Nursing shared governance at hospitals – it’s Finnish future?

Abstract

Purpose The purpose of this study is to describe council structure, its benefits, supportive and obstructive factors and developmental needs as a part of shared governance in a university hospital. Design/methodology/approach This is a descriptive study, where semi-structured interviews with 12 nurses was conducted in 2014 and documents from 75 council meetings from 2009 to 2014 were gathered and analyzed. Qualitative content analysis method was used on the data. Findings The study hospital has been developing nursing shared governance with unique structure and processes of councils. Professors and university researchers act as chair and members are voluntary nursing staff. The factors supporting the councils are nurse managers’ support, enthusiastic personnel and neighboring university. The factors obstructing the councils are lack of time, understanding and skills. The work of the councils benefits the organization by improving patient care, harmonizing nursing practices and informing decision-making. The council’s developmental needs were more visibility, concentration into everyday problems and interprofessionality. Research limitations/implications Applying nursing shared governance structures into an organization improves the professional practice environment of nursing personnel. Practical implications The study hospital has its own, unique council structure. It did not cover the whole hospital or all of the nursing personnel, but it is already producing promising results. It should be given an official status and more support from nurse managers, and it should be developed into an inter-professional discussion. The results presented here indicate that shared governance, even, in its early stage, contributes positively to the quality of care, harmonizes nursing practices and informs decision-making. Applying shared governance structures into an organization improves the professional practice environment of nursing personnel. The study showed concrete supporting and obstructing factors that should be notified in nursing leadership. Originality/value Despite the extensive empirical studies on nursing shared governance, there is very little research on councils in the Scandinavian countries.

Components of the Magnet® model provide structure for the future vision of nurse managers’ work: A qualitative perspective of nurse managers

“…One very clear findings is that Finnish nurse managers expect a shift towards shared governance in health care organisations. Several studies have shown that shared governance increases staff's work engagement and empowerment (Olender et al., 2020), improves clinical outcomes (Moreno et al., 2018), enhances patient care, harmonizes nursing practices and enables informed decision‐making (Kanninen et al, 2019). Shared governance is still rarely implemented in Finnish hospitals, but some preliminary results are promising (Kanninen et al, 2019).…”

“…Several studies have shown that shared governance increases staff's work engagement and empowerment (Olender et al., 2020), improves clinical outcomes (Moreno et al., 2018), enhances patient care, harmonizes nursing practices and enables informed decision‐making (Kanninen et al, 2019). Shared governance is still rarely implemented in Finnish hospitals, but some preliminary results are promising (Kanninen et al, 2019). Our results indicate that nurse managers want changes to the traditional leadership culture, and regard the new generation of nurses as ready for such change too.…”

“…Our results indicate that nurse managers want changes to the traditional leadership culture, and regard the new generation of nurses as ready for such change too. However, enthusiastic personnel and nurse managers’ support are needed to assist their organisations’ strategic planning (Kanninen et al, 2019; Olender et al., 2020). Needs for cooperation and networking were also noted in the responses, including extension of links beyond managers’ own organisation.…”

Nurse Manager Core Competencies: A Proposal in the Spanish Health System

“…Brooks-Cleator et al [27], in his studies on transculturality and governance, focus on the importance of the nurse in establishing a culture of safety. The involvement of nurses in social action committees has achieved a great impact on the everyday problems of people [28], highlighting the importance of their participation in decision making [29]. When the nurse is involved in the different parts of the healthcare process (management and nursing care), better results are achieved [30], communication is enhanced, together with collaboration between the different professional groups, innovation, organizational commitment and retention of staff [23].…”

Professional governance in Finnish nursing – measured by the Index of Professional Nursing Governance

“…Previous studies have also shown that nursing personnel in Finland are likely to be dissatisfied with the nursing process and their ability to obtain feedback from their nurse leaders. They also reportedly regard their managers' transformational leadership qualities as moderate and their nurse directors as distant (6,5,7).…”