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decision-making, hospitals, nurse staffing, policymaking



  1. Bartmess, Marissa P. BSN, RN
  2. Myers, Carole R. PhD, RN, FAAN
  3. Thomas, Sandra P. PhD, RN, FAAN


Background: Hospitalized patient and nursing outcomes improve when nurses are involved in decision-making practices through shared governance structures. Yet there has been little research investigating how staff nurses are involved in hospital staffing policymaking and how they perceive this process.


Purpose: The study's primary aims were to increase understanding of staff nurses' perceptions of factors that hinder or support nurse involvement in hospital nurse staffing policymaking and to learn more about how nurses are, or would like to be, so involved. We also collected nurses' work environment and demographic information to further inform our understanding.


Methods: This study used a qualitative descriptive approach. Using QuestionPro software, we solicited open-ended responses to semistructured questions to explore the topics of interest. The online form was distributed via social media. Results were analyzed using conventional content analysis. Multiple-choice questions related to demographics and nurse work environments were also included, and these results were analyzed using descriptive statistics.


Results: Thirty-two staff nurses completed the online form between April 5 and May 24, 2021. Identified themes include "We aren't asked": structural barriers to staff nurse involvement; "No one cares": workplace culture barriers to staff nurse involvement; and "'They' versus 'we'": lack of power sharing for staffing decision-making. Participants described feeling powerless with regard to, and having little to no involvement in, hospital staffing policymaking. Yet they also expressed their desire to be engaged in this process and offered suggestions for how nurse involvement in such policymaking could be improved.


Conclusion: Our findings provide crucial insight into how organizations can address existing structural barriers to nurse involvement, offer more equitable opportunities for nurse involvement, foster more inclusive workplace cultures, and recognize the value of nurse input and autonomy regarding staffing decisions.