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Shared Governance in the Healthcare Sector: Pros and Cons

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“In spite of the failure of shared governance to “take” at some hospitals, and its demise at others as fallout from takeovers, makeovers, participation fatigue of administrators, and staff nurses weary of meetings, there’s hardly a bad note among true believers.” (Hess, 2014.) Nursing shared governance is a very useful resource and tool in the Healthcare environment. Not only does shared governance and the nursing council model empower the nurses of an organization, but it also enables work to flow properly, and decisions to be made proactively. This paper will discuss the organizational structure of nursing shared governance.

The way in which nursing shared governance is structured is very important. There are various councils that have a sole purpose and are centered on the needs of the hospital or company in which they work. For illustrative purposes, we will name five unit councils. There can be as many or as few councils as meet the needs of any organization. The various councils as displayed in the figure below are “Practice”, “Quality,” “Education,” “Management,” and “Coordinating”. The central operations council is where all the ideas, issues and information come together so that it can be dispersed to all the people affected, and issues can be addressed.

Unit councils are able to make decisions at their unit level, and they are part of the other shared governance councils. The issues addressed by the various councils will be issues that directly pertain to their expertise and designation. For instance, the need for continuing education and training would be addressed by the Education unit or committee. The coordinating of schedules or activities may be taken on by the coordinating committee, although it would ideally also have input from the management committee. The committees are able to work independently, but are also able to coordinate with the other committees with all information and decisions being issued to the operations council. “Shared governance is an organizational model through which nurses control their practice as well as influence administrative areas.” (Hess, 2014.)

The councils operate much like the Government in that they have specific committees or councils that determine and work on specific processes. The nurses take their concerns, or questions to a specific committee and are also given the opportunity to serve on designated committees. It is essentially a system by the nurses for the nurses. Final approvals are made at a senior staff or management level. The chair and Co-chair have final say within the councils. Depending on the issue a staff member has, they can go to the committee or council that the said issue falls under. Shared governance is an excellent way to boost morale and productivity. Not only are the nurses better able to voice their concerns, but they also have a say in how their designated departments are run, and how they practice their skill sets and care.

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