Shared Governance and Rapid Response Teams Beyond Clinical Practice: The Nurse Executive Advisory Cabinet

Nurses have continuously met challenges and adapted to change within an environment that is in constant flux. Given the need to transform care models and systems to respond to healthcare reform while balancing the quality and cost equation, nurses are working within a rule- and policy-imposing structure that profoundly affects their level of control over nursing practice (CONP) and engagement. Nurses are challenged to work in an environment in which the pressure to add value, optimize resources, and decrease expenses is moving at a faster pace than the work to transform the clinical delivery model and workflow. Consequently, this may result in a decreased sense of autonomy and overall CONP, augmenting the case for change. This sense of urgency, the need to find new solutions to old problems, presents an opportunity to creatively re-engage nurses in a greater breadth (i.e., type and level of involvement) of decision making and influence over practice and the context in which care is delivered.