Shared Governance Elevates Clinical Nurse Voices

Published in Sibley Memorial Hospital Nursing Annual Report - Fiscal Year 2020

Nurses are experts at knowing the needs of the patients they care for every day. In the last year, Sibley nursing leadership has worked to strengthen the structure and function of nursing councils in the hospital, emphasizing the importance of the perspective of clinical nurses by appointing them as council chairs and seeking their insight on nursing priorities.

“It is so important that a clinical nurse serves as a chair of a council because we have our finger on the pulse of what is going on in nursing practice,” says Lisa Kirk, an orthopaedic nurse who serves as chair of the Clinical Practice Council. “We can use our experiences to make positive change within our committees and bring issues we see in practice to the councils to make a difference for patients.”

The work of elevating the voices of clinical nurses started as the discussion about the council structure began. After an honest conversation with nurse leaders about what was working and what wasn’t, nursing leadership held a retreat for nurses to brainstorm alternative council structures and ways to enhance cross-council cooperation.

Interestingly, although brainstorming teams were randomly assigned, each group came up with a similar framework of necessary councils. The council list was based on lessons learned from other organizations, including other hospitals in the Johns Hopkins Medicine system.

The new Sibley nursing shared governance structure includes councils that focus on six areas:

  • Quality
  • Evidence-based Practice and Research
  • Night Shift
  • Clinical Practice
  • Professional Development and Education
  • Nurse Practitioners and Advanced Care Providers

Each council is chaired by a clinical nurse provider with interest and experience in that area. The chair participates in a coordinating council that works directly with the chief nursing officer and nurse leadership to determine workflow and priorities.

Kristin Winston, a labor and delivery nurse who just finished her term as chair of the Night Shift Council, says serving as the voice for an often overlooked group like night shift has been extremely rewarding. “It’s critical to have a clinical nurse with night shift experience as chair of this council. Most of the clinical nurses on night shift have similar concerns and having that awareness as chair helped me relate to issues brought to the council and better support staff.”

The shared governance structure also has an added bonus for the council chairs and clinical council members—it gives the nurses firsthand leadership experience beyond their own bedside units and introduces a set of new concepts that will help them become better day-to-day leaders on their units. That knowledge also sets the stage for understanding the processes and challenges hospitals face every day when it is time to make key decisions for patients, nurses and the rest of the hospital staff.

“I have learned a lot,” says Kirk. “I have learned how to lead a meeting and how to bring the conversation back to the main point. I’ve also learned so much about the process of reviewing and renewing our hospital’s policies and procedures. Every meeting I learn more about our different units and ways we can unify the way we practice.”

Ultimately, bringing clinical nurses to the forefront of nursing governance makes the participants better nurse leaders and care providers at the bedside today, and is the first step to encouraging them to become tomorrow’s nurse managers, directors and chief nursing officers.