Shared Governance in Nursing: Explained

Shared governance in nursing is a collaborative decision-making model that empowers nurses to take an active role in shaping their practice, policies, and work environment. Rather than relying solely on top down directives, it decentralizes authority giving bedside nurses a voice in clinical and organizational decisions.

Key Principles:

• Accountability: Nurses are responsible for outcomes and quality of care.
• Empowerment: Encourages leadership at all levels, not just management.
• Collaboration: Promotes interdisciplinary teamwork and shared responsibility.

Models:

Several models of shared governance exist, each with distinct structures and approaches:

1. Councilor Model: This model features various councils (e.g., practice councils, quality councils) focusing on specific aspects of nursing practice. Councils are composed of staff nurses and management representatives who collaborate to address practice issues.
2. Unit-Based Model: Emphasizes shared governance at the unit level, where decisions related to unit-specific issues are made collaboratively by the nursing staff and unit leaders.
3. Shared Leadership Model: Integrates leadership roles among nurses, promoting a distributed leadership approach where responsibilities and decision-making are shared across different levels.

Structural Elements:

1. Councils (e.g., Practice, Education, Research)
2. Committees (e.g., Quality, Safety, Staffing)
3. Task Forces (e.g., Policy development)
4. Unit-based councils

Why It Matters

• Improves patient outcomes by leveraging frontline insights into care delivery.
• Boosts nurse engagement and job satisfaction, reducing burnout and turnover.
• Fosters innovation through collective problem-solving and continuous improvement.
• Strengthens professional identity, allowing nurses to lead change rather than just implement it.

Theoretical Perspectives on Shared Governance

Several theoretical perspectives provide a foundation for understanding shared governance:

• Transformational Leadership Theory: Emphasizes the role of leadership in inspiring and motivating nurses to participate in decision-making and achieve organizational goals.
• Participatory Management Theory: Focuses on involving employees in decision-making processes to enhance their commitment and performance.
• Complexity Theory: Highlights the dynamic and interconnected nature of organizational systems, emphasizing the need for adaptive and collaborative approaches.

Steps to Implement Shared Governance

Outline the steps involved in implementing shared governance in a healthcare organization. These steps may include:

• Assessment: Evaluate the current organizational structure and readiness for shared governance.
• Planning: Develop a strategic plan for implementing shared governance, including goals, timelines, and resources.
• Training: Provide training and support to staff members on shared governance principles and practices.
• Execution: Implement shared governance structures and processes, such as councils and committees.
• Evaluation: Monitor and evaluate the effectiveness of shared governance initiatives and make necessary adjustments.

Tools and Metrics for Assessing Shared Governance

Discuss various tools and metrics used to assess the effectiveness of shared governance initiatives, such as:

• Surveys: Use surveys to gather feedback from nurses and other stakeholders about shared governance practices.
• Performance Metrics: Track performance metrics related to patient care, nurse satisfaction, and organizational outcomes.
• Evaluation Reports: Prepare evaluation reports to analyze the impact of shared governance on organizational performance.

REFERENCES

1. McKnight H, Moore SM. Nursing Shared Governance. [Updated 2022 Sep 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK549862/
2. Boswell C, Opton L, Owen DC. Exploring Shared Governance for an Academic Nursing Setting. J Nurs Educ. 2017 Apr 01;56(4):197-203.
3. Dyess SM, Sherman RO, Pratt BA, Chiang-Hanisko L. Growing Nurse Leaders: Their Perspectives on Nursing Leadership and Today’s Practice Environment. Online J Issues Nurs. 2016 Jan 14;21(1):7.
4. Darby Faubion, What is Shared Governance in Nursing? (With Examples, Benefits, & How to Implement), https://www.nursingprocess.org/shared-governance-in-nursing.html

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