shared governance

Is "shared governance" another term for team nursing?

It's the use of staff nurses via committee to make decisions on how nurses do their jobs in your facility. Supposedly, the committees (education, professional practice, quality) handle problems proposed by the bedside nurse. At least that's how I think it works. I need more info.

I will give you some advice, and that is it will only work if you get a lot of support from management and the higher-ups. The bedside nurses get extremely frustrated putting their time and effort into something to have it go no where.

I think the best way to start would be divide it by floors/units not practices (education, skills, etc). At least on a floor level the bedside nurses can usually identify the problems their floor has and propose their own solutions. However bringing everyone together from different units together to try to work on something, for example how to manage NGTubes, some units may have tons of input if its something they do frequently, others may have very little/no buy-in, and the end result may be divided.

We have started this same thing a few months ago. I am in support of it but have not seen changes. There have been a few snags that have encouraged nurses not to be involved. Nurses do not want to be apart of it because no one believes it will amount to anything.

Sounds good in theory and so far that is it.

This is being mandated by admin. so I guess they will support it. I am a bedside nurse so I absolutely understand the mistrust of anything new admin. wants to try and I will say this is the 3rd attempt in my 29yrs at this hospital, to implement sg. I'm trying to be more positive and would be very happy if we could make this work. I've always had a problem with people who don't do my job telling me how to do my job. That being said, any ideas on how to start? Admin has already chosen to have 3 committees to represent quality, education, and professional practice with suggestions for each about what we cover. I just don't understand how you go from the ideas to actually doing it so anyone who can help, I would be most appreciative. Thanks for the comments.

so how did you guys start? what types of things have you tried? what worked and what didn't?

When it was first started, my manager sent out invites in the mail, made personal calls to invite all the nurses to boost initial attendance. I have only attended one meeting and suggested a change. So far my suggestion is the only one I know of.

Of the first meeting I attended, I felt too much time was spent trying to figure out why no one (especially noc shift) did not want to attend. I have a feeling it will fizzle if there is too much talk. Especially if the talk is of other topics besides changes for the better.

Shared Governance has been around for more than 30 years and more often than not, it fails. There are some programs that have lasted for many, many years. The characteristic common to the ones that survive is that the committees are truly driven by staff Nurses, not the administration. You need administration's cooperation, but if the committees just become puppet governments for the administration then it will never gain the respect of the floor staff and will fail.

Work with the administration but control your own agenda and be assertive.

Nursing voted for the people we wanted on the committees, then admin. chose the chair and co-chair. These got together and chose the people we wanted in the individual groups. We tried to choose a representative group to cover all the units. That's as far as we've gotten. We have another mtg next week where we are supposed to come up with objectives that support the hospital mission statement (guess I'll need to look that up:o) I guess I'm just lost about what happens after that.

Our hospital is about 3 years into shared governance and we are just starting to roll our interventions. We started with quality, professional practice and 3 Rs(recruitment, retention and recognition).

The initial committees drew up bylaws and set up a schedule, maybe your management has already done this for you. Each committee meets once a month, for an 8 hour period. A CNS facilitates each committee meeting.

The quality committee sets goals based on NDNQI indicators like falls, pressure ulcers, CAUTI.

They developed protocols on skin care, falls, and removing foleys within 48 hours of insertion. They have rolled them out and are collecting data on compliance and effectiveness.

The 3Rs have put on a banquet and brought in speakers for Nurses's week. They have a yearly tea for nurses with significant work anniversaries (5, 10, 20 years etc). This last year they created awards recognizing nursing staff in 4 categories:leadership, advocacy, rising star, and legacy.

Professional practice has reviewed and updated our hospitals standards of care for compliance with state and national standards. They review critical incidents/near misses involving nurses to see if it could have been avoided.

Hope this helps!