Like health systems across the country and around the world, Emory Healthcare in Atlanta faced a personal protective equipment shortage when the coronavirus pandemic hit.
The system was running out of gowns and had to decide whether to recycle or wash them. Instead of making that decision themselves, Emory’s leaders turned to their nurses.
“As we were moving through the pandemic, I had really thought about how much are we engaging our front-line clinicians in making decisions about what they do to keep themselves safe,” said Sharon Pappas, chief nurse executive for Emory.
Because Emory has what is called a shared governance or professional governance system in place, nurses already served on unit-, hospital- and system-level governance councils in which they share in decisionmaking. When Pappas directed the gown dilemma to the councils, nurses came together to decide to transition from paper gowns to cloth ones that could be washed.
“To me, that was a wonderful application of professional governance engaging them,” Pappas said. “When people feel in control of decisions, it contributes positively to their well-being. They don’t feel like decisions are being pushed to them.”
Involving nurses in conversations and decisions about patient care, safety, training and operations has helped systems better respond to the coronavirus pandemic in a way that empowers them, even as they tackle unprecedented levels of stress, leaders say.
“These individuals are in the best position to really decide what clinical care should look like,” Pappas said. “It’s our job as clinical leaders to create a work environment where that’s possible.”
Since its introduction a few decades ago, professional governance is now in place at about a quarter of the country’s roughly 4,200 acute-care hospitals, estimated Tim Porter-O’Grady, a nurse and a healthcare consultant who is often referred to as the pioneer of the professional governance model. “It’s still a journey that we’re on,” Porter-O’Grady said. “As much as I’d like to think we’re at a place where we value what each professional brings to the collective, it’s still not fully there.”
The tenets of professional governance are embedded in the American Nurses Credentialing Center’s voluntary Magnet and Pathway to Excellence programs, which recognize healthcare organizations that value and prioritize nursing. At last count, there were 540 Magnet and 192 Pathways to Excellence-recognized hospitals, a number that grows about 10% to 15% each year, according to Rebecca Graystone, vice president of the Magnet Recognition and Pathway to Excellence programs.
“While it is a recognition of nursing excellence, it is a recognition of the entire healthcare organization because of the interprofessional nature of how healthcare is delivered. It’s a recognition of all of those voices,” Graystone said.