Nursing leadership shared governance is a collaborative decision-making model that
empowers nurses at all levels to have a voice in their practice, contribute to the
decision-making process, and influence policies that affect their work and patient care.
This approach fosters a sense of ownership, accountability, and professional growth
among nurses, ultimately leading to improved patient outcomes, operational efficiency,
and job satisfaction

Key Elements of Nursing Leadership Shared Governance

  1. Empowerment and Autonomy
  • Nurses are given the authority to make decisions about their practice, fostering a
    sense of ownership and accountability.
  • Encourages nurses to take initiative and make informed decisions that directly
    impact patient care.
  1. Collaborative Decision-Making
  • Involves nurses in key decisions related to clinical practice, protocols/nursing
    standing orders, policies, and procedures.
  • Utilizes committees or councils composed of staff nurses, nurse leaders, and other
    healthcare professionals to ensure diverse perspectives are considered.
  1. Interdisciplinary Collaboration
  • Promotes collaboration between nursing staff, clinicians, and other healthcare
    professionals to improve patient care and streamline processes.
  • Encourages open communication and teamwork across different departments and
  1. Professional Development and Education
  • Supports continuous education and professional development opportunities for
  • Encourages nurses to pursue certifications, attend workshops, and participate in
    ongoing training programs.
  1. Transparency and Communication
  • Ensures open and transparent communication between nursing staff and leadership.
  • Regularly updates staff on decisions, changes in policies, and the outcomes of
    shared governance initiatives.
  1. Evidence-Based Practice
  • Promotes the use of evidence-based practices in nursing care. The core is to
    educate the nursing leaders and staff about what evidence based practice is, and why it
    is important. Many times you also have to educate operations leaders and clinicians as
    well in order to obtain support
  • Encourages nurses to participate in research, quality improvement projects, and the
    implementation of best practices. Once you get their participation it is helpful to educate
    on change management as well. Without the understanding of change, many of the
    best-designed improvements will fail.

Implementation Strategies

  1. Establish a Governance Structure
  • Create councils or committees for different areas of practice (e.g., clinical practice,
    quality improvement, education, and competency, patient safety).
  • Define roles and responsibilities for council members, and agree on a charter for each
    committee, and ensure representation from all nursing levels and for ambulatory care or
    hospital-based outpatient assures that you have representation from a great variety of
    practices and practice settings.
  1. Engage Leadership Support
  • Secure support from nursing leadership and administration to ensure the success of
    shared governance initiatives. Many times this takes extensive conversations,

education and tracking outcome data in the way of patient outcomes, staff satisfaction,
enhanced physician efficiency.

  • Encourage leaders to actively participate in councils and support the decisions made
    by the nursing staff.
  1. Promote Participation and Engagement
  • Encourage all nurses to participate in shared governance activities and decision-
    making processes.
  • Provide opportunities for nurses to contribute their ideas, feedback, and expertise.
  1. Provide Education and Training
  • Offer training programs to educate nurses about the principles and benefits of
    shared governance. We provided ongoing training, but the first meeting of the year was
    devoted to reviewing the charter, conducting education on the topics and process
    involved in that committee. It was met with very positive feedback.
  • Provide resources and support to help nurses develop the skills needed to
    participate effectively.
  1. Evaluate and Adjust
  • Regularly evaluate the effectiveness of shared governance structures and
    processes. We completed an evaluation every year and would make changes to the
    charter, process and structure.
  • Collect feedback from nursing staff and make adjustments as needed to improve
    participation and outcomes.

Benefits of Nursing Leadership Shared Governance

  1. Improved Patient Care
  • Engaging nurses in decision-making leads to more informed and effective clinical
    practices, resulting in better patient outcomes. Our biggest gain here was the true

understanding or nursing practice and evidence based practice. This was a new
concept to many of our ambulatory nurses and nursing leaders.

  1. Increased Job Satisfaction and Retention
  • Empowering nurses to have a voice in their practice enhances job satisfaction,
    professional fulfillment, and retention rates. Having input into their practice, policies,
    protocols, competency gives them a true sense of ownership and growth.
  1. Enhanced Professional Growth
  • Provides opportunities for nurses to develop leadership skills, advance their careers,
    and contribute to the profession. We had so many outcomes that the participants
    outlined including increase comfort in defining nursing practice, presenting information
    to groups, teaching their staff and co-workers, and grow in their own knowledge not only
    about their particular practice, but also learned so much about other practices.
  1. Better Communication and Teamwork
  • Promotes open communication and collaboration among nursing staff and other
    healthcare professionals, improving overall teamwork and efficiency.
  1. Innovation and Continuous Improvement
  • Encourages a culture of continuous improvement, innovation, and evidence-based
    practice in nursing care.

By implementing shared governance in nursing leadership, healthcare organizations
can create an environment where nurses are empowered to influence their practice,
leading to higher quality care, improved patient outcomes, and greater job satisfaction. I
have created this structure in a few organizations and found it to be so gratifying to
everyone that participated and the efficiency, the quality of nursing practice, the
collaboration with our clinician partners, and staff engagement all improved.
Please reach out if you would like support to engage your nursing leaders, clinicians,
and other healthcare professionals in a shared governance structure that will increase
staff engagement, improve care, and help with employee retention.

Reach out today to schedule a quick conversation! We are so excited to work with you.