Dynamic Leadership for Shared Governance

“Dynamic Leadership for Shared Governance” was sponsored by AONE and held June 29-30, 017 in San Antonio.  The speakers were Marjorie Maurer, MSN, RN, NEA-BC; Beverly Hancock, DNP, RN-BC; Tim Porter-O’Grady, DM, EdD, Scd(h), APRN, FAAN, FACCWS; and Rachel Start, MS, RN. 

Many thought-provoking points were made about leadership’s role in “shared decision-making”:

• It’s all about making decisions and who owns the decisions
• CHANGE is the work
• Must be purposeful and evidence-driven
• Ambiguity hides accountability

Structure for effective shared decision-making is crucial.  It is important to have a charter or by-laws that clearly demarcate membership and roles.  In addition, it may sometimes be important to use a “shared agreement” that is signed by all parties in order to set clear expectations with a timeline.  Above all, the structure must be staff led and the decision processes involved leadership.

Accountability elements of authority and autonomy are important for all to understand.  Authority is about “the power” to make a decision.  Autonomy is about “the right” to decide.  Leadership transfers authority to shared governance structures (in collaboration) to give them the right to make certain decisions.  In order for the council membership effectively to make decisions, they must have competency in decision-making.  The manager’s clear role is education and transformational leadership.

Nurse Leaders are key in successful shared governance structure, process, and outcomes; they must create their role as the “agent” of the decision and not the decision maker.  Leadership development is key in shared governance, as the nurse leader mentors, partners in agenda setting and evaluation of decisions made by the council.

Nurse Leaders must start with “why” for their staff to become engaged in shared decision-making.  Often nurses are comfortable with just knowing “what” is going to happen and “what” they are to do.  Using principles of partnership, equity, accountability and ownership is transformational for staff to become “why oriented.”

Finally, it is important to know the difference between change versus transformation, in order for shared decision-making to be effective. Change is doing something better or different than already exists.  Transformation is doing what is not currently possible until the leader trusts first and is transparent on the way to be and not focusing on the way to do. 

Transformational leadership is the essence of shared decision-making, which creates an engaged and trusting team.