Candy Burns is a vice president of nursing at a multisite hospital system with a total bed capacity of 1016. Nurse
Burns began her job 2 months ago. When she was hired, she advocated a shared governance approach to professional practice and promised to downsize the nursing management team. The organizational chart is pyramidal and has 12 levels, from the chief executive officer to the clinical nurse. Nurse Burns worked hard on a plan to implement a new model of professional governance. Two months later, she decided to have a clinical and administrative track and divide authority between the two. Nurse Burns has established a task force of managers, directors, supervisors, coordinators, charge nurses, and clinical nurses to formalize a committee or forum structure and determine the responsibilities for each group. She also has charged the group with eliminating the three levels of nursing management. They are to supply recommendations on how to place or retrain the employees from the bumped positions and give suggestions on how to implement a peer evaluation system in the hospital system.
1. These are a lot of changes for one hospital system. (a) What can Nurse Burns point to as some advantages of implementing a model of shared governance in a previously bureaucratic organization? (b) Suppose the nursing staff is resistant. Can Nurse Burns make a case for this model's ability to empower and improve nurses' performance? If so, how?
2. Nurse Burns is met with strong resistance from several nurse managers. They come to her as a group to express their concerns. One manager, who seems to speak for the group says, "I feel I've been stripped of not just my roles and responsibilities, but my usefulness as well. How do I even fit in here if my nurses now make most of their own clinical decisions?" How should she answer?
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