1. Porter-O'Grady, Tim DM, EdD, APRN, FAAN
  2. Weston, Marla J. PhD, RN, FAAN
  3. Clavelle, Joanne T. DNP, RN, NEA-BC, FAAN
  4. Meek, Paula PhD, RN, FAAN

Article Content

Nurse leaders play a vital role in comprehending and promulgating the structures and relationships that demonstrate nursing professional governance (NPG). Contemporary leadership science has long abandoned industrial age hierarchical structures and management models in favor of more complexity-grounded and collateral approaches to organizational leadership. Nurse leaders are crucial to creating the infrastructure and nurturing the culture that enables and sustains staff investment in their proprietorship of professional nursing practice. The competent, contemporary nurse leader understands that the outcomes of the work of the nursing profession cannot be obtained or sustained without the practicing nurse's ownership, engagement, and full participation in nursing decisions and actions related to nursing knowledge, practice, competence, and quality.


A positive professional practice environment enables nurses in the work of professional practice: generating new knowledge through nurse-led research; coordinating, integrating, and facilitating patient care; enhancing peer dynamics; expanding evidence-grounded problem solving; and advancing health outcomes. Professional practice, communication, collaboration, and transdisciplinary relationships must be structured in a way that equitably aligns professional nurses with other health professionals at every level, setting strategy, policy, protocols, and practices that inform and improve patient care and community health. Indeed, the originating intent and design of NPG was to create structures for these essential relationships and to engage the character and capacity of professional nurses as an equitable partner in translating clinical principles into interprofessional practices and relationships across the healthcare continuum.


For over 40 years, nursing shared governance in healthcare laid the foundations for NPG across the globe and has matured as the preferred structural framework for professional nursing practice. The aggregate of NPG research over these four decades has demonstrated NPG's positive impact on patient and organizational outcomes, nurse satisfaction, and nurses' engagement in decisions affecting their practice. However, data over these years also reflect a significant amount of controversy and confusion over precisely what NPG is, its uniform implementation across the health system, its place in Magnet(R) model components and sources of evidence, and its impact on nurses and health outcomes. During the pandemic, evidence of the value of NPG was often left behind, as institutional incident command structures were constructed to handle crisis decisions, clearly suggesting a lack of knowledge and/or commitment related to the principles that underpin NPG. The utilization of NPG and engagement of nurses in critical decision making was often diminished and sometimes extinguished in the midst of this crisis. This lack of inclusion of staff nurses in decision making contributed to disengagement, disinvestment, lack of trust, and loss of ownership, adding to the many reasons nurses abandoned their organizations during this time, some choosing to practice for high paying travel agencies and others even leaving the nursing profession altogether.


All of this reminds us of the essential role that sound research plays in the practice of a profession. It is not a far leap of logic to affirm that nurse leaders must be fully invested in the research process related to patient care, as well as NPG, the practice environment, professional structures, and collateral relationships. For leaders, nursing research related to these factors should not be periodic projects or initiatives, but rather should reflect a deep and continuous exploration of the evidence, which reveals the interface of these components and the impact of their aggregation on the practicing nurse and on outcomes of the delivery of care.


New tools and instruments, such as the Verran Professional Governance Scale(C)1 reviewed in this issue, are available to assist nurse leaders in delving into the structural and environmental elements that enable or impede nursing professional practice. Emerging from this extrapolated body of evidence are templates and algorithms which suggest and validate appropriate and consistent elements of structure and relationship that enable and advance the work of the profession. Practice leadership must not continue to see research as an academic exercise. Data generating opportunities can be rooted in models, theories, and standards of evidence-based methods and can be deliberately designed into the processes, models, roles, and measures of nursing practice and care. Doing so makes research a normative part of nurses' work, deepening their appreciation for its utility and facilitating needed changes in nursing practice that are applicable and timely.


We hope that this research issue of JONA renews and reinvigorates the nurse leader to identify both the value and opportunity of their engagement in nursing research and in the use of empirical data to positively impact the professional practice environment and patient care. At a time when the very foundations of health organizations and providers of care are pushed to the edges of tolerance and resilience, it becomes necessary to renew our affirmation of scientific and research processes and re-evaluate and reconfigure for effective health service delivery. This transformation certainly cannot be obtained without the investment and commitment of nursing organizational and practice leadership. The test of our success will be nursing leadership dedication to and investment in the research activities that provide both the discipline and society evidence of the prevailing and sustaining value of science-based nursing practice.




1. The Verran Professional Governance Scale(C): confirmatory and exploratory analysis. JONA. 2022;52(5):273-279. [Context Link]