Collaboration Decision Making: Through Shared Governance

Function of the Committee

I attended a meeting for the nurse staffing committee in my healthcare facility. The committee is tasked with the responsibility of making recommendations on the nurse staffing plan most suited to promote safe and effective patient care, reduce turn over, and ensure adequate nurse staffing. The purpose of this committee’s meeting was to address a practice that has been used over the years, but had been found to be under-productive. This required reaching a collaborative decision on the most optimal staffing plan. Generally, a work plan is given where the nurses are divided in the different shifts. The common practice is that the day and afternoon shifts have the same number of nurses. However, the night shift has fewer nurses than each of the other two shifts. Additionally, equal numbers of nurses are divided to the different sections. The plan fails to put in consideration that there are sections where nurses are required to see more patients than others. 

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The argument behind the whole practice is that each nurse will have to be placed in each shift, and every department in different time periods through a rotation program. While arguing that the workload is more on certain shifts and departments, they also agree that each nurse will have to go through each phase, just at different times. The committee, therefore, attempts to address the issue by ensuring that the workload for each nurse in whatever shift, is bearable.

Roles of those in attendance

The role of the nurses in the meeting was to verify the number of patients being admitted in the hospital and at what times. They were also supposed to give their reviews on their experiences with the current plan, and give recommendations on the changes they would want in the hospital. I made several observations at the meeting. The head nurse of each department spoke and gave a brief overview of situation in their respective departments. Most of the head nurses agreed that things had changed, and that night shifts were as busy, almost as the day shifts.  Which I agreed because working in male admission, most of our new admit comes at night, and that keeps us busy. They also gave recommendations on the number of nurses most suitable for the different shifts. The administrator presented data on the times the nurses do  their rounds at night  based on the patient observation level while in the day time they go down to the mall for different activities and the nurses do not have much to do. 

  Nurses that was selected to attend  the meeting spoke about their experiences. Most of them pointed out that there were times when they had too much workload. They also said that the number of patient visit was volatile with some days having a few patients to attend to while other days having high number of patients being attended. Few nurses were okay with the practice, but others felt differently. They pointed out on the need of having optimal workload. They said that there are times they didn’t have the motivation to come to work when they remembered they were to be on a busy shift. The nurses discussed amongst themselves their opinions on the changes needed at the hospital.

An analysis was conducted on the number of patients in the different units. They also gave their opinions on the number of nurses who should attend particular shifts in different departments at different times. The nurses came to an agreement on the numbers, and agreed that nurses of distributing the workload amongst the nurses. At the end of the meeting, most of the nurses were content with the recommendations made, and were eager for the implementation of the recommendations. They felt that the new changes would motivate them to work, as they wouldn’t idle around, neither would they be overburdened by their responsibilities.

Evidence of shared governance

At the end of the meeting, it appeared as though all the nurses were in agreement with the recommendations. The agreement shows that the hospital heads could have made the decisions themselves, and communicated the change without involving the nurses. However, the fact that the nurses were asked to their opinions, it is an indication of shared governance. They collected data from several parties, who had would face a direct effect of the conclusions (Cristofoli, Markovic, & Meneguzzo, 2014). The administrator brought data as evidence of the patients seen at different times. It is evidence that their opinions are valued, and that the nurses wanted to work with real data and not speculation.

The heads of a departments, are aware of the problems experienced in their respective departments and could provide quality recommendations based on experience (Cox Sullivan et al., 2017). The departmental heads understand the problems on staffing that they were facing. It, therefore, makes it easier for them to raise their views and their recommendations. The nurses were also given a chance to speak about the problems they face. They are the people most affected by the practices. They can give into detail, their problems, feelings, and recommendations for a better working environment.

Conclusion

There are several advantages of the collaborative decision making through shared governance. The most important thing is that each person gets a chance to speak their minds (Ott, & Ross, 2014). They are able to tell their problems as they are. Due to the hands-on experience, they are able to give recommendations that best solve their problems. Another advantage is that colleagues have a reduced chance of blame game (Siller et al., 2016). When they are represented, they may feel as though those representing them failed to address their problems in the ways that they would have desired. It does not only create a good working environment, but also improves the nurses’ relationships, as well as relationships between the nurses and their departmental heads.

References

Cox Sullivan, S., Norris, M. R., Brown, L. M., & Scott, K. J. (2017). Nurse manager perspective of staff participation in unit level shared governance. Journal of nursing management, 25(8), 624-631.

Cristofoli, D., Markovic, J., & Meneguzzo, M. (2014). Governance, management and performance in public networks: How to be successful in shared-governance networks. Journal of Management & Governance , 18(1), 77-93.

Ott, J., & Ross, C. (2014). The journey toward shared governance: the lived experience of nurse managers and staff nurses. Journal of nursing management , 22(6), 761-768.

Siller, J., Dolansky, M. A., Clavelle, J. T., & Fitzpatrick, J. J. (2016). Shared governance and work engagement in emergency nurses. Journal of Emergency Nursing , 42(4), 325-330.

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