Leveraging Shared Governance to Build a Healthier Work Environment in a NICU

Abstract

Purpose: A unit-shared governance model was established in the NICU at Tampa General Hospital to enhance nursing autonomy and improve job satisfaction, teamwork, and patient outcomes.

Significance: Shared governance models have been introduced within health systems to shape healthy work environments.

Strategy and implementation: The NICU experienced an extended hiring freeze that led to a significant nursing shortage and staff dissatisfaction. A unit-shared governance model was established to address key areas of concern. This led to the development of the new employee orientation committee. Their goal was to make significant changes in the onboarding and precepting process, including: (1) revising the Registered Nurse Competency-Based Orientation tool to align with a 3-phased orientation process, (2) incorporating a systems approach throughout the orientation period, (3) embedding references to best practices and policies, (4) creating a reference list of recommended reading materials, and (5) developing a skills checklist to guide in selection of patient assignments. The final step was developing a NICU preceptor course to increase consistency between preceptors and standardize orientation.

Outcomes: Recent engagement survey results revealed significant improvements in employee satisfaction, validating key improvements made in the onboarding process.

Keywords: healthy work environment; orientation; precepting; shared governance.