Shared Governance Leadership: 10 Lessons

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A few years ago, my Chest Pain unit nominated me to represent them on our hospitals newly created Shared Governance Committee, or SGC. We began by talking about topics we would like to work together on with hospital leadership. I must have been more enthusiastic than most, because this committee nominated me to be its chairman. Yet, I quickly realized that I had been duped. Most of the 30 representatives in attendance did not want to help much to get the committee started, much less commit to a role that would require more than what they wanted to give.

In other words, our shared governance committee had a motivation issue. I racked my brain about this for a while, thinking and hoping there were ways I could motivate members of the committee to give more than what they were currently. Now after chairing the SGC for a year, I can say that it has been an invaluable learning experience. I've learned some lessons that I will carry with me for the rest of my life. I started with a list of fifteen big tips and whittled them down to ten. These tips are for those who enter leadership roles within hospital shared governance committees and need to be able to deal with motivation issues while also executing the essential leadership tasks. I hope you find them useful.

1. Find out who the motivated people are as soon as possible.

You will usually have a few more motivated people in the group than what you realize, so begin making these assessments immediately. These individuals may be quieter than the rest at first, or even hang around afterwards to chat about anything related to the SGC. After figuring this out, you will have a much easier time in delegation and task completion, without having to go to the same people for everything over and over. They will make your role two times easier and will happily help, so long as you show true appreciation in return.

2. Be willing to ask for help.

Asking for help from committee members is not considered weakness, but it is if you fail to ask for it. The key to asking for help is to give everyone the reasons for why need their help. I found that more people will be much more cooperative if you are willing to meet them halfway with the realities of the situation, which is sometimes just a lack of hands on deck, time or resources.

3. Hold your fellow nurse officers accountable and meet with them regularly.

Hold your Vice-President accountable. This can be difficult, especially if your relationship is not its finest with this person. The Vice-President should be ensuring that all the assigned subcommittees and projects are coming along in between each SGC session. If you do not have a scribe, request a volunteer from the group to keep up with the notes and speakers for each meeting. You will also need to review and approve with the committee in the beginning of each session a summary of the past session, and you will also need these summaries to reference in future meetings as well. Lastly, try to learn as much as you can about your fellow nurse officers, and use this knowledge to enrich your working relationships.

4. Meet with your leadership mentor.

It is possible you will have anywhere from one to four members of hospital leadership present at each meeting to assist in guidance when requested or needed. They may be unit managers or directors. You will want to hitch yourself onto one of these people. Preferably, you will want to choose the one you deem that is knowledgeable about shared governance, accountable, that listens to you, and is a good people person or leader. Good leaders are typically good communicators as well. If you can find the person who best fits this description, you will find that generating each meeting's agenda will be much easier.

5. Keep track of time and plan ahead.

You have the gavel. You must be steadfast in sticking to the projected time budget for each speaker and topic. You do not want any of the hospital leadership having to tell you that it is time to move on because you are falling behind on the agenda items within the set time frame. Also, it really stinks to not be able to complete your carefully planned agenda list! Also, schedule your guest speakers early and not late in the meetings. They will likely arrive late at times, and you should allow for some flexibility in your agenda to account for this. Make sure to give yourself enough time between meetings to plan, rather than two days beforehand. It takes time to line up speakers to come to these meetings. For example, if the SGC wants the hospital CMO to come to talk about an issue of concern to them, you will need to make sure they will be there for the day you are having your meeting. Also, it is a good idea to send future scheduled speakers a gentle reminder email, one or two days before the event as well. Be sure to get their contact information for this.

6. Be prepared to quell heated discussions.

A caveat to this is to diffuse these only if they are escalating quickly or become non-substantive or personal. There can be utility to conflicts if they are devoid of the personal punches, and the rest of the committee may gain some insight into the problem from these exchanges. Be prepared, however, to get with leadership beforehand and let them know that you plan on being fully intentional with this caveat and what the limits would be, because the last thing you want to do is destroy any group cohesion that can be near impossible rebuild.

7. Establish the committee's most essential function.

Each shared governance counsel will have a communication pathway that allows members to go back and spread the SGC's message to everyone on his or her respective unit while simultaneously collecting feedback from each staff member of that unit. Then, feedback from the floor's staff will funnel back up through the same pathway it came down from. This function is very important, because the SGC represents the nurses' voices. This should be running smoothly and dependably before the SGC begins taking up any major resolutions to pass through the counsel.

8. Keep your big agenda items small.

This can be the biggest derailment of your leadership role on the committee, because it relates to momentum and motivation. Remember that we get pleasure out of attaining worthy, realistic goals. No madder what, you must always begin with small goals, and build your momentum slowly from there. Always keep your agenda realistic. For example, tackling the issue of unsatisfactory bedside reports occurring at shift change due to other contending peak unit demands may not be feasible when considering that it is tied to the much broader complex issue of hospital throughput. You may pass a resolution to present it to leadership, but you may lose any initial backing you had from your hospital's Chief Nursing Officer, thus losing your momentum. This is because the goal was too broad and complex. Instead, chose to work on things that the counsel can either influence directly or create and maintain. For example, if there is a nagging Pyxis or Med-Station issue that could be fixed on the floors, assign two or three people to a subcommittee to begin an inquiry about the problem, and go from there. Or, you could work on a simple and unique employee recognition initiative to point out special behaviors that the committee votes should be rewarded within the hospital. Last but not least, do not try to do too many agenda items at once. You will have to decide what is too much. If you can do these things and stay within some set boundaries, then you will have no problem scoring some early momentum from small victories, which are BIG motivators.

9. Build your political capital outside of SGC meetings.

That's right. I said it. This may feel unnatural but try not to think of it as anything too crazy, because it's not. This is more about being social with those you are involved with inside the SGC meetings, including any leadership that are working with you to get certain items done. So, if you happen to see the lead pharmacist who made a stop by the meeting last month, say hello and something earnest about how much you appreciate their presence at the last meeting, or their initiative in the agenda that you are both working on. This will aid your committee's efforts in the future.

10. Promote group cohesion whenever possible.

Promoting group cohesion will aid in the pursuit of motivating and unifying your members. What can you do to promote group cohesion? At the beginning of every meeting, ask everyone how they are doing. Try to make time for this in the beginning of each meeting or even before starting each meeting, when the feel is less formal. Try to get shy members to share by indulging them in something they might find interesting and try to get members who you have never seen talking to one another to engage in something that links them. This method of self-disclosure allows people to build confidence in one another by risk-taking in small ways, so that as time passes, these connections become more worthwhile if they are nurtured. Also, proposing and having all members agree to no personal attacks or judgment will help cohesion. If members know they will not be attacked for their personal views, then the bond will remain stronger and individuals will be more likely to contribute to the discussion in the room.