Shared governance administers and deploys the services of organizations through partnering with the management and the staff. In a care unit, the nurses own the clinical practices and deliver support services to the patients. Through the shared governance, the nurses are taught how to practice their profession. They also can enhance their performance so as to take up greater autonomy levels and be in control of their nursing practice. Generally, governance is a structure by which an organization performs its duties and exercises the authority thereof. When the governance is shared, it primarily describes concepts of equality, collegiality or professional accountability for a certain structure of governance. In health facilities, shared governance is an approach where services and systems are put into partnership. Systems accountability involves the roles and activities which increase system effectiveness; linkages, functions and the duties in the hospitals. This is categorized under the department of the managers (management). Additionally, service accountabilities highlight the actions and tasks related to the hospitals purpose and it is categorized as the responsibility of nurses. Basically, shared governance believes that nurses in every health unit must oversee their practice and take part in decisions affecting this practice. By employing shared governance, the managers of nurses show a concern to refinement of partnerships of high quality among the nurses and also the works to be done. Generally, the nurses should act responsibly and with authority to know what care to give and how to deliver it. This paper describes the experience that I had in the shared governance council and what I achieved while there (Porter-O'Grady, 2014).
There were many lessons which were taught in the shared governance council and first was on how and when to respond to a call by a patient and to attend to a need of a patient. The light calls by patients are a sign that the patient need to be attended to. In hospitals, use of call lights is primarily a way through which patients can get to the hospital staff and their caregivers. It empowers the patients and gives them an environment to control themselves when they are stressed while being hospitalized. In addition, it acts as a welfare tool whereby it allows patients to connect with the nurses and tell their needs when they want any routine help or experience an acute conditional change. Patients who are hospitalized have the trust that when they use a light call, in a timely manner somebody must answer back to it. The systems of call lights are used by patients in communicating their needs to the nurses and thus when these calls are answered directly, the perception of patient regarding the quality of service as well as his/her satisfaction is affected. To nurses, when a patient calls, it is like an assurance that the patients will be able to communicate if they need any assistance whereas others view it as being interrupted from their work. Seemingly, when there are frequent calls from the patients, there is creation of backlog of activities for a nurse who is almost ending his/her shift and that is why many nurses ignore or respond late to these calls (Jacobson, 2015).
When there is a call from a patient, a nurse must put into priority that call and leave whatever they are doing to attend to the patient. Conversely, different calls require different urgencies; therefore, nurses should prioritize these calls and respond to the most important ones first. Additionally, a single nurse cannot be able to respond to many calls simultaneously. The nursing staff as a team should work together in a care unit for patients which includes a timely response to the patients calls. Nurses should work as a team in accomplishing their tasks. Likewise, in some situations a nurse may not understand the need of the patient thus nurses as colleagues should support each other in understanding their work and supporting patients. Nursing staff should see it as their own responsibility to respond to calls whether assigned to that patient or not because it is their duty to ensure that all patients are attended to. Therefore, every nurse should dedicate his/her time in serving the patients. However, in addition to responding in time to patients calls, nurses should also exercises ethical conducts of nursing. One should knock the door to the patients room and when they enter they ought to give a soft face to the patient by smiling to them and greet them humbly. Then after that a nurse should enquire on the need of the patient and what kind of help they require. If the nurse cannot help the patient he/she should immediately call for help from the staffs who can handle the situation. This boosts the confidence of patient to the nursing staff and they feel satisfied (Jacobson, 2015).
Secondly, we discussed about the issue of noise in hospitals and how we can control it as the nursing staff. Noise in hospitals is very common and many people do not seem to understand the implication it has to the patients as well as the staffs. A hospital setting is an active and living organism. The environment speaks, breaths and it consists of its acuity level. It has its level of decibel and own life. For creation of a hospital environment which is quieter, we ought to understand and also control the noise which arises when no one is talking or doing anything. The zero acoustic ground must be established. If there were no people in the hospital, we would only remain with the noise flow which is the level from where noises arise. This noise flow emanates from various technologies having the same volume continuously in presence of people or not. These are air conditioning, ventilation and heating machines. Ice machines are place more conveniently where the flows and walls can amplify their sounds, than soundproof. Slamming of doors also create a lot of noise as well as carts which have hard wheels being pulled, flow waxes, vacuum cleaners. All these should be in use only when they minimally disrupt the staff and patients. There are also other sources of noise such as the bell rings which echo flows and walls and sounds of elevators.
On the other hand, there is the human noise which results from moving people. These are sounds of feet on the flow. Nurses tend to make a lot of noise while moving around. There are also noises from people talking, not necessarily in loud tones but when there are very many voices, they cause noise. Communication equipment also make noise in hospitals. Telephones, personal pagers, emergency paging, cell phones and those who respond to these make a lot of noise. Lastly, hospitals experience noises from the visitors, patients and other things like televisions. Some visitors like the elderly people tend to speak loudly and also some patients due to various conditions make loud noises. All these noises have impacts in the hospitals: depriving sleep, agitating, aggressing and causing restlessness to patients, increasing pain and ineffective management of pain, slowed healing of wounds, privacy violation and the risk of increased errors by nurses and doctors. There are several measures which can be undertaken to fix noise in hospitals. For one, hospitals should assess and engage everyone in the hospital so as to explain the noises and define what ought to be done and the best result.
The flows and walls must undergo sound masking and acoustic treatments, repair and maintenance of hospital equipment to reduce their noise pollution, enacting policies which regulate communication technology and more importantly implement an organizational culture required in hospitals. The nurses and other staff should adhere to the ethics and apply the professionalism required in hospitals. Talking loudly, having interrupting conversations or unnecessary movements should be eliminated. The nurses should also take a responsibility of teaching one another the importance of silence and together as a group should prevent noise pollution in hospitals. The final issue which was addressed was regarding hospitality carts. These are the mobile carts used by nurses in delivering their services and products to the patients. The carts should be highly maintained to ensure they do not make noises and disturb patients. They must also be strong and stable to carry around items to patients in need. Besides, nurses should ensure that the drawers, cabinets and lockers in patients room are clean and tidy and that the patients can access and reach them out easily. Nurses should collaboratively clean and organize these carts and make sure it contains all what patients require (King Edward's Hospital Fund for London, 2013). The keeping of every equipment that is used by the nurses on a regular basis makes the execution of their duties an easy and manageable task. Cleanliness helps the nurses and the patients to acquire infections.
In summary, the nurses should act professionally in delivering their services. They should demonstrate skills, knowledge and dedication to their work. A nurse cannot attend all patients alone hence they should all work as a team and where one member does not understand what ought to be done, they should enquire and assist each other as colleagues. Nurses should also read widely about the nursing practices so as to gather more knowledge and learn from others and through this they would develop their ability to handle patients needs in a more sophisticated way. It is important to realize that they are responsible for each other and every decision made by one affects the entire group. Everyone should leadership skills in identifying and dealing with issues and problems regarding patients care. The decision making process should not be left on one individual but as a group. Each and every opinion of a nurse counts and should not be taken lightly. Moreover, nurses are accountable for how they use utilize the resources of the hospitals thus they must use them efficiently without wastage. More importantly, they must exercise ethics in carrying out their jobs. The patients are their main concern so they must ensure they are attended for and fully satisfied.
Hamilton, N. W. (2012). Academic ethics: Problems and materials on professional conduct and shared governance. Westport, Conn: Praeger.
Jacobson, K. L., & United States. (2015). Is our pharmacy meeting patients' needs?: A pharmacy health literacy assessment tool : user's guide. Rockville, MD: U.S. Dept. of Health and Human Services, Public Health Service, Agency for Healthcare Research and Quality.
King Edward's Hospital Fund for London. (2013). Noise control in hospitals: Report of a follow-up enquiry. London.
Porter-O'Grady, T., Hawkins, M. A., & Parker, M. L. (2012). Whole-systems shared governance: Architecture for integration. Gaithersburg, Md: Aspen Publishers.
Porter-O'Grady, T. (2014). Interdisciplinary shared governance: Integrating practice, transforming health care. Sudbury, Mass: Jones and Bartlett Publishers.
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