Kear Article Essay

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Spotlight On

Volume 42, Number 6, pp 315-317
Copyright B 2012 Wolters Kluwer Health |
Lippincott Williams & Wilkins

Nursing Shared Governance
Leading a Journey of Excellence
Mavra Kear, PhD, RN
Pamela Duncan, MSN, RN
Janet Fansler, MS, RN
Kathy Hunt, MSN, RN
This article describes how a community hospital engaged nurses through the nursing shared governance model to select a PPM that aligned nursing values and priorities with the organization’s vision and mission.
Nurse satisfaction and nurse retention are positively impacted after the implementation of a professional practice model (PPM).1-3
Adoption of a PPM reflecting the heart and soul of the nursing culture provides a framework for exemplary nursing care defined through transformational leadership, empowered professionals, and collaborative interdisciplinary relationships.4-6 Integrating model components into a strategic plan provides a cohesive framework consistent throughout an organization and focuses on empirical outcomes for patient, provider, and organization. Embedding model compoAuthor Affiliations: Professor (Dr
Kear), Department of Nursing, Polk State
College, Lakeland, Florida; Clinical Nurse
Specialist (Ms Duncan); Chief Operating
Officer and Chief Nurse Executive (Ms
Fansler); Director of Professional Nursing
Practice (Ms Hunt), Lakeland Regional
Medical Center, Lakeland, Florida.
The authors declare no conflict of interest.
Correspondence: Dr Kear, Polk State
College, 3425 Winter Lake Road, Lakeland,
FL 33803 (; mkear@tampabay
DOI: 10.1097/NNA.0b013e318243362a

nents into performance evaluation structure and processes assures that values, beliefs, and intentions are evident in daily work.7

Nursing Shared Governance
Nurse engagement was critical to the success of the initiative focused on identifying a framework that would guide nursing practice at
Lakeland Regional Medical
(LRMC), an 851-bed not-forprofit hospital in Florida. Nursing shared governance was a key component in the process of selection of a PPM. Composed of 8 councils, nursing shared governance at
LRMC provides opportunities to promote the leadership of the direct care nurse through involvement in decisions related to professional nursing practice, patient safety, quality care, nurse satisfaction, work environment, and evidence-based practice. To further strengthen and enhance the shared governance structure, unit-based councils (UBCs) have been established on all clinical units where all staff members work together to provide excellent patient care on a department level.
The nursing shared governance model brings together chairpersons of all governance councils in monthly meetings of the nursing practice council (NPC), which is

attended also by the director of professional nursing practice and the chief nurse executive (CNE).
The NPC and UBCs were integral in the multilevel approach used to select a unifying PPM.
A steering committee was established involving representatives from all levels of nursing, including direct care, management, advanced practice, and administration. The goal of the committee was to clarify nurses’ values and the culture of nursing at LRMC, ensuring that the right PPM was chosen. It was important to committee members that all 1,504 registered nurses
(RNs) had an opportunity to participate in the discovery process.
An electronic survey was created consisting of 4 open-ended questions carefully crafted using broad terms that focused nurses on selfreflection (Figure 1).
The survey used a polling Web site. All nurses received an invitation to participate including an
Internet link to the survey. A welcome page assured respondents of the right to not participate, anonymity, and aggregate reporting.
The link was communicated via e-mail blast, a hyperlink on the hospital intranet, flyers posted on units, and business cards handed out by nursing governance representatives. Personal contact from

JONA  Vol. 42, No. 6  June 2012