This excerpt was taken from the book, Shared Governance: A Practical Approach to Reshaping Professional Nursing Practice.

When establishing the selected shared governance process structure, identify how many councils (bodies or groups) will be created to include all five accountabilities or disciplines. Once the disciplines are accounted for, there is no right or wrong way to design the structure or process. One organization chose to create five governing councils: (a) nursing assembly (management/coordinating council), (b) practice council, (c) quality and research council, (d) professional development council, and (e) unit-based councils, which were connected to each of the other four councils. This approach allowed nursing to slightly reduce the number of council meetings staff nurses would need to attend while still maintaining representation in each governing body.

Focus on council membership

When recruiting members for the shared governance councils, consider factors such as representation, contributions, membership mix, size of councils, length of time of participant service, and meeting times.

a. Representation--especially from a service context. These representatives will speak on behalf of those services when decisions have to be made.

b. Contributions--by each member that grows over time; work may be assigned to members to be done in the meeting or to be taken back to their units/areas and completed there. Reports on tasks and progress are given at each council meeting.

c. Membership mix--Staff governance councils (practice, quality, professional development) need to be composed mostly of staff nurses, about 70%-90% clinical staff. The other council members should be management or support staff. These are staff nurse councils. They will make staff decisions that affect clinical practice, quality, and competency. Messages of empowerment, equity, autonomy, and accountability are delivered in an effective and clear way so that shared decision-making emerges in the partnership between staff and management.

d. Size of councils--Number of participants depends on the number of units represented. Usually, only 7-15 members are recommended. However, some organizations have more representatives at the table. All nursing units/areas should have someone at the table to represent their voices in the discussions and shared decision-making. Keep in mind, however, that the larger the group the more difficult it is to get consensus and make decisions.You would have to address this issue at the beginning of work in larger groups.

e. Length of time of participant service--It often takes about a year for a participant to learn the roles of assigned councils. Therefore, a two-year term seems to be emerging as the standard length of service commitment for each council member. With such a term, consider rotating half of the members off one year and the other half off the second year. This rotation would provide continuity of process, with at least one-half of the members every year having served for one year and being able to orient and mentor the incoming council members.

f. Meeting times and structures--How organizations elect to structure their council meetings and times will depend on factors unique to that staff.

• Some councils meet once a month for eight hours (a full day) to accomplish the tasks of the council. This approach allows members to focus on the business of the council instead of dividing their attention with concerns about the patients or tasks they left on the unit for an hour or two.
• Other councils have a monthly "Meeting Day" when all councils meet, usually for an hour each, at different times to allow staff members to attend their meetings and return to work around the council meetings. Breaks of 15-30 minutes between council meetings allow staff members who serve on more than one council to get to the next one without disrupting or interfering with the work of other councils. A schedule of such a day might look like this:

  8am-9am Management or Coordinating Council
  9:30am-10:30am Quality Council
  11am-12pm Professional Development Council
  12:30pm-1:30pm Practice Council
  2pm-3pm Research Council

• Council meetings cannot be optional. Attendance has to be mandatory if staff nurses and nursing leadership are to have a voice in shared decision-making and if they are to be able to complete and communicate council activities. It is critical that nursing leadership support and facilitate staff attendance at assigned council meetings. It is also important to provide time and opportunity for communication of information and/or data gathering to complete council assignments (e.g., unit inservices). Each nurse leader/manager and his/her staff should discuss and resolve these details from the beginning.

Each council is structured with certain accountabilities or disciplines. Staff councils must identify the authorities that belong to the staff and operate within the staff framework.

Editor's note: This excerpt was adapted from the book, Shared Governance: A Practical Approach to Reshaping Professional Nursing Practice. To find out more about the book and to order a copy visit http://www.hcmarketplace.com/prod-4428.html.