Published Jul 13, 2009
Good day everyone! I'm Mitchelle. A graduate student from the Philippines. I have been assigned to present in my class about "Self governance in the Nursing profession". And for 2 weeks now I have researching about the said topic, but unfortunately I have come up with only a few resources.
To cope up with this, I decided to add in my report a survey (opinions) of nurses regarding self governance in our profession. I kindly ask for everyone's help in this matter. I welcome all opinion no matter how small it may be.
So here are the questions...
1. What do you know about the history of the Nursing profession's struggle for autonomy?
2. How would you compare the hospital organization in the past and in the present in terms of nurses' self governance?
3. What are the hindrances affecting self governance in nursing?
4. How can self governance in nursing be improved?
5. What are the repercussions of self governance of nursing in the practice?
6. What is the current status of Nurse's self governance in your institution? 7. What do you think is the future of self governance in nursing?
Thank you very much! God bless ^_^
Self-governance is a FARCE. If you really want to study it, look for a Magnet hospital, usually it's one of the conditions of becoming a Magnet facility.
The Farce part is that they set up committees of "floor nurses" that are carefully groomed and surveyed by management prior to being put on the committee. Then when the committee comes up with a bright Idea like "we're going to have more nurses for the patients" it gets rejected by management because "we're out of money". BS, you are not out of money! You get money from the state, the fed, non-profit tax breaks etc.... The hospital does not just implement what they decide on, if they ever do decide.
TOTAL FARCE. (But it does sound nice, like most PR stuff)
I work in a Magnet Hospital, and actually we have the policy that everyone HAS to be on a committee, and be active on said committee. Our raises depend upon it. I do agree that many ideas are shot down, but we have actually made some changes where I work. For some ideas on this, look up the Robert Wood Johnson Foundation and Transforming Care at the Bedside (TCAB). We have taken many of those ideas and adapted them to work in our facility. I think we should also keep an eye to the future, as with the state of healthcare in the US, it may force more autonomous practice to help keep cost down. I hope these ideas help you with your project
So you have to be active in commitee's ( giving up your own time for no pay ) or your ( at present ) non existent pay raise will be adversely effected , so that you can come up with recomendations that may be good for staff and patients , but because they cost money , will be shot down .
" it may force more autonomous practice to help keep cost down " shouldn't we be more worried about improving patient care , rather than keeping costs down ? .( Having said that I have nothing against keeping costs down , in principle as long as it does not adversely effect patient care ) .
Sorry , this was not meant to be an attack on anyone , but rather an attack upon the whole mindset of Nurses who act like faux management , with more concern for the bottom line than patient care .
NRSKarenRN, BSN, RN
It would be helpful if you presented your ideas about "Self governance in the Nursing profession", then we could give your our perspetives or experiences
.....instead of this being viewed as just doing someone's school assignment.
herring_RN, ASN, BSN
We had "shared governance", various councils, and were empowered.
When management gives you power they can take it away.
We as nurses have power already.
WE are the only people with the education, experience, and legal authority to carry out the Nursing Process.
Hospitals exist to provide NURSING CARE. We are essential.
Therefore direct care nurses need to control our practice to benefit our patients.
The best managers understand and advocate for nurses.
But all too often they are forced to nurse the budget. Whe most staff nurses document factually how lack of equipment, unsafe staffing, or ineffective policies harm patients AND recommend a solution it helps good manager do their job.
Alas some systems don't want safe effective patient care. They want "excellent" patient satisfaction surveys.
I worked for 5 years at a government hospital with self governance (only on our unit) and we decided our schedule (it was in pencil and would not be printed till all the shifts were filled in by us...so if we wanted to know the schedule, we'd adjust our plugged in shifts). We had unlimited comp time (no ot) to cover for census downtime so we always had staff, never used agency once, no OT and we'd all show up for comp time, surgeries woudl drop off and some of us would go skiing for the day or take the afternoon off if all was well and get stuff done at home.
We made forms, 24 hour open door visiting policy (which resulted in less visits, less complaints) and on and on. It was the absolute best situation and I plan on putting this in place soon as I'm able where I am now.
We even evaluated each other, graded each other, etc. It all worked just fine because the unit council was rotating between reps (who would poll their people before voting). We hired, fired, interviews, approved products...we were the director. Management would only shoot down ideas that were against policy. Because we were 5 reps of 35 staff, not as many volunteered their hour or two a month (more often if interviews were happening, most meetings were voted on so we we could schedule to be on staff that day and get paid).
Eventually we got comp time for meeting so that worked nice on ski days.
We only had a couple openings in 5 years; leaving that job was the stupidest thing I've done in my life.
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