This type of engagement is important for nurses it

medication errors and peer reviews of medical documentation. This type of engagement is
important for nurses it aids in their professional development and being involved in committees
brings about changes that are realistic and meet the needs of both patients and staff (American
Nurses Association, 2015).
Shared governance in nursing practice integrates core values and beliefs that professional
practice embraces, as a means of achieving quality care. Shared governance models improve
nurses’ work environment, satisfaction, and retention (American Nurses Association, 2015).
Shared governance helps to create a sense of responsibility in decision-making. Bedside nurses
along with leadership make decisions for the good of the patients and the organization. When a
group comes together to share ideas from different perspectives the decision process produces
outcomes that are considerate of all parties. Shared governance generally address practice,
management, quality and education.
Team nursing is another way nurses come together with shared goals and responsibilities.
With team nursing the well-experienced nurse is teamed up with a novice nurse to care for
patient. The mentor protégée model increases self-confidence for new nurses and allows them
access to the knowledge and experience that the mentor nurse has obtained through years of
experience. On the other hand, the new nurse may have new emerging knowledge to share with
the long time practicing mentor. Sharing knowledge, the responsibility and common goals for
positive patient outcomes ("Team nursing benefits both staff and patients," 2005).
Nurses and nurse leaders follow a hierarchy of authority that shows who is in charge of
who. This hierarchy is the chain of command. A chain of command goes from the bottom to the

PROFESSIONAL NURSING PRACTICE 16
top of an organization. It establishes accountability, lines of authority and decision making
power. Chain of command communicates which employee is responsible for what decisions in
their interaction. Job titles, that define each level of the organization, further communicate
authority and responsibility to organizational stakeholders and outsiders (Heathfield, 2017).
Leaders should foster a learning environment that includes training and career
development. Employees that continue to add to their skill sets sustain and enhance the
productivity of the organization. One-way organizations try to accomplish retention and
development is by implementing a clinical ladder. The clinical ladder is a structure of grading
nurses based on patient care skills, it rewards nurses for dedication and recognizes nurses for
proficiency and usually comes with monetary compensation (American Nurses Association,
2015). The clinical ladder motivates nurses that are goal oriented it can be an engaging and
challenging method for development and retention.