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The staff on your unit have become increasingly frustrated with hospital policies regarding staffing ratios, on-call pay, and verbal medical orders but feel that they have limited opportunities for providing feedback to change the current system.

You would like to explore the possibility of moving toward a shared governance model of decision making to resolve this issue and others like it but are not quite sure where to start. Who do you need to involve in this discussion and at what point? Managers and executives are a good place to start the discussion with. They look at the organization, both internally and externally, to make choices. You would also need to involve your nurses and encourage them to tell you their specific concerns. How might you determine if the overarching organizational structure supports shared governance?

You might determine if the overarching organizational structure supports shared governance if the organizational culture is cohesive. Also if there is a willingness to act as a team. Trust needs to be established between the manager and the unit nurses and staff so that she can know exactly how they feel. How would you determine if external stakeholders would be impacted? You would determine if external stakeholders are impacted by How would you determine if organizational culture and subculture would support a shared governance model? What types of nursing councils might be created to provide a framework for peration?

Include what they would be responsible for. Who would be the members on these councils? The members on these councils would include nurses, nurse practitioners and other members that represent different members of the interdisciplinary team What support mechanisms would need to be in place to ensure success of this project? Resources for the staff to greatly improve the skills and care on the unit. You would also consider rewards and incentives. What would be your role as a supervisor in identifying and resolving employee concerns in a shared governance model?

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