The concept of shared governance in the healthcare setting is not a foreign notion. Many hospitals around the world have collaborative nursing committees, like a unit based council (UBC), where staff nurses work together through shared decision-making processes to identify issues, develop solutions, and implement change that will directly affect the unit and patients they work with (Ortin, 2021). These meetings become an excellent venue for staff empowerment, team building, and collaboration. As a staff nurse with 12 years of experience, I was well-versed in UBCs, having served in both chair and co-chair roles. However, my transition to a novice nursing professional development (NPD) practitioner redefined my role within shared governance. 

Upon entering the NPD field, I found it particularly challenging to “get to know” the over 100 staff nurses on the cardiothoracic intensive care unit (CTICU) I was covering. Not only was I new to my NPD role, but my prior critical care background didn’t include experience in cardiac surgery. If you’ve ever worked with critical care nurses before, you know we can sometimes be difficult to impress, and sayings like “eat their young” get thrown around often. I was posed with the challenge of familiarizing myself with the staff, creating trusting relationships so that I could assess their needs effectively, and implement meaningful educational opportunities with their buy-in. By utilizing the NPD practice model, I was able to partner with the UBC to foster staff’s professional development, disseminate information regarding identified knowledge gaps, and promote a culture of inquiry and evidence-based practice (EBP).

Getting Buy-In

Once I connected with the CTICU’s UBC, I partnered with the chair and co-chair to establish a dedicated five-minute time slot at the end of their meeting, allowing me to present on topics of interest or high relevance to the staff. Our UBC has an excellent staff turnout, with typically 50-75% unit participation. Having monthly access to this captive audience of staff from all shifts was a huge benefit. It allowed me to see off shift staff that I wouldn’t typically encounter in my daily rounding, and attending the monthly meetings increased my visibility and accessibility to those who might not typically seek me out.

As NPD practitioners, we frequently engage in environmental scanning to identify practice gaps amongst our learners to create meaningful educational opportunities and contribute to positive patient outcomes (Banister & Resseguie, 2024). This needs assessment can take place in various forms; it may be a traditional survey distributed to staff and unit stakeholders, feedback from safety and quality leadership, or even as simple as a touch-base conversation with staff to see what they feel their needs are at that point in time. These monthly UBC meetings became a great way for me to see the issues staff were facing and prioritize what felt most critical to them. I turned my five-minute time slot into micro-learning sessions, with a single-objective focus to provide just-in-time education for immediate use in practice (Cronin & Durnham, 2024). These abbreviated educational offerings felt manageable to the staff, and me. They didn’t require days of preparation like a typical course offering would, and many of the topics were reinforcement of previous education, so I had an arsenal of resources to pull from.

Bridging the Gap

For this arrangement to work, it had to be mutually beneficial to both parties. I had to bring something to the table for the staff nurses in addition to the educational component. As an NPD practitioner, I wanted to promote their professional development and further scientific inquiry by utilizing my expertise in policy, guidelines, and resources while also promoting interprofessional collaborations. Understanding the daily challenges the nurses faced allowed me to provide multifaceted support, offering not only education but connections to key partners to advance their projects. For example, during one meeting it was identified that our continuous renal replacement therapy (CRRT) device data was not communicating with our electronic medical record (EMR). This barrier led to staff frustration. The staff were unable to resolve the problem on their own, but I was able to connect them with our education specialist from the device company who has experience executing these integrations and assisted them with the process. Additionally, our collaboration created a space for open dialogue. This provided me with the opportunity to inform staff about unfamiliar policies and highlight the 24/7 support resources available on the intranet.

Blurring the Lines

Although this experience has been overwhelmingly positive, occasionally there has been some role confusion and mixed messages along the way. My goal is to empower the nurses, so I focused on providing support while ensuring the meeting remains under their leadership. However, if misinformation or recommendations that deviate from hospital policy are shared, I provide clarification to ensure alignment with hospital policy. There have also been times where team members speak on topics directly related to NPD classes or initiatives that become misconstrued because they are not the subject matter expert or originator of the information. Presenting at the end of the meeting has been helpful in these situations because I can circle back to topics that may require correction or redirection.

Looking to the Future

These monthly UBC meetings have become something I look forward to participating in, and although my role now is more supportive in nature, it has helped me become a part of their team. The need for education at this time is very high with an increase of novice nurses in the critical care setting, and these micro-learning sessions have become a popular way to support the staff. I am now collaborating with a group of “education champions” to further disseminate these micro-learning sessions outside the monthly UBC meetings. In these sessions they will discuss varying critical care topics in ten-minute unit huddles across all shifts. The team leads and I collaborate to ensure all teaching materials and objectives align with hospital policies, guidelines, and approved resources, and are grounded in evidence-based practice. Additionally, I am pleased to report that the concept of having the unit NPD practitioner on the UBC meeting has spread throughout our hospital’s cardiac surgery line, and I now have a regular time slot on our cardiac surgery stepdown’s UBC meetings as well.

Integrating into an established team always has its challenges. By participating in shared governance, I was able to thoughtfully build relationships, support team members in their professional development and scientific inquiry and facilitate their learning, all while creating a strong collaborative foundation for our future.

References

Banister, S., & Resseguie, C. (2024). A novel approach to supporting ambulatory nursing professional development. The Journal of Continuing Education in Nursing, 55(9), 449–455. https://doi.org/10.3928/00220124-20240718-02

Cronin, J., & Durham, M. L. (2024). Microlearning: A concept analysis. Computers, Informatics, Nursing, 42(6), 413–420. https://doi.org/10.1097/CIN.0000000000001122

Orton, A. (2021). Supporting nursing autonomy through shared governance. Nursing Management, 52(12), 44–46. https://doi.org/10.1097/01.NUMA.0000800404.94545.fb