Nursing is a profession which is driven to positively affect the outcomes of patients and the healthcare industry through quality improvement, evidence-based practice, research, and innovation. Our profession is guided by standards of practice and a code of ethics rooted in the principles of compassion, collaboration, and critical thinking. As with other professions, nurses have the authority, accountability, and autonomy over nursing practice. In fact, in all 50 states, the law prohibits any member outside of the licensed profession of nursing to control nursing practice (Porter-O’Grady, 2019).
One litmus test for nursing authority, accountability, and autonomy within a healthcare organization is shared-governance. Nursing shared-governance is the mechanism by which the organization supports and promotes decision-making by the nurses who ultimately operationalize the outcome of the decision (Guanci, 2018). It is the embodiment of the philosophy that nurses have the autonomy and accountability to make decisions about nursing practice and the care delivered to the patients they serve. The design of a shared-governance council promotes a multidirectional flow of information between direct care nurses, leadership, interprofessional teams, and the Chief Nursing Officer. While decision-making is entrusted to those in direct care roles, shared-governance draws its strength from the guidance of transformational leaders who support the decision-making process by communicating the parameters and constraints of the situation and moving forward with the decision made by the council. To use a naval analogy, nurses steer the ship while leadership charts the path. Shared-governance is a core tenant of nursing excellence and is vital to the success of organizations’ achievements in high-quality care, excellent patient satisfaction, and increased nurse engagement.
UAMS shared-governance councils include unit-based and organizational councils. Unit or clinic based councils discuss unit/clinic specific issues or concerns related to specific patient populations. Organizational shared-governance councils include the inpatient and ambulatory nursing councils, with newly elected council chairs, Carol Brizzolara, BSN, CCRN, RNIV, H4, and Brenda Willett, BSN, RN, Paracentesis Clinic, respectively. Representatives from all units, areas, or service lines attend the council meeting monthly to discuss equipment and supply issues, quality initiatives, and concerns at the unit/clinic level. We are pleased to recognize and celebrate the work of UAMS nurse practitioners, certified nurse midwives, and certified registered nurse anesthetists in the formation of the first ever, APRN council at UAMS. A passionate desire to be involved in the decisions that affect their practice and profession led Crystal Marcussen, APRN, WHNP-BC, and Tesa Ivey, APRN, WHNP-BC, to work together with the Center for Nursing Excellence to establish the APRN council. For more information, Crystal’s article on page.
Your voice and engagement are imperative to achieving the mission of UAMS and advancing the profession of nursing. If you want to get involved in or understand more about nursing shared-governance at UAMS, please email CenterforNursingExcellence@uams.edu.
Gaunci, G. (2018, December 12). Shared governance: What it is and is not. Association for Nursing Professional Development. https://www.anpd.org/blog/shared-governance-what-it-is-and-is-not
Porter-O’Grady, T. (2019) Principles for sustaining shared/professional governance in nursing. Nursing Management, 50(1), 36-41. doi: 10.1097/01.NUMA.0000550448.17375.28