Governance In Nursing Essay


Discuss about Governance in Nursing.


Shared governance in nursing can be defined as the working model of participatory decisions making in healthcare centers. Here, the nursing professionals are organized to make decisions about their quality improvement, clinical practice standards, staffs as well as professional development and researches. This mainly takes place while acting as one of the important professional of the multidisciplinary team which provides importance to four important aspects (Clavelle et al. 2016). These are the equality, empowerment, accountability and partnership. Equality mainly involves shared as well as equal focus on patients, services and staffs which are considered by researchers to be highly essential in providing safe and effective care. The next aspect is empowerment where the nursing professionals should gain the authority as well as the autonomy to make decisions about their nursing practices which will ensure them following the principles of beneficence for their patient’s welfare. The third aspect is accountability where the nurse should develop the responsibility and willingness to participate in practices which are ethically and legally apt by proper decision making with the partners of the multidisciplinary teams (Ott and Ross 2014). The next aspect of the shared decision making is called the partnership which mainly emphasizes on the collaboration as well as teamwork among the different experts of the multidimensional teams and also among caregivers and patients and families. The NMBA standards of nursing practice also states in standard 2 that nurses should engage in therapeutic and professional relationships I order to bring out the best health outcomes of patients.

A very good example can be provided for a patient who had been admitted to the hospital due to her increase in pain of her knees due to the osteoarthritis. The patient was obese and therefore it was important to appoint a dietician to educate her about the diet and fix up a diet plan. Although the nursing professional had the due to treat her for pain management, an orthopedic physician was consulted to provide his suggestion son the treatment to be followed for her. A physiotherapist was also allocated for her to maintain a therapeutic session with her helping her to overcome her pain. The nursing professionals had to provide the correct medications for her as it was her duty. A social carer was also assigned to her to help her conduct her daily activities as she was quite old and had the chance of fall. Besides, a counselor was assigned to her as she was suffering for depression due to her loss of independency and had withdrawn herself. All the work of teams were coordinated by the nursing professionals besides caring for the patient in each of her aspects and helping her lead a better life with compassion, empathy and kindness.

Clinical governance:

Clinical governance may be defined as the domain in the healthcare sectors where the nursing professionals are considered as the main epitomes who are responsible for the quality and safety of the patient care to achieve high standards of clinical care. This mainly includes using his management of resources, clinical and self governance. Researchers are of the opinion that there are many aspects which are extremely important for nurses to maintain clinical governance. This includes proper interactions between service user, carer and public involvement. The next important aspects are risk management and clinical audit. Besides, staffing and staff management, education and training, clinical effectiveness and clinical information are also important. Researchers are of the opinion that nurses are held accountable for the continuous improvement of the quality of the care for the patients through their services (Smith, Latter anmd Blenkinsopp 2014). It also instructs the nurse for safeguarding high care of the nurses by creating an environment in which excellence in clinical care is encouraged. Following evidence based care and maintaining its effectiveness by applying this practice in the workplace ensures safe care for the patients and also ensures quality where the patient can get well due to the application of the most modern forms of treatments (Prenestini et al. 2015). The NMBA standards of nursing practice states that the nurses should provide safe, appropriate and responsive quality nursing practice so that patients can get well. Standard 4 and 5 states that nurses should comprehensively conduct assessment and should also develop a plan for nursing practice which would help in providing the most modern and best quality care.

An example can be provided here. Previously nurses were prevented to use oxygen in COPD patients as they believed that it could lead to hypercarbia and acidosis which could lead to death. Nowadays, it is believed that evidence based protocols in turn help to prevent hypoxia and organ failures resulting in larger longevity (Holm et al. 2016).

Self governance:

It can be defined as the attribute of nursing profession which is encompassed by applicable licensure and legal rules. It requires no supervision or direction from the others giving the nursing professionals the responsibility to take duties for performing responsibilities on their own accountability. In this type of governance, each individual of the nursing profession are expected to maintain their duties and provide the best practices for the betterment if the health conditions of the patients. This would demonstrate the ability of the nurses to engage in proper decision making about the management issues (Bradham et al. 2016). It would also demonstrate the ability to engage in the development of standards of practice. It should also include expert confliction resolution skills as well as proper negotiation skills. Often all these may lead to creation of a pressurized situation but the nurses should make themselves skilled to handle all pressures an stresses effectively to dedicate themselves for the welfare if the patients and provide the best care without feeling stressed or burned out (Consiglio et al. 2014). NMBA standards of nursing practice states that every nurse should think critically and analyze the nursing practice to bring out the best outcomes in standard 1..

An example can be provided. Often family members of the patients force or request the nurses to tell them about the confidential information about the patients when the patient himself does not want to disclose to families. This might create a very strenuous situation for the nurse as it might lead to legal obligations. Here it is the capability of the nurse to handle such situations under pressure effectively and come out victorious.


Bradham, C.U., Dalme, F.C. and Thompson, P.J., 2016. Personality traits valued by practicing nurses and measured in nursing students. Journal of Nursing Education, 29(5), pp.225-232.

Clavelle, J.T., O’Grady, T.P., Weston, M.J. and Verran, J.A., 2016. Evolution of structural empowerment: moving from shared to professional governance. Journal of Nursing Administration, 46(6), pp.308-312.

Consiglio, C., Borgogni, L., Vecchione, M. and Maslach, C., 2014. Self-efficacy, perceptions of context, and burnout: a multilevel study on nurses. La Medicina del lavoro, 105(4), pp.255-268.

Holm, K.E., Casaburi, R., Cerreta, S., Gussin, H.A., Husbands, J., Porszasz, J., Prieto-Centurion, V., Sandhaus, R.A., Sullivan, J.L., Walsh, L.J. and Krishnan, J.A., 2016. Patient involvement in the design of a patient-centered clinical trial to promote adherence to supplemental oxygen therapy in COPD. The Patient-Patient-Centered Outcomes Research, 9(3), pp.271-279

Ott, J. and Ross, C., 2014. The journey toward shared governance: the lived experience of nurse managers and staff nurses. Journal of nursing management, 22(6), pp.761-768.

Prenestini, A., Calciolari, S., Lega, F. and Grilli, R., 2015. The relationship between senior management team culture and clinical governance: Empirical investigation and managerial implications. Health care management review, 40(4), pp.313-323.

Smith, A., Latter, S. and Blenkinsopp, A., 2014. Safety and quality of nurse independent prescribing: a national study of experiences of education, continuing professional development clinical governance. Journal of advanced nursing, 70(11), pp.2506-2517

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