RN Voices are Heard Through UW Health's Enhanced Nursing Councils

In 2004, the beginnings of a nursing shared governance and council structure were in full swing at UW Hospitals and Clinics. Ten councils were made up of 40 percent direct care nurses with a nursing director chairing each meeting. By 2014, the councils expanded to 13 and membership moved from 40 to 60 percent direct care nurses, with each council chaired by a direct care RN. In 2016, the councils grew to include an even broader representation of nurses from a variety of clinical settings that represent a truly integrated UW Health.


Part of what fueled the sensitivity and awareness for nurses to have more of a voice, were the principles of Magnet® that state: "Nurses throughout the organization are involved in self-governance and decision-making; making structures and processes that establish standards of practice and address issues of concerns."


Face-to-face, two-way communication between leadership and direct care staff enables us all to make the best decisions to create a safe and successful practice environment for patients, families and staff.In 2014, anecdotal comments about the operation and effectiveness of the councils sparked the formation of a workgroup, which was endorsed by the UW Health Nursing Executive Council, and charged to conduct a formal evaluation of the current council structure that would include:

  • A review of council goals, accomplishments, relation to strategic goals and projected costs.
  • A manager survey that collected information regarding issues related to scheduling and attendance.
  • Index of Professional Nursing Governance (IPNG), a validated tool that defines the governance distribution of the study group on a continuum of traditional to selfgovernance.

Results of the IPNG survey indicated that nurses perceived UW Health's governance structure as traditional and that nurses had little input. The results of the evaluation were shared at All Council Day and a Council Revision Workgroup was commissioned to develop a plan to revise UW Health's current shared governance structure. The proposed changes— including better collaboration and communication among councils, having all nursing areas represented, work/council time allotted for projects, and educational plans among other improvements—were implemented in July 2016.


"One of the most exciting changes we made to the shared governance structure is having our nursing executive leaders meet with the council chairs and chair-elects—a total of 16 direct care nurses—each month to review direct care RN submissions of ideas and concerns," states Ann Wieben, BSN, RN-BC, chair of the Nursing Coordinating Council. "That face-to-face, two-way communication between leadership and direct care staff is invaluable. It enables us all to make the best decisions to create a safe and successful practice environment for patients, families and staff."


Wieben is also aware of the work ahead and fully committed to the improvement process. "One of our main priorities is finding the best communication strategies to reach all direct care staff as our organization continues to grow," Wieben continues. "We are also dedicated to making the entire process of shared governance more transparent so that direct care staff know all the ways that direct care nurses are involved in decision making and changes here at UW Health."