Nurses' critical reflections of working in unit practice councils-A qualitative interview study

Area of Science:

• Nursing Management
• Healthcare Organization
• Qualitative Research

Background:

• Healthcare organizations globally seek increased personnel involvement in decision-making processes.
• Unit practice councils are established to facilitate unit-level decision-making on specific issues.
• Limited research exists on nurses' direct experiences within these councils.

Purpose of the Study:

• To explore and describe the lived experiences of nurses serving as members of unit practice councils.
• To understand the facilitators and barriers influencing nurses' participation in unit-level decision-making.

Main Methods:

• A descriptive qualitative study design was employed.
• Semi-structured interviews were conducted with 16 nurses across two clinics in a Finnish university hospital.
• Thematic analysis was utilized to analyze the interview data.

Main Results:

• Two primary themes emerged: 'inchoate unit practice councils with insufficient allocated working time' and 'partial empowerment of nurses through the organization's evolving Magnet project'.
• Nurses reported challenges related to time constraints and the nascent stage of council development.
• Evidence of partial empowerment was observed, linked to organizational initiatives like the Magnet project.

Conclusions:

• Unit practice councils in the studied settings are underdeveloped, hindering effective shared decision-making and the support of nurses' professional autonomy.
• Sustained support from all organizational leadership levels is crucial for the future effectiveness of these councils.
• Fostering trust and respecting professional autonomy are essential for successful shared decision-making, benefiting both nurses and leadership.