Enablers and barriers of implementing shared governance in nursing departments: a case study from the United Arab Emirates
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16 dic 2024
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Categoría del artículo: Original article
Publicado en línea: 16 dic 2024
Páginas: 415 - 426
Recibido: 12 ene 2024
Aceptado: 25 mar 2024
DOI: https://doi.org/10.2478/fon-2024-0046
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© 2024 Siboj Kurup et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.
Demographic data analysis_
| Category | F | % |
|---|---|---|
| Male | 4 | 26.7 |
| Female | 11 | 73.3 |
| 24–30 | 2 | 13.3 |
| 31–45 | 13 | 86.7 |
| 46–60 | 0 | 0 |
| >60 | 0 | 0 |
| 1–4 | 0 | 0 |
| 5–15 | 11 | 73.3 |
| 15–24 | 4 | 26.7 |
| >24 | 0 | 0 |
| Staff nurse | 14 | |
| Charge nurse | 1 | 6.7 |
| Nursing manager | 0 | 0 |
| Pediatric Intensive Care Unit (PICU) | 1 | 6.7 |
| Emergency Department | 1 | 6.7 |
| Medical ward | 1 | 6.7 |
| Surgical ward | 3 | 20 |
| Intensive care unit | 1 | 6.7 |
| Cardiac care unit | 1 | 6.7 |
| Operation room | 3 | 20 |
| Specialized Medical Unit (SMU) | 1 | 0.067 |
| Outpatient clinics | 3 | 20 |
| Diploma | 0 | 0 |
| Bachelor | 14 | 93.3 |
| Master | 1 | 6.7 |
| PhD | 0 | 0 |
Thematic data analysis_
| Questions and sub-category | F | Participants | Main themes and sub-themes |
|---|---|---|---|
| Participants understand the concept of shared governance. | |||
| Authority and empowerment | 8 | 6[P3, P4, P5, P6, P10, P11] | The majority of participants mentioned at least one right phrase or sentence related to the concept of shared governance. |
| Sharing/involvement in decision making | 12 | 8[P2, P3, P5, P9, P10, P12, P13, P14] | |
| Partnership with the management | 6 | 4[P1, P9, P10, P11] | |
| Teamwork | 5 | 4[P5, P8, P12, P13] | |
| Sharing the rules or activities | 2 | 2[P1, P7] | |
| Participation | 2 | 2[P12, P14] | |
| Accountability | 1 | 1[P9] | |
| Equity | 1 | 1[P9] | |
| Improving leadership qualities among nurses | 1 | 1[P8] | |
| Participants understand the benefits of shared governance. | |||
| Nurses can solve their problems by themselves | 7 | 5[P1, P3, P5, P14, P15] | The majority of participants mentioned at least one benefit of shared governance. |
| Nurses can escalate their concerns | 5 | 5[P1, P2, P6, P8, P9] | |
| Nurses will be treated equally | 2 | 2[P3, P11] | |
| Patients will get a safe and better quality of care. | 2 | 2[P11, P13] | |
| Nurses become happy. | 1 | 11[P1] | |
| Improve staff-patient ratio. | 1 | 11[P12] | |
| The work environment is improved. | 1 | 11[P12] | |
| Nurses will work as a team. | 1 | 11[P8] | |
| The participants demonstrated contradictory views about the outcome of implementing shared governance in their hospital. | |||
| Nurses who have not seen any changes, are aware of any outcome or perceive low outcome. | 26 | 9[P1, P2, P3, P4, P8, P11, P12, P13, P14] | A greater number of participants did not perceive positive outcomes of implementing shared governance. |
| Nurses who think that they cannot come up with a solution until it is a multidisciplinary approach. | 1 | 1[P1] | |
| Nurses who think that the work structure itself has empowered all the nurses whether having a shared governance or not. | 1 | 1[P1] | |
| There are no minutes of meetings or updates shared with the staff like any questions raised or any problem solved. | 1 | 1[P12] | |
| Not all nurses are raising concerns as they are not asked to do so. | 1 | 1[P13] | |
| All nurses are under one umbrella. | 1 | 1[P2] | A smaller number of participants perceived positive outcomes of implementing shared governance. |
| Nurses are happy as they have a group led by nurses to make the decision. | 1 | 1[P5] | |
| Staff are not afraid to object and they can say and raise their concerns. | 4 | 4[P6, P7, P9, P10] | |
| Nurses are advocating for their patients and they are not afraid to escalate things. | 2 | 1[P6] | |
| We have now more unity. | 1 | 1[P7] | |
| Nurses can start a new project with the shared governance team. | 1 | 1[P7] | |
| The shared governance council helped nurses to reduce overtime. | 1 | 1[P14] | |
| Many have improved their leadership skills since individual responsibilities were given to each staff. | 1 | 1[P2] | |
| Immediate manager understanding and support could be significant enablers of implementing shared governance. | |||
| Work culture enhances shared governance activities and participation | 1 | 1[P1] | Participants perceived several enablers of implementing shared governance, that is, the immediate manager understanding and support, senior management support, work culture, nurse cooperation and teamwork, and multicultural nurses. |
| I mmediate manager understanding and support | 17 | 11[P2, P3, P4, P6, P7, P8, P9, P10, P11, P13, P14] | |
| Senior management support | 2 | 2[P7, P9] | |
| Multicultural nurses help a lot | 1 | 1[P14] | |
| Nurses’ readiness, cooperation, and teamwork are the enablers. | 3 | 3[P5, P8, P14] | |
| Participants perceived several significant barriers, mainly nurse’s attitudes and behaviors, lack of management support, and time. | |||
| Some nurses might feel that maybe our concern is not so important. | 1 | 1[P1] | Nearly half of the participants (50%) perceived nurse’s attitudes and behaviors as a barrier. |
| Nurses will not tell their concerns because they think that they will not be heard or frightened by top management. | 3 | 3[P1, P2, P3] | |
| Lack of nurse’s interest and commitment. | 2 | 2[P4, P7] | |
| Some nurses are reluctant to follow suggestions from others. | 1 | 1[P5] | |
| Some issues cannot be sorted out and it is really hard to find a solution. | 1 | 1[P10] | |
| Lack of open communication between nurses and the management. | 1 | 1[P2] | A greater number of participants (80%) perceived the lack of the senior manager’s support as a barrier. |
| Nurses spend their time and come on their off days. | 10 | 8[P4, P5, P8, P10, P11, P13, P14, 15] | |
| The immediate manager’s authority is limited and not empowered to act or does not act. | 2 | 2[P12, P15] | |
| The manager does not solve the problem within a given time and they keep promising. | 1 | 1[P14] | |
| Hierarchy, lack of senior management support, and the management take the final decision. | 13 | 7[P3, P4, P6, P12, P13, P14, P15] | |
| We don’t get feedback about the problem that was raised. | 1 | 1[P14] | |
| Nurses mentioned the time as a constraint for implementing shared governance, including conducting convenience meetings and other activities. | 16 | 9[P6, P7, P8, P9, P10, P11, P13, P14, P15] | A greater number of participants (60%) perceived the time of meetings and other activities as barriers. |
| Nurses turnover | 4 | 3[P4, P5, P15] | A small number of participants perceived other barriers, that is, nurse turnover and virtual meetings. |
| The meetings turned to virtual due to the COVID-19 pandemic and after. | 1 | 1[P7] | |
| Participants were positive and enthusiastic to improve the current situation of shared governance. | |||
| Involve nurses more/more meetings/involve more nurses. | 12 | 8[P2, P3, P4, P7, P8, P12, P13, P15] | A greater number of participants (80%) recommended increasing senior nursing management support. |
| Management support/empowering nurses/listening to nurse’s concerns. | 9 | 7[P3, P4, P8, P12, P13, P14, P15] | |
| To allocate a certain amount of time suitable for nurses to discuss things and do other activities | 10 | 4[P2, P3, P5, P10] | |
| Adequate staffing | 1 | 1[P5] | |
| Motivate nurses. | 4 | 2[P9, P15] | |
| Share the positive outcomes/success stories of the shared governance with nurses to improve their participation. | 8 | 5[P1, P4, P7, P13, P15] | A small number of participants (33%) suggested sharing positive outcomes with nurses. |
| The nurses should participate/voice out what they want to say/be more proactive. | 3 | 3[P3, P4, P13] | A small number of participants suggested that nurses should positively contribute. |
| Increase nurse’s awareness of what is shared governance. | 4 | 3[P5, P13, P15] | A small number of participants (20%) suggested increasing nurse’s awareness. |
| To see some implementation should happen. | 1 | 1[P11] | Other participants suggested various strategies to motivate nurses to participate in implementing shared governance. |
| Follow-up issues by collecting data, and taking them to the next level are very important. | 1 | 1[P10] | |
| To set meeting dates as per staff convenience | 1 | 1[P9] | |
| Assign a special process of writing any issue on a piece of paper and submit it to the shared governance team. | 1 | 1[P1] | |
| Update nurses by sharing minutes. | 1 | 1[P12] | |
| Face-to-face meetings are better than virtual meetings. | 1 | 1[P7] | |
| Involve other allied health professionals. | 1 | 1[P10] |