From the editor

doi:10.1016/j.jvn.2004.12.005

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Volume 23, Issue 1 , Page 1, March 2005

From the editor

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This past winter, we had the opportunity to have Magnet appraisers on-site at our 5 Metro Region hospitals to validate our application for “Magnet Status” re-designation. The week-long survey process was intensive but very positive. During their visit, the Magnet appraisers met and interviewed more than 1000 nurses and leaders. They visited every nursing unit at each hospital reviewing the many factors that affect our success, satisfaction, and clinical outcomes. We demonstrated that our structure empowers the practitioner, ensures autonomy, places decisions where they belong, supports professional practice, and advances clinical outcomes. The summation meeting with our surveyors applauded our excellent nursing practice and innovations. Our nurses demonstrated that we uphold the tradition to support professional, competent, and compassionate nursing practice.

It is interesting that the majority of hospitals that have achieved “Magnet Status” use shared governance as their structural model for sustaining nursing practice.¹ Shared governance is a relevant and vital issue in the structuring of professional practice. It is the foundation for the meaning and value of empowerment concepts and structural contexts for nursing practice. Although shared governance is not unilaterally grounded in nursing theory, it fits well with the practice character and form of professional nursing.² It has taken us many years to refine and develop congruence between management behaviors and the structural imperatives of a shared decision-making model. We have achieved a synthesis between the staff’s competence in making their own decisions about their practice and profession, and our leaders’ ability to facilitate this process.

We have seen a growth in interdisciplinary relationships reflecting a high level of clinical interaction to advance the work of our profession and positively impact patient care. As we are challenged to partner toward interdisciplinary care, our journey continues toward professional accountability, autonomy, and practice. Nurses have the right to lead and direct their own practice. The Magnet health facilities have shown us the value of shared governance in nursing. In places that maintain nurses’ autonomy, care outcomes are improved and staff retention is manifested in a body of nurses whose tenure and skills provide excellence in patient care.³ Collaborative practice groups have demonstrated the value of nurses working with other practitioners to research and develop practice patterns based on sound outcome-driven data.

Shared governance is simply a structural model through which nurses can express and manage their practice with a higher level of professional autonomy. All shared decision-making models incorporate 4 principles: partnership, equity, accountability, and ownership.⁴ It is the presence of these factors in a sustaining organizational format that is the best validation that our decision-making model supports these values. Our shared decision-making model has provided a format and structure that allow the processes of practice decision making, autonomy, service excellence, and organizational influence to logically and consistently unfold.

In this issue, the articles and columns featured address many aspects involving the nursing process, including the “Magnet Status” process. I invite each of you to share with us your experiences in shared governance concepts, implementation, and/or research to contribute to this dialogue regarding the value, efficacy, and processes of nursing shared governance. Please consider sharing with your peers any shared governance activities, research findings/outcomes, or practice innovations. Let the Journal be your avenue to continue advancing our nursing profession!

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References

Aiken L . Superior outcomes for magnet hospitals . In: McClure M , Hinshaw AS editor. Magnet hospitals revisited: attraction and retention of professional nurses . Washington (DC): American Nurses Publishing; 2002;p. 61–81
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