Evolution of Structural Empowerment: Moving From Shared to Professional Governance

Measuring Professional Governance: The Swedish Version of the Verran Professional Governance Scale©

OBJECTIVE

To translate the Verran Professional Governance Scale© (VPGS©) into Swedish, adapt it to the Swedish context, and validate it.

BACKGROUND

Magnet®-recognized hospitals have proven successful in reversing negative trends regarding nursing shortage. A change in organizational and management structures is required, and professional governance is fundamental. However, in a Swedish context, there are no validated instruments to measure professional governance.

METHODS

The instrument was translated from English to Swedish and synthesized into a unified version. It was back translated, discussed in an expert panel, and pilot tested with cognitive interviews of nurses.

RESULTS

A new Swedish version of the VPGS© was developed. The expert group reached a consensus, and the scale-level Content Validity Index value shows high relevance. Some words and sentences were revised, and an introduction was added.

CONCLUSIONS

The study generated a Swedish version of the VPGS©, which can be used to measure nurses' perceptions of professional governance behaviors.

A Road Map for the Development of a Decisional Authority Framework for Professional Governance Using Accountability Grids

Although resources are available to guide structures and processes for professional governance, limited information exists about defining and legitimizing the decisional authority needed to support direct care nurses' ownership of clinical practice as well as the role of nursing leaders. This article presents a road map for creating and implementing clinical nurse, nurse leader, and nurse executive accountability grids with clearly delineated authority to provide a decisional authority framework for professional governance in one organization.

What scholarly practice means to respiratory therapists: An interpretive description study

RATIONALE

Engagement in scholarly practice has been associated with professional empowerment, role satisfaction and improvements in care delivery and patient outcomes across many healthcare professions. However, in evolving professions like respiratory therapy, scholarly practice is excluded from competency frameworks, resulting in a gap in education and subsequent application of this competency in practice. An exploration of scholarly practice in respiratory therapy may provide insights into evolving professions that face tensions between meeting competency requirements as outlined in frameworks and providing quality healthcare to the populations they serve.

AIMS AND OBJECTIVES

The aim of the study was to explore what scholarly practice means, and how it manifests in practice from respiratory therapists' (RTs) perspectives.

METHODS

We used interpretive description methodology. We purposively sampled participants to obtain varied perspectives of scholarly practice in respiratory therapy. We conducted 26 semistructured interviews with RTs in different roles (clinicians, educators, researchers, leaders and managers) across Canada and analysed the data using inductive analysis. Data collection and analysis proceeded concurrently.

RESULTS

We developed five main themes: (i) the identity of a scholarly practitioner in RTs; (ii) factors influencing scholarly practice; (iii) one's impression of their professional self-image; (iv) scholarly practice as a vehicle for changing practice and (v) the complex interconnections between knowledges and practices.

CONCLUSION

Scholarly practice appears to be a multifaceted phenomenon encompassing a wide range of activities and skills including conducting research, reflective practice, application of research to practice, and contributing to the advancement of the profession and healthcare. Scholarly practice is influenced by organisational context and culture, available resources, intrinsic motivation and external political context. We identified similarities between professional identity and the description of the scholarly practitioner, suggesting that these two phenomena may be interconnected. Furthermore, participants believed that scholarly practice could enhance the image, credibility, legitimacy and professionalisation of the profession.

Abandoning Blue-Collar Management: Leading Nursing Professionals Into a New Age for Practice

Leading professionals require a different set of skills from those used for most employee work groups. This article reviews the reasons why nursing professionals need different leadership capacity and what some of those changes might be.

Why Shared Decision Making Matters

Shared decision making is a hallmark of Magnet® organizations. Although the terminology can vary, the essence is the same: nurses at all levels, and in all settings, need to be a part of the decision making structure and process. Their voices, along with those of their interprofessional colleagues, ensure a culture of accountability. During times of financial challenges, trimming shared decision making councils may seem an easy place to save money. However, eliminating the councils may lead to increased unintentional costs. This month's Magnet Perspectives takes a closer look at the benefits of shared decision making and its enduring value.

The lens of Yin-Yang philosophy: the influence of paradoxical leadership and emotional intelligence on nurses' organizational identification and turnover intention

PURPOSE

This study aims to use "both-and" thinking of Yin-Yang philosophy to extend the field of leadership literatures and explore the influences of paradoxical leadership and emotional intelligence on organizational identification and turnover intentions of nurses.

DESIGN/METHODOLOGY/APPROACH

The authors adopted a cross-sectional survey completed by 285 nurses in Taiwan. SPSS 22, PROCESS and AMOS 21 were used for data analysis.

FINDINGS

The results reveal that paradoxical leadership has a significant positive relationship with nurses' organizational identification and a significant negatively relationship with their turnover intentions, and organizational identification partially mediated the relationship between paradoxical leadership and turnover intentions. The results further show that emotional intelligence strengthens the effect of paradoxical leadership on organizational identification, and paradoxical leadership had a stronger indirect effect on turnover intentions through organizational identification under strong emotional intelligence.

ORIGINALITY/VALUE

Paradoxical leadership can strengthen managers' abilities in dealing with interrelated and substantial issues and correspond to organizing and belonging paradoxes in holistic thinking processes. Health-care organizations must shape a coordinated institution and offer training initiatives to increase managers' ability and attitude to control organizational rules and procedures while allowing employees' flexibility and autonomy according to the requirements of the situation, which will maintain both organizational short-term benefits and long-term growth.

The predicting effects of professional governance and structural empowerment on job satisfaction among Jordanian nurses: A cross-sectional study

AIM

This study aimed to investigate the role of professional governance and empowerment in predicting nurses' job satisfaction.

BACKGROUND

Nurses can lead the way to enhance health care quality for all if they work in safe, satisfying and empowering environments. Professional governance and structural empowerment are associated with favourable work conditions and environments. However, studies addressing the predicting effects of professional governance and structural empowerment on job satisfaction are still limited.

METHODS

A cross-sectional design was applied. Online self-reported questionnaires were completed by 126 nurses. The analysis consisted of descriptive statistics, Pearson r correlation and hierarchical multiple regression to address the research aim.

RESULTS

Job satisfaction moderately correlated with structural empowerment (r = .40, p < .001) and professional governance (r = .30, p < .001). The final regression model revealed that 30% of the variation in job performance scores can be predicted by professional governance, structural empowerment and some demographic characteristics (R²  = .30, F = 8.67, p < .001).

CONCLUSIONS

Working in an environment that incorporates empowerment conditions, genuine support and valuable opportunities will increase the nurse's job satisfaction. Additionally, nurses will have higher job satisfaction if they have their voices heard.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurse managers should properly assess the existing situation in each institution, implement already-tested-for-effectiveness and efficiency interventions and create new ones based on nurses'-specific needs.

The Verran Professional Governance Scale: Confirmatory and Exploratory Analysis

This article describes psychometric testing and refinement of the Verran Professional Governance Scale (VPGS), which measures behaviors associated with professional governance. Phase 1 reduced the items on the scale based on floor and ceiling effects and redundancy of items. Phase 2 examined structural construct validity using exploratory (EFA) and confirmatory factor analysis (CFA). The final 22-item instrument demonstrates satisfactory internal consistencies and fit indices and significant positive correlation between the VPGS, job satisfaction, and control over nursing practice.

Professional Governance in a Time of Crisis

The global COVID-19 health crisis has significantly altered the structures and processes of healthcare in innumerable unanticipated ways. No profession has been more impacted or challenged than nursing. In many settings, nursing professional governance has been abandoned or neglected. The impact of this trend is outlined in this article. The authors suggest to nurse leaders that nursing professional governance can be an invaluable mechanism for nursing engagement in the midst of managing a crisis.

Diversity, Equity, and Inclusion in Nursing: The Pathway to Excellence Framework Alignment

The promotion of diversity, equity, and inclusion (DEI) in nursing is a topic of renewed importance, given the civil unrest following the death of George Floyd and identified disparities in health and health outcomes during the COVID-19 pandemic. Despite its progress, the nursing profession continues to struggle with recruiting and retaining a workforce that represents the cultural diversity of the patient population. The authors completed a review of the literature on DEI in nursing and found a scarcity of studies, and that a limitation exists due to the strength of the evidence examined. This article aims to provide a review of the literature on DEI in nursing, outcomes and strategies associated with organizational DEI efforts, and knowledge on how the American Nurses Credentialing Center Pathway to Excellence® Designation Program framework supports DEI initiatives. The authors further provided recommendations for nurse leaders and a checklist of proposed questions for assessing commitment, culture, and structural empowerment initiatives toward a more diverse, equitable, and inclusive organization.

Transforming Shared Governance: Toward Professional Governance for Nursing

For more than 40 years, shared governance has supported structural empowerment and engaged nurses in their practice. Although progress has been made in advancing nursing ownership of practice through shared governance, mature nursing autonomy has yet to be achieved. It is time to evolve to professional governance, emphasizing accountability, professional obligation, collateral relationships, and decision making. Nurse leaders are provided with historical context and recommendations for effectively leading professional governance in an empowering work culture.

Leveraging Professional Governance During the COVID-19 Pandemic

Dynamic nursing leadership and engagement of nursing at all levels are critical to effective care delivery. During the COVID-19 crisis, many organizations suspended non-COVID-related meetings, including professional governance councils where practice decisions are made. This article highlights how shared or professional governance was leveraged during this global pandemic at a large academic medical center and community hospital effectively sustaining autonomous nursing practice while responding to a rapidly changing environment and impacting quality patient care.

Professional Governance Scale: Instrument Development and Content Validity Testing

Instrument development and content validity testing resulted in a new instrument to measure the relatively new concept of professional governance. Professional governance is defined as the accountability, professional obligation, collateral relationships and decision making of a professional, foundational to autonomous practice and achievement of exemplary empirical outcomes. Fourteen experts with subject matter expertise either in measurement development or in creating professional practice environments assessed the validity of the proposed items and the instrument. The resulting Professional Governance Scale consisted of 75 items that adequately covered all attributes and their characteristics and had a Relevancy Mean Individual Content Validity Index of 95.

"It breaks your soul": An in-depth exploration of workplace injustice in nursing

AIM(S)

To understand nurses' experiences of injustice in the workplace and to identify the impact of injustice on well-being.

BACKGROUND

Little is known about how nurses view injustice or its effects on their well-being, although research indicates that such perceptions are central to workplace practices such as performance management and outcomes such as employee well-being.

METHOD(S)

A qualitative study was conducted with semi-structured interviews for nurses employed in Australian public hospitals. Data were analysed using content analysis.

RESULTS

Experiences of injustice and unfairness negatively impacted on performance and the personal health of nurses. Unfair treatment was met with reduced effort and commitment.

CONCLUSION(S)

This study provides valuable insights into how nurses perceive and experience injustice at work and supports the link between injustice and nurses' decreased well-being and effectiveness.

IMPLICATIONS FOR NURSING MANAGEMENT

Implications for nurse managers include the need for managers to engage in regular conversations regarding systemic barriers to performance and implementing performance management as an ongoing dialogue designed for employee voice and relationship management. This process also suggests a need for leadership development in nursing management. Using such steps and strategies would significantly enhance best practice in nursing management.

Leading DNP Professionals: Practice Competencies for Organizational Excellence and Advancement

The doctorate in nursing practice (DNP) role is quickly emerging across the United States in numerous practice settings, especially in hospitals, outpatient services, and academic institutions. There is now a need for guidelines to evaluate the enactment of the standards used to create DNP education and practice, competencies expected in practice, and the outcomes and value created by this role. This article presents a DNP Performance Demonstration and Impact template created on the basis of the AACN (American Association of Colleges of Nursing), NONPF (National Organization of Nurse Practitioner Faculties), and AONE (American Organization of Nurse Executives) standards to assist leaders in evaluating DNP performance from a standards-driven perspective.