Shared Governance in Nursing: 5 Best Practices for Facilities

Shared governance in nursing serves as an important avenue for engaging nurses at all levels to enhance care quality. Through shared decision-making, nurses and their leaders can work together to cultivate a more positive work environment and improve patient outcomes.

But what exactly does shared governance mean, and how can leaders build this concept into their management practices? We’ll discuss the importance of this leadership model and share tips for implementing it at your healthcare facility.

What Is Shared Governance in Nursing?

Shared governance is a leadership model enabling nurses to actively participate in decision-making that shapes unit- or facility-level policies. This generally involves the creation of a nursing council that makes practice recommendations to their leaders. Four common models are typically used in shared governance:

• Unit-based models utilize a unit-level council of nurses who work with their manager to address issues impacting care delivery.
• Councilor models promote coordination of ideas across departments, involving regular meetings between different unit-level councils.
• Administrative models enable executive-level coordination over the recommendations relayed by unit-based councils.
• Congressional level models rely on the formation of a collective congressional council that’s elected to represent all nurses across a facility.

Shared Governance in Nursing: Examples

To get a better idea of what this decision-making framework looks like in practice, we’ll go over a few examples of shared governance in nursing below.

Example 1: Unit-Based Council

A geriatric department holds monthly council meetings in which six floor nurses meet with the unit manager. The council recommends implementing a fall prevention protocol to address the increasing number of patient falls occurring on the unit. The manager updates the unit’s policies accordingly by requiring use of the Morse Fall Scale during routine assessments.

Example 2: Administrative Council

The chief clinical officer (CCO) meets with nurse representatives from all unit-level councils each month. Council members relay concerns about patient safety due to understaffing. The CCO acts on these issues by mandating a minimum nurse-to-patient ratio across departments and allocating funds for managers to hire more nurses.

What Are the Benefits of Shared Governance in Nursing?

Shared governance allows frontline nurses to take more control over their practice and contribute their insights and knowledge from the floor. By empowering nurses to advocate for their peers and patients, this leadership model can serve as an effective avenue for improving care delivery. When implemented properly, shared governance has been shown to:

• Reduce the rate of preventable medical errors
• Improve nurse job satisfaction and retention
• Save units on operational care costs

5 Best Practices for Promoting Shared Governance

Shared governance is best promoted through strong teamwork, leadership, and communication. Follow these best practices to implement a system that’s beneficial for both you and your staff.

1. Form a Democratic Council

The first step to shared governance is creating a democratic council that regularly meets to elevate the voices of nurses. Set up a system in which nurses can apply and be elected as council members through a staff wide vote. To promote transparency, ensure council meetings stay open to all staff who wish to attend and remain involved in the council’s planning.

As an additional tip, consider creating incentives to encourage nurses to become council members. This can be done through a clinical ladder program or financial incentives such as a pay raise or bonus for participating nurses.

2. Let Frontline Nurses Take the Wheel

As a nurse leader, it’s important to actively attend council meetings without taking control. While you can help facilitate these meetings, it’s important to let your nurses take the wheel in discussing recommendations that you can then take to the management level. This will ensure that your nurses feel empowered to communicate their needs without feeling overshadowed by
your presence.

3. Incentivize Ongoing Participation

One issue that contributes to poor shared governance is a lack of buy-in from nurses. After working 12-hour shifts, it can be difficult for nurses to feel motivated to participate in council meetings. Additionally, it’s common for nursing councils to lose steam over time. To help prevent this, follow these tips to incentivize ongoing participation:

• Schedule meetings on weekends, evenings, or during off-shift days
• Encourage council members to continuously invite staff to meetings
• Regularly update staff at all levels about the council’s progress

4. Act on Recommendations in a Timely Manner

Keeping your nurses engaged also involves ensuring that their efforts aren’t going to waste. The goal of forming a council is to influence management-level change. Beyond simply attending council meetings, it’s important to act swiftly on any recommendations given to you by the council. Follow these strategies to stay on top of actions discussed during meetings:

• Actively track and log all recommendations discussed by the council.
• Incorporate actionable changes into your unit’s budgeting and planning.
• Relay concerns up the leadership ladder to inform facility-level changes.

5. Keep Your Nurses Informed About Leadership-Level Progress

Communication is a fundamental pillar of shared governance. As your nurses share their thoughts with you, it’s equally important to keep your nurses in the loop about leadership decisions influenced by their recommendations.

This means relaying both good and bad news. If certain changes can’t be implemented, communicate this to your nurses and explain why. This maintains transparency and avoids misunderstandings among your staff. Conversely, if council-informed changes have led to improvements, share these wins with your staff and celebrate your collective efforts together.

Promote Teamwork and Collaboration at Your Facility

Building and maintaining shared governance in nursing takes time and money — but that’s where we come in. Our nursing experts can provide the timely healthcare resources you need to build a stronger and healthier workforce — without adding to your bottom line.