There are certain words and phrases that are used frequently in nursing and medicine – sometimes so frequently that we lose our understanding of their true meaning. Or sometimes, we may not have really understood them at all.

For me, “shared governance” was one such phrase. In the past, if someone had asked me what shared governance meant, I would have had some difficulty explaining it in great detail. Sure, I would have answered that it’s a model for nurses to work together and manage themselves, but beyond that, I’d have been at a loss.

That is, until, I did some reading. Now I feel better prepared to discuss shared governance and its role in nursing. Here’s what I’d say now:

Shared governance is collaboration, whether in scheduling staff, educating new staff, or implementing evidence-based practice. It involves teamwork, problem-solving, and accountability, with the goals of improved staff satisfaction, productivity, and patient outcomes. It is working together to make decisions that affect nursing practice and patient care. It is working with other disciplines for the good of the patient. It is collaborating to improve nursing practice. 

Allow me to share the following excerpt which I found very enlightening:

The structure is shared governance; the process is professional nursing practice; the outcomes are positive productivity data.¹

Is a shared governance structure in place where you work? Have you been involved with implementing shared governance? I'd love to learn more; it sounds like the ideal working environment, but I'm wondering - does it truly exist?

1. Church, J.A., Baker, P., Berry, D.M. (2008). Shared governance: A journey with continual mile markers. Nursing Management, 39 (8).

Change is not usually easy. Nurses who have made nursing their second (or third or fourth…) career deserve much recognition and respect. Imagine being an expert accountant, someone who people seek out to answer their financial questions and meet their needs, and then starting over from scratch in a new environment, with new people, learning new skills and knowledge.  Imagine returning to the novice role after already having travelled that path of novice to expert. Remember those days of care plans and clinicals, searching for a job, and then starting work in an unfamiliar unit or facility. Now imagine doing it all over again. A bit overwhelming, isn’t it?

In the January/February issue of Nursing Made Incredible Easy, Sally Jo Borrello, MSN, RN, CTTS, takes a closer look at the second-career nurse.  She reminds us that while individuals pursuing nursing as a second career are usually adult learners who are more serious and confident than their younger counterparts, they still face the same long hours of studying and class preparation. Many are also sacrificing personal and family time to obtain their degree.

The author goes on to share tips for experienced nurses to mentor second-career nurses. Building a mutually respectful and trusting relationship is key. Remember that this mentee is bringing his or her background and knowledge to the relationship also, so be open to learning quite a bit yourself. Use positive feedback to support and guide this student or new nurse.

Are you a second-career RN or currently pursuing nursing as a second career? Please chime in with your thoughts and experiences!

   Recent news about pertussis outbreaks that have resulted in infant deaths is causing serious concern in the healthcare community. Back in August 2006 and again in July 2010 the Institute for Safe Medication Practices (ISMP) issued a warning about confusion of Adacel and Daptacel which are vaccines for the prevention of tetanus, pertusis, and diptheria. ISMP explained how administering the incorrect vaccine to infants can result in ineffective immunization leaving babies vulnerable to infection. The IMSP Medication Safety Alert from July 1 2010 reported that "Part of the problem is that the official names of the products are very similar although stated in different order on the labels. One of them, diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP), is sold under the brand names DAPTACEL and TRIPEDIA (Sanofi Pasteur), and INFANRIX (GlaxoSmithKline). This formulation is for active immunization of pediatric patients 6 weeks through 6 years of age. The other vaccine, tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine (Tdap), is sold under the names BOOSTRIX (GlaxoSmithKline) and ADACEL (Sanofi Pasteur), and is meant to be used as booster shots for older children, adolescents, and adults."

   This is back to school season and vaccines are on the minds of parents, schools nurses, pediatric nurses and NPs. This is a perfect time to review our procedures for prescribing and administering childhood vaccines to ensure that the correct vaccine is ordered and administered each time. For more details on the recommended vaccine schedule, go to the Center for Disease Control and Prevention website at http://www.cdc.gov/vaccines/recs/schedules/.