Shared governance: a children's hospital journey to clinical nursing excellence

Global Oncology Nursing Recruitment and Retention: A SWOT Analysis

OBJECTIVES

This article documents the current status of global recruitment and retention of oncology nurses. A strengths, weaknesses, opportunities, and threats model was used to identify internal-to-nursing recruitment and retention factors/influences and external opportunities and threats as well as strategies and initiatives to improve the current situation.

DATA SOURCES

Data sources include published and grey literature from around the world.

CONCLUSION

Despite the increasing cancer burden threatening public health worldwide, recruitment and retention of oncology nurses remains challenging. Nursing strengths include action by oncology nursing associations, prelicensure nurse recruitment and preceptorships, and models of hospital shared governance. Nursing weaknesses include nurse bullying, practice models that curtail clinical nurses' autonomy, and hierarchical and inflexible nursing leadership. External to nursing are opportunities exemplified by international partnerships in oncology care and international oncology conferences for networking and learning. Examples of external threats are a lack of oncology nursing faculty, disrespectful media portrayal of nurses, community misconceptions about cancer curability, and hazards of cancer nursing.

IMPLICATIONS FOR NURSING PRACTICE

Governments and hospital authorities wishing to successfully address cancer control must strategically plan for the recruitment and retention of an adequate nursing workforce. Opportunities such as government recognition of oncology specialty training, shared governance, continuing specialized education, advanced practice nursing roles and career paths, and participation in national cancer control planning will increase and sustain a critical oncology nursing workforce.

The perception of shared governance and engagement in decision-making among nurses

BACKGROUND

Shared governance is a structural framework for operationalizing nursing ownership and accountability for nursing practice. Healthcare institutions are striving to promote healthy and satisfactory work conditions to retain their qualified personnel and achieve organizational stability and high care quality. However, little is known about nurses' participation in governance in developing countries.

AIM

This study aims to evaluate the levels of shared governance, also known as professional governance, among nurses in Jordan. The demographics of the study participants will also be assessed.

METHODS

The current study used a cross-sectional design implementing an anonymous online survey technique to collect data from 111 nurses on the Index of Professional Nursing Governance (IPNG). Descriptive statistics were performed to evaluate the nurses' perception of the concept of shared governance in the domains of personnel, information, resources, participation goals and conflict resolution, and practice.

RESULTS

Among the 111 nurses, 55% of the participants were females, 45.5% were affiliated with governmental hospitals, and about half of them worked in critical care units. The analysis showed that the mean score for the total IPNG was 113 (SD = 26.28). The analyses of the mean scores of IPNG domains ranged from 11.5 (SD = 4.6) for goals and conflict resolution to 23.8 (SD = 5.7) for access to information.

DISCUSSION

The results revealed that nurses' average perception of professional governance demonstrated shared governance, and more specifically, in the lower level of shared governance where decisions are made primarily by management with some staff input. Analysis of the domains of governance revealed that participants' scores corresponded with shared governance in the areas of information, resources, goals and conflict, and practice, while traditional governance was prevalent in the governance of nursing personnel and participation.

CONCLUSION

There is an agreement on the need of moving the position of frontline nurses to the center of their organizations where equity, accountability, and ownership are the pillars of participative governance. Frontline nurses need further empowerment to be more actively engaged especially in the management of nursing staff and related structures and in the participation in structures connected to governance activities at different organizational levels such as in committees.

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.

Nurse managers' perception of governance among Korean nurses

AIM

This study aims to ascertain nurse managers' perception of nurses' governance and explore their perception of facilitating and hindering factors of shared governance.

BACKGROUND

Shared governance has been introduced in nursing as a plan to improve nursing service quality. There is limited understanding about how governance is implemented.

METHODS

A mixed-methods design was used to elicit Korean nurse managers' views.

RESULTS

Quantitative data revealed the level of nurses' governance perceived by nurse managers as shared governance. However, among the subdomains, 'control over personnel' and 'participation in committee structures' indicate traditional governance. Analysis of qualitative data identified the factors that facilitate or hinder the subdomains: 'stifled atmosphere', 'nurse manager's encouragement', 'lack of opportunity and perception of the given authority' and 'flexible organisational structure'.

CONCLUSION

Findings from the study can be used to inform shared governance programmes for hospitals.

IMPLICATIONS FOR NURSING MANAGEMENT

Health care organisations, nurse managers and nurses must take action at each level to improve the current nurse governance situation. A flexible organisational culture with opinion windows for participation by nurses is important for shared governance. Supportive leadership of nurse managers and nurse-directed implementation could advance shared governance.