Engaging Nursing Staff Through Shared Governance

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Two female and a male nurse examining an x-ray photo with a male doctor

Determining how to engage nursing staff has been an ongoing health care issue. Researchers have reported that disengaged staff can impact turnover rates, which increases costs to the institution. One way to improve staff engagement is to introduce the shared governance model. Does your facility have a shared governance model? Here are some reasons to consider it.

A Brief Overview of the Shared Governance Model

The shared governance model isn’t new to the nursing community. Essentially, shared governance is a set of policies and regulations that allows staff to participate in the decision-making process. Instead of putting the responsibility on one member of the group, it is shared among team members. This model has been applied to university boards of directors, as well as to health care facilities, most notably among nursing staff. In short, shared governance means people take accountability for their actions, they participate in decision-making, they research pertinent issues, they respect differences of opinion and they are active participants in the management of their workplace.

How Is Shared Governance Effective and Engaging for Nurses?

Shared governance can allow nurses to take on more responsibility for their practices and thus feel like they have more control and power. When nurses feel more empowered in their workspaces, they are more likely to be engaged and satisfied in their roles, which in turn has a positive effect on patients and the staff as a whole. Researchers have revealed that a shared governance model resulted in improved patient safety and care, increased employee retention and satisfaction, and decreased length of stay.

How to Implement a Shared Governance System

While this system sounds simple, any change can be challenging. Health care administrators and leaders may have difficulty sharing decision-making power, or nurses may have difficulty assuming additional responsibility. Successful implementation of this system includes four elements:

  1. A committed nurse leader who is willing to take the lead in implementing the system and orienting staff.
  2. An effective training model that continues to offer education to employees as they learn the nuances of the system, so they can fully understand and participate.
  3. A leadership or management team that is willing to stay committed to the implementation of the system.
  4. Clear goals for the shared governance system that measures its progress and eventually achieves implementation.

Within these elements, nurses need to hold one another accountable and focus on the task at hand, as well as implement effective, inclusive, open communication.

Heart shape made out of stethoscope tube on a blue nurse coat

Proven Results

Several medical facilities and hospitals have implemented this model, and most have found continued success. Here are a couple examples.

Carolina Medical Center (CMC), a Magnet-dedicated hospital, implemented a shared governance system in 2011. The model was developed by a team of bedside nurses who worked at the facility and were interested in creating a system that focused on joint accountability and unified decision-making. They hoped to create a model that could be used at all of the CMC centers to help facilitate excellent care. The nurses created a system that held nurses accountable, allowed remote staff members to attend meetings through teleconferencing, promoted timeliness by holding meetings with a set agenda of tasks and involved one multidisciplinary team member. Their model was so effective it inspired other medical professionals at CMC to adopt it, most notably the CMC health care technicians (HCTs). Overall, the model was a success. There was a significant increase in staff engagement. Most notably, RN council participation went from 32 percent in 2011 to 52 percent in 2014. HCT participation went from 51 percent in 2012 to 63 percent in 2014.


Penn Presbyterian Medical Center (PPMC) implemented a shared governance system in 2008. The primary focus was on unit-based clinical leadership teams that helped boost patient care, offered advanced certifications to nurses and, like CMC, continually educated staff on the shared governance model. Penn Presbyterian succeeded in patient safety, shared governance, continued staff education and nursing specialization growth. As a result, they were awarded Magnet status.

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