Building the next generation of leaders through shared governance

FigurePOSTPANDEMIC, THE HEALTHCARE world faces greater challenges. Organizations must manage higher-acuity patients, while striving for improved quality and outcomes and navigating a shortage of both clinical RNs and nursing leaders. In November 2023, the American Organization for Nursing Leadership (AONL) published a survey as part of its longitudinal study.1 Of the 2,476 nurse leaders surveyed, 12% planned to leave their positions, and 23% were considering leaving their positions. The AONL also asked nurse leaders how their work satisfaction could be improved. The study showed varied responses from nurse leaders, including more transparent communication and increased support for professional governance councils. To improve patient experience and attain better quality outcomes, organizations must have talented and knowledgeable healthcare leaders.2 Furthermore, leaders cultivate their skills through time and experience.2 Structured programs that focus on evidence-based and best practices for leadership competencies can prepare nurses at all levels for future leadership opportunities. Many clinical nurses move into leadership roles with no leadership training and are unprepared for what the role demands. Organizations must take a proactive approach to building future nurse leaders. PREPARING FOR THE FUTURE: BUILDING RELATIONSHIPS How do we prepare the next generation of nurse leaders while looking at what the data and evidence tell us? Developing relational competencies should be a key part of succession planning given the essential role that relationships play in building a healthy workforce.3 What better way to begin implementing succession planning activities and developing future leaders' relational competencies than through shared governance? Shared governance enables clinical staff to gain leadership skills through many different avenues. Being part of a shared governance council provides members with opportunities to build relationships and work on communication styles. It creates an environment for open communication and respect for differing viewpoints and opinions. Communication and collaboration are qualities of a strong nurse leader.4 These skills are supported by a shared governance structure. Participation in shared governance also fosters relationships through consensus decision-making; members are actively listening and are open and honest with each other, creating an emotionally safe space.5 The chair and cochair's duties and responsibilities also provide leadership growth and development. These responsibilities include creating agendas, leading meetings, dealing with differing opinions, facilitating consensus decision-making, addressing practice changes that arise from council meetings and decisions, and conducting follow-up after council meetings.5 CREATING A PLAN OF ACTION Most organizations have a shared governance structure, either formal or informal. You can begin by examining your council membership. Do you have clinical nurses as members of your shared governance council? Educating all members on the shared governance structure and process is important because they need to understand the overall process and expectations of the distinct roles. Education specific to the chair and cochair roles is especially valuable because that's where your leadership development begins. Educating staff on what shared governance is and what it can do promotes staff buy-in. You can also create structures and processes to support shared governance, such as holding all nursing organization shared governance meetings on one day. Professional development programs offer “points” or credit for being part of a shared governance council or holding a chair or cochair role. These roles have built-in professional time that's devoted to creating an agenda, meeting with a council leader or sponsor, reviewing minutes to send out to the council, and following up on the council's work. The most important thing is to start where you are. Utilize councils you already have in place to develop and implement leadership education. The National Institutes of Health provides a great strategy for succession planning that can be incorporated into nursing shared governance.6 When thinking about succession planning for a nursing leadership role, it's important to consider and develop a profile for the knowledge, skills, abilities, and competencies needed to be successful in that position. From there, you can identify a talent pipeline, which often starts with the clinical nurses involved in shared governance. A gap assessment can help determine what skills a successor needs to develop, and these skills can then be cultivated through educational opportunities and experiences using the shared governance structure. When utilizing shared governance as a succession planning opportunity, the leader or leaders of the unit/department, service line, or organization-wide council can support this process in many ways. Nurse leaders are a resource not only to the chair and cochair but to the council as a whole. They coach and mentor the staff leaders (chair and cochair), which includes fostering a culture of accountability.5 Leaders should meet with the chairs and cochairs before the group meeting to discuss the agenda, set guidelines, articulate expectations around projects, and discuss the goals the council is working on. They can also support the staff leaders by establishing norms for looking at different points of view through open, two-way communication.5 TABLE 1: - Leadership responsibilities when supporting shared governance for succession planning Be a resource Share relevant information and create a respectful environment Be a coach/mentor to staff leaders (chair/cochair) How to lead a meeting How to set guidelines and expectations How to follow up on commitments How to foster a culture of accountability How to facilitate open conversations How to establish norms for looking at different or opposing opinions and discussion How to engage members in problem-solving LARGE ACADEMIC CENTER: ORGANIZATIONAL STRATEGY One large academic medical center with more than 1,000 beds knew the impact of shared governance, especially in the development of leaders, but had experienced challenges related to the COVID-19 pandemic's effects on healthcare and shared governance structures. Postpandemic efforts to revitalize the impact of shared governance within the organization welcomed a large number of nurses serving as unit-based council chairs with little to no leadership skills. The shared governance structure provided an opportune platform for clinical nurse leadership. Organizing an outcomes-focused, working unit council with their peers, leading collegial conversations, and collaborating with interprofessional teams was a challenge for these nurses. To mentor, support, and retain these nurses, a leadership development series was created and incorporated into the hospital-wide shared governance monthly meetings. The organization holds monthly Clinical Nurse Council meetings, and the unit-based council chairs from every unit/department, including inpatient, ambulatory, and procedural areas, attend these meetings. An initial needs assessment showed that the shared governance council wanted more education regarding communication specific to handling discussions with patients and families who are upset and angry and having crucial conversations with colleagues. Topics identified on the needs assessment also included basic business acumen, such as staffing and productivity. The Magnet® Program Director, who facilitates nursing shared governance, began coordinating with the executive leadership team to provide focused leadership development learning sessions during the shared governance meetings. Nursing vice presidents, nursing directors, the CNO, and several other advanced leaders taught 1-hour sessions based on the clinical nurses' needs. Topics included managing critical conversations, identifying a personal leadership style, determining when a different leadership style is appropriate, understanding the basics of staffing grids and productivity, and performing service recovery with patient experience. Evolving topics are forthcoming monthly as clinical nurses identify additional needs, and new unit-based council representatives join the shared governance council. As this organization approaches a year of leadership offerings, an annual online survey will be used to evaluate the overall leadership offering and topics. It's also important to note that since the organization began revitalizing its shared governance structure and implementing leadership educational programs, 7.5% of its shared governance members have been promoted to nurse manager positions. A PARTNERSHIP FOR GROWTH Leadership development and succession planning are integral characteristics of the organization's plan to grow future nurse leaders. Marrying together leadership development and clinical nurse shared governance seamlessly enables the identification of future leaders. Clinical nurses can develop tools and identify resources to improve their leadership skill set for any formal or informal roles they're serving in currently or aspire to move into in the future. As a nursing leadership position opens, the unit-based shared governance chair is often looked to first for an internal promotion. With a leadership development program in place through shared governance, these nurses are set up for success.