Nurses are in general leaders at heart but sometimes they need a model to express the need for shared leadership. Through the use of the shared governance model we as nurse leaders can empower the staff to implement changes, patient excellence, and cost effectiveness in institutions worldwide.
Vision Concepts and Review
The nursing vision to be discussed in this review is shared governance and how we as nurse leaders can use it to empower other nurses. Nursing practice models like shared governance is appealing to nurse leaders because of the benefits that it brings to the nursing profession. Unlike other nursing models shared governance has shown to improve nursing outcomes, improve job contentment and satisfaction, increases personal capacity, and accountability. Implementing change as a group can be dependent on the management leading the group of professionals, shared governance can aid in the managerial response (Upenieks, 2000).
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Evidence
According to Upenieks, (2000) the type of model used did not matter the outcomes were similar. All showed role autonomy and increased job satisfaction with self governance models. Shared governance increase the communication between managemnt and the staff . with further statisical review shared goverance is expected to show many cost-effectiveness and educational influences in a postive flow. It will also diversiify nursing leadership styles (Upenieks, 2000)
Shared governance can be adapted by nurse leaders to and individaual need of any organization. Shared goverance can provide the framework to increase the team work through out the organization and down to the indidual units. The driving force for the shared governance is the postive outcomes. The outcomes that drive the nurses and leaders are: improvement of nurses skills from increased education, creates a positive work envirnment, postitive learning envirnment, staff satisfaction, staff feel valued, creates a team work envirnmnet, promotes multiprofessional collaboration. Some of the projects implemented during shared governance meetings can bring to the institution key core practices to the staff and implemented by nurse leaders. The findings from the suggestions of the core staff caring for the patients have been shown to have great impact on patient care with multiple postive patient outcomes (Scott, 2005).
With Shared governance models can have multiple committess for staff with the use of subcomittees can be valuable use of staff to increase education and effectiveness of the comittees to have a trickle down effect on education or shared information. During these committees nurses are empowered to be nurse researchers and develop beyond there defined role as a nurse and espire to make a difference, to empower each other and make a differnce to the nurseing process as a whole. Evidence of empowerment is overwhelming and the impact to the patients is great and that is what nurse leaders are looking for in a leadership model (Larkin, March 31, 2008).
How Nurses Factor in the Vision
Nurses that are part of an organization the participates in ant shared governance or collaborative model as stated above have many benefits and have a higher sense of self empowerment in their work. Leadership with shared governance models has the benefits of the satisfied staff and the cost effectiveness of the committees.
Nurse leaders can drive the shared governance by having these three basic councils in the model, practice development, education, and human resources. Other subcommittees can be research, quality, practice and policy, with research and devolvement of all the above. With these councils it is not always beneficial to have these committees to be separate but to be collaborative with each other. Leaders can find that founding the committees can have some difficulties with implementation. The potential difficulties can be interpersonal conflicts, time conflicts with the members, committee members that have conflict, members not sharing ideas, questioning of effectiveness of the committee or how much pull the committee actually has with management, delegation of officers, how to involve patient problems, prioritizing projects, will the upper management take the ideas seriously, and how to avoid a meeting that is nothing but a meeting for staff complaints (Scott, 2005).
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An example of how nurses can impact the organization with the use of shared governance models is to bring a problem to the committee and also to use it as a clinical ladder project. A nurse at the local hospital has noticed that the patient population has an increased risk for sleep apnea. She brought this problem to the committee and started doing research with the committee. She involved anesthesia, PACU nurses, and staff nurses. A model was developed that if the patient met certain criteria that they would have an OSA band placed on them and would follow an extra group of precautions for patients that have or are at risk for sleep apnea. This followed the patient from pre-op to discharge. Once OSA precautions were implemented they would receive extra time in pacu and if they were admitted would go to a specific OSA monitored bed that had lower nurse to patient ratios and extra monitoring of oxygen levels. Once the patient would be discharged they would receive follow up education on risks of sleep apnea and suggestions to take to primary care for diagnosis if they were not already diagnosed.
With the described example of shared governance nurse management and leaders worked with the committee and implemented a change for the better care of these patients. Many benefits can be shown and followed with these models.
Conclusion
Shared governance is a tool in the vision in leadership in nursing one that can be highly effective and a high sense of empowerment within all aspects of the nursing process. Nurses that are not in management can become leaders within their profession. Shared governance is a great model for leaders to implement and factors in all types of leadership styles and is beneficial to all units, and all institutions. Leaders can empower there staff by implementing shared governance no matter what model is followed or even if it is followed properly it is still a benefit to all. Leaders need to embrace that staff nurses will have a better work ethic, better patient satisfaction, more safe and effective care, collaboration of staff, and engaging the staff to do what is best for the patient. Using shared governance can also be great cost effectiveness for the institution. Leaders in nursing can literally take things from the bedside and take it directly to the boardroom. Nurse leadership in the organization can empower others and they empower each other and it is a win win situation for the patients, staff, and institution
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