Nurses Agent of Change Through Governance

In spring 2005, some nurses in O’Brien’s group expressed concern about the care of patients who were taking the blood thinner Coumadin. Variations in blood consistency could put patients at risk of life-threatening clotting or bleeding. Once patients on this medication left the hospital, there was no procedure in place to determine how frequently they should return to have their blood tested.

Agreeing this issue needed to be addressed, the council extensively researched how often patients should be tested. In September 2005, the hospital implemented new guidelines based on the council’s findings.

“It was really invigorating to be part of something that affects patient care in a good way,” says O’Brien, now a unit manager. “As a member of the council, you really get past your day-to-day duties and start to think about what you are doing. It makes you think like a professional, and that is the part that is really fulfilling.”

Another perk of shared governance is the chance to work alongside physicians to achieve a common goal. “Nurses have historically been under physicians, and to come together collaboratively is really rewarding,” O’Brien says.

Taking Ownership

Governance councils can also pursue goals that require input from multiple departments. That was the case at El Camino Hospital, when the emergency department partnership council decided reducing hospital bed wait times by 20 percent was in order.

Meeting in monthly, two-hour sessions, the council, which included physicians, nurses, an emergency department technician and administrative staff, decided to establish a triage area for ER patients who could be treated quickly, thus leaving ER beds free for patients with more serious conditions.