Few can understand the moment-to-moment needs of hospital patients as well as the nurses who care for them. It makes sense, then, that nurses play a key role in the important policies, procedures and decisions that influence how patients are treated.
Under City of Hope’s new shared governance design structure, nurses are coming together to make their voices heard on issues including safety, quality of care, education and research, and the institution’s leaders are listening. Shared governance stands as a critical component in City of Hope’s ongoing quest to gain accreditation with the American Nurses Credentialing Center as a Magnet nursing hospital, a designation recognizing excellence in patient care through nursing services.
“Shared governance will help us achieve excellence because it will allow nurses to influence and adapt clinical practice policies and procedures for the best care of patients within different areas of City of Hope,” said Larry Kidd, R.N., vice president of patient care services and chief nurse executive. “When we listen to good ideas and trust our nurses’ experience, we also create a positive environment that allows us to retain our valuable staff.
“Along with our goal to be the best provider of patient care, we are striving to be the best employer for nurses.”
Under the shared governance model, staff nurses exert control over their practice and can participate at a level that would otherwise lie beyond their grasp. A national movement stretching back some 25 years, shared governance recently has resurged in the nursing world, allowing — and even expecting — nurses to step up to make informed recommendations on policy and clinical practice.
City of Hope nursing leaders created their version of shared governance after examining similar structures at several small and large hospitals. Nurses also were inspired by Katie Skelton, R.N., M.S.N., vice president of patient care services at St. Joseph’s Hospital in Orange, Calif., who spoke at City of Hope on Oct. 4. St. Joseph’s operates under a shared governance design structure.
At its simplest, shared governance entails that bedside nurses meet through representational councils to discuss and agree on critical issues.
The inpatient and clinic areas of the Medical Center, from Unit A to the Surgical Clinic, send a nursing representative to sit on each of the councils. The councils, which are now being formed, consist of about 14 members.
The first of four councils, the Clinical Nurse Practice Council, recently held its second meeting. The council will discuss and provide recommendations on issues such as pain management protocols, explained Lisa Huntsinger, R.N., of the Intensive Care Unit (ICU), who chairs the council with Regina Buchanan, R.N., B.S.N., clinical director of the ICU and Evaluation and Treatment Center, as advisory co-chair.
Representatives from other areas, such as pharmacy, safety and occupational health, clinical supportive care and education, have attended the clinical nurse practice meeting, and the council will continue working with other departments throughout the institution.
The three other nursing councils to follow will address issues including quality, leadership and education and research.
Many nurses have been eager to serve, volunteering during their non-work hours to improve Medical Center services. Clinical Nurse Practice Council members are encouraging more to come forward, and soliciting their ideas through suggestion boxes or talks during staff meetings.
“It is so exciting to see such a knowledgeable and enthusiastic group of R.N.s working together to continue to look at the best practices for our patients, utilizing evidence-based practice,” Buchanan said.
The Clinical Nurse Practice Council meets the second and fourth Friday of each month from 9:30 to 11:30 a.m. in Conference Room C.