Who do I need to involve in the discussion and at what point?
To implement the shared governance decision-making model, it is required to involve the staff of the unit in the discussion (Marquis & Huston, 2017). It is paramount to involve not only nurse leaders, but staff nurses in the discussion (Fisher, Jabara, Poudrier, Williams, & Wallen, 2016). Staff nurses should be involved in the discussion first so that they would be able to provide feedback about their situation without fearing that their leaders would be dissatisfied with the criticism. Nurse leaders should be involved later so that they could provide their point of view on the situation in question.
How might I determine if the overarching organizational structure supports shared governance?
To determine if the organizational structure (in particular, the organizational culture and subcultures) would support shared governance, it is needed to find out whether employees who are members of different subgroups are willing to share their thoughts on the situation in the hospital, and whether they approve of their leaders and believe that the latter would listen to criticism and take it into account rather than punish the employees for insubordination. This can be done by asking the employees who are lower in the hierarchy to complete anonymous surveys or write their comments anonymously. On the other hand, to determine if external stakeholders will be impacted, it is needed to assess the potential impact of the changes on these stakeholders (Marquis & Huston, 2017). For instance, shared governance will likely help improve patient care, so patients will be positively affected by the changes.
What types of nursing councils might be created to provide a framework for operation?
It is possible to create such nursing councils as Nursing Clinical Practice Council and Staff Nurse Advisory Council (Penn Medicine Princeton Health, n.d.). These councils might be of great benefit to the surgical services department because they would allow for developing the standards of nursing practice and evaluating and enhancing the currently existing procedures (which, in particular, involves the staffing ratios), as well as for facilitating communication between the staff nurses and their leaders (Penn Medicine Princeton Health, n.d.).
Who would be the members of these nursing councils?
As for the Nursing Clinical Practice Council, its members should include mainly staff nurses who would be able to participate in developing the standards of nursing; however, nurse leaders should also be present as members of this council, but they should not have privileged control over the council. As for the Staff Nurse Advisory Council, it should be recommended that only staff nurses need to be included as its members because this council is supposed to communicate their opinion to the supervisors (Penn Medicine Princeton Health, n.d.).
What support mechanisms would need to be in place to ensure the success of this project?
To ensure the success of this project, it is pivotal to implement mechanisms that would allow for making sure that the staff nurses who participate in shared governance are not punished by their superiors for offering criticism of the currently existing system and for providing advice on how to improve it (Marquis & Huston, 2017). It is also pivotal that the decisions of the staff nurse teams and councils are implemented, and that the nurse teams and councils (and not only their superiors) have some resources that they can control and use even if the superiors do not approve. If this is not done, the decisions of the nursing councils will not carry any real weight.
What would be my role as a supervisor in identifying and resolving employee concerns in a shared governance model?
As a supervisor, my role in identifying and resolving employee concerns would be to ensure that the nurses do not fear to speak out and provide their feedback on the existing situation, and, importantly, that the decisions that nurse councils make are indeed implemented. It is also paramount to make sure that the nurses have the chance to provide their feedback and propose their solutions, rather than simply, e.g., discussing agendas proposed by their leaders (Marquis & Huston, 2017).
References
Fisher, C. A., Jabara, J., Poudrier, L., Williams, T., & Wallen, G. R. (2016). Shared governance: The way to staff satisfaction and retention. Nursing Management, 47(11), 14-16.
Marquis, B. L., & Huston, C. J. (2017). Leadership roles and management functions in nursing: Theory and application (9th ed.). Philadelphia, PA: Wolters Kluwer Health.
Penn Medicine Princeton Health. (n.d.). Nursing shared governance. Web.