Clinical nurses perceptions on shared governance application at the National Center for Cancer Care and Research

Abstract

Aim:Organizational restructuring and reform in the health care system have led to uncertainty and susceptibility among clinical nurses and their work environment. As a result, a negative effect on the nurse's role in decision making and delivery of patient care has been created. If nurses at the National Center for Cancer care and Research (NCCCR) have the ability to influence decisions that affect them the result will be more positive outcomes for patients, for the organization, and for the nurses themselves.Methods:This study confirms the importance of shared governance and its positive effects on nurse recruitment and retention, nurse satisfaction, and optimal patient outcomes. The study investigated the internal and external factors that affect clinical nurses’ (CN) professional practices. The descriptive study design using the Hess Index of professional Nursing governance addressed to CNs in addition to the questionnaire including seven open ended questions generated quantitative and qualitative responses on the nurses’ perceptions of share governanceat the NCCCR. Section I of the survey included demographic information about the CNs. Section II included 86 questions addressing six subscales, (I- Professional control, II- Organizational influence, III-Organizational recognition, IV-Facilitating structures, V- Liaison and VI- Alignment. These questions were rated on 5 point Likert scale.Results:A sample of 200 CNs was invited to participate in the study. 105 CNs responded to this study (52.5percent). The overall mean scores for each of the six subscales, which range between 1.9092 and 2.1484, indicate that CNs generally perceive that their work environments are controlled by nursing management-administration only, or primarily nursing management-administration with some staff nurse input. The qualitative responses revealed internal and external factors. The themes representing the internal factors include influencing decision making, quality of care, professionalism and satisfaction. Themes relevant to