Shared Governance in Nursing: 5 Best Practices for Facilities
Shared governance in nursing is a type of leadership model that actively involves nurses at all levels in systemwide and policy-level decisions. By facilitating a truly collaborative decision-making structure, nurses and their leaders can cultivate practice-informed quality standards that enhance patient care and outcomes.
Developing shared governance — and nursing engagement by extension — often requires the adjustment of feedback channels, communication pathways, and the staffing structures that accommodate its practical application. Attention to detail matters because a well-designed program can boost job satisfaction, decrease the risk of costly turnover, and optimize the standards of practice that yield better quality indicators.
Use this guide to help manage the change process with essential context, real-world examples, and best practices for successful implementation at your facility.
What Is Shared Governance in Nursing’s Practical Application?
Shared governance enables nurses to actively participate in decision making that shapes unit- or facility-level policies. This generally involves the creation of a council meant to develop (and advise leadership on) practice recommendations. The organizational scope of these nursing shared governance committees is guided by one of four fundamental approaches.
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Unit-Based |
In this type of shared governance, a unit-level council of nurses would work with their manager to address issues impacting care delivery. |
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Councilor |
This model involves regular meetings between different unit-level councils to promote coordination of ideas across departments. |
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Administrative |
Administrative models enable executive-level coordination over the recommendations relayed by unit-based councils. |
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Congressional Level |
In facilities that utilize this model, a collective congressional council is elected to represent all nurses across a facility. |
Shared Governance in Nursing: Examples
To get a better idea of what this decision-making framework looks like in practice, we’ll go over a few examples of shared governance in nursing below.
Example 1: Unit-Based Council
A geriatric department holds monthly council meetings during which six floor nurses meet with the unit manager. The council recommends implementing a fall prevention protocol to address the increasing number of patient falls occurring on the unit. The manager updates the unit’s policies accordingly by requiring use of the Morse Fall Scale during routine assessments.
Example 2: Administrative Council
The chief clinical officer (CCO) meets with nurse representatives from all unit-level councils each month. Council members relay concerns about patient safety due to understaffing. The CCO acts on these issues by mandating a minimum nurse-to-patient ratio across departments and allocating funds for managers to hire more nurses.
What Are the Benefits of Shared Governance?
Shared governance nursing examples like those outlined above highlight the ways this framework can empower and engage clinical staff. Participation in these councils allows frontline nurses to take more control over their practice and contribute their insights and knowledge from the floor.
By advocating for their peers and patients, nurses involved in this leadership structure can directly improve care delivery. When implemented properly, shared governance has also been shown to:
- Reduce the rate of preventable medical errors.
- Improve nurse job satisfaction and retention.
- Lower operational care costs.
5 Best Practices for Promoting Shared Governance
Shared governance is best promoted through strong teamwork, leadership, and communication. Follow these best practices to develop a system that’s beneficial for both you and your staff.
1. Form a Democratic Council
The first step to implementing shared governance is to create a democratic council that regularly meets to elevate the voices of nurses. Set up a system in which nurses can apply and be elected as council members through a staff-wide vote. To promote transparency, ensure council meetings stay open to all staff who wish to attend and remain involved in the council’s planning.
As an additional tip, consider creating incentives to encourage nurses to become council members. This can be done through a clinical ladder program or financial incentives such as a pay raise or bonus for participating nurses.
2. Let Frontline Nurses Take the Wheel
As a nurse leader, it’s important to actively attend council meetings without taking control. While you can help facilitate these meetings, it’s important to let your nurses take the wheel in deciding which shared governance project ideas to prioritize. This will ensure that your nurses feel empowered to make meaningful impacts on quality improvement and communicate their needs without feeling overshadowed by your presence.
3. Incentivize Ongoing Participation
One issue that contributes to poor shared governance is a lack of buy-in from nurses. After working 12-hour shifts, it can be difficult for nurses to feel motivated to participate in council meetings. Additionally, it’s common for nursing councils to lose steam over time. To avoid these motivation-based barriers to shared governance in nursing, consider using one of the example strategies below.
- Schedule meetings on weekends, evenings, or during off-shift days.
- Encourage council members to continuously invite staff to meetings.
- Regularly update staff at all levels about the council’s progress.
4. Act on Recommendations in a Timely Manner
Keeping your nurses engaged also involves ensuring that their efforts aren’t going to waste. The goal of forming a council is to influence management-level changes. Beyond simply attending council meetings, it’s important to act swiftly on any recommendations given to you by the council. To reap the full benefits of shared governance in nursing, stay on top of actions discussed during meetings by:
- Actively tracking and logging all recommendations discussed by the council.
- Incorporating actionable changes into your unit’s budgeting and planning.
- Relaying concerns up the leadership ladder to inform facility-level changes.
5. Keep Your Nurses Informed About Leadership-Level Progress
Open communication is a fundamental pillar of shared governance. Nursing examples (from feedback and staff surveys) often demonstrate their interest in leadership decisions and the rationale that prompted process changes.
This means relaying both good and bad news. If certain nursing recommendations can’t be implemented, communicate this to your teams and explain why. This maintains transparency and avoids misunderstandings among your staff. Conversely, if council-informed changes have led to improvements, share these wins with your staff and celebrate your collective efforts together.
Promote Better Teamwork and Collaboration at Your Facility
Implementing shared governance in nursing takes time and can be costly, but that’s where we come in. Our expert-backed facility guides and healthcare management resources can help you build a stronger, healthier workforce — all at no cost to you.