last aspect of strategic management is evaluating the effectiveness of strategies used. Huber (2014), describes “analysis needs to review four areas: strengths, weaknesses, opportunities, and threats (SWOT)” (p. 334). Through prioritization, the threats are avoided, weakness are lessened and strengths are empowered to increase patient safety with medication administration, by insuring patients receive “the right drug at the right time to the right patient” (Weston & Roberts, 2013. para. 11). Most importunately, applying shared governance or allowing decision making amongst the staff, allows leaders to inforce equality in the nursing workforce. Shared governance is an important current focus in nursing practice, as the desire for increased autonomy and accountability is encouraged with voicing of nursing opinions to assist in better quality healthcare. Huber (2014) mentions that shared governance “is a partnership between management and clinical staff. Research suggests that registered nurses who are empowered to make decisions through shared governance have higher nurse autonomy and increased confidence in decision making “ (p. 249). As discussed, positive personality qualities, use of strategic management and including the partnership of shared governance all directly facilitates a leader or mangers

Turnover in nursing healthcare is a major issue impacting the performance and profitability of healthcare organizations. These organizations require a stable highly trained and fully engaged nursing staff to provide effective levels of patient care. The above mentioned topic is meaningful in any leadership/management organization because of the financial cost of losing a single nurse which has been calculated to equal about twice the nurse’s annual salary .Losing these critical employees, negatively impacts healthcare organizations in a variety of ways including decreased quality of patient care, increased contingent staff costs, loss of patients and increased nurse and medical staff turnover.

Although it is related to the term, its definition differs in a sense that mutual authority does not aim to overshadow the ascendancy needed in addressing hierarchy of command in the environment of the ED. Mutual authority then is to be defined as the ED nurses’ capability to act independently from command in managing a given situation. This is with respect

In regards to Health Care Organizations, I focused on the western medical culture, more specifically the management of nurses in U.S hospitals. I have sustained a passion about nursing for the majority of my life and as years have passed, I always thought that nurses had sole responsibility for their workload and the success of their medical unit. After close research, it has come to my attention that managers have a significant influence on the quality of service that a nurse provides during a work shift and the success of their organization.