Glossary
SE - Structural Empowerment

SE1: Professional Engagement-Describe and demonstrate the structure(s) and process(es) that enable nurses from all settings and roles to actively participate in organizational decision-making groups such as committees, councils, and task forces.

Findings

Missing:

  • Except for the CNO, narrative description and verifying evidence for the processes that enable nurses at all levels to actively participate in organizational decision-making groups were not provided

Resolution:

  • Narrative descriptions and verifying evidence provided

Nursing directors, managers, coordinators, and direct care nurses actively participate in over 20 interdisciplinary task forces, committees, and shared governance nursing councils. It is the culture and expectation at Jersey City Medical Center that nurses at all levels have a professional obligation to actively participate in organizational decision making. This is established through the ongoing commitment and participation in various nursing and interdisciplinary committees, councils and task forces. During the RN orientation program, all new nursing employees are introduced to the JCMC Magnet Shared Governance Structure (Reference SE1-A). The purpose and significance of membership and council goals are reviewed and discussed to encourage participation by the newly hired nurses.

Nursing Directors, Managers and Leaders provide various opportunities for nurses who are interested in attending nursing and interdisciplinary councils. As discussed in EP9, direct care nurses participate in self scheduling. This process allows the nurses to either schedule themselves to work on scheduled meeting dates or request the day off if they prefer to attend the meeting during their non-working hours. Nurses who attend meetings on their own time are paid for meeting attendance. Please refer to Reference SE1-B for evidence of a direct care nurse who worked the morning shift from 7am to 3pm, punching in at 6:15am for meeting attendance.

Nurse driven coverage is supported and provided by direct care nurses so that nurses assigned to the councils can leave the unit to attend nursing council and multidisciplinary meetings. Nursing leaders assist with this process by posting meeting dates in advance to ensure adequate staffing and commitment by attendees. Charge nurses and coordinators frequently provide coverage for direct care nurses and assume responsibilities for nursing assignments during meetings (Reference SE1-C). In addition, the chairs of Quality and Safety Council, Claudia Garzon-Rivera RN, CNL, CCRN and Nursing Research Council, Mabel LaForgia RN, CNL, CCRN, developed and implemented guidelines for virtual attendance to provide additional opportunities for nurses to participate in council decision making when unable to attend the meeting. Please refer to Reference SE1-D for guidelines for virtual participation.

In addition to active participation by nurses in nursing councils, JCMC nurses and nurse practitioners participate in many interdisciplinary committees such as the Critical Care Committee (Appendix SE1-E & SE1-F ), Infections Control Committee (Appendix SE1-G ) and SE1-H ), and Pharmacy and Therapeutics (P&T) (Appendix SE1-I and SE1-J ). These forums provide nurses and nurse practitioners the opportunity to be involved in organizational decision making.

Nurse Practitioners bring a variety of expertise and knowledge to organizational committees. As salaried employees, nursing leadership provides them the autonomy and flexibility to adjust their schedules in order to participate in organizational meetings. For example, Jessica Babich NP-C attends the Infection Control, Environment of Care meetings, and is the chairperson of the Sharps Safety Evaluation Committee (Appendix SE1-K and SE1-L ) on a monthly basis. In order to attend these meetings Ms Babich closes the employee health office during meeting times. Nancy Pain Palliative Care NP also attends various organizational monthly including the Ethics Committee, Critical Care Committee Meeting, and Adverse Events Team. Due to her ongoing responsibilities to patients and family members, nursing leadership provides her with a smart phone and laptop so that she can maintain accessible to patients families and staff during the meetings.

Implementation of New Nursing Structure at JCMC

In 2013, a new nursing model was implemented to further enable nurses from all settings and roles to actively participate in organizational decision making. Under the leadership of Rita Smith RN, DNP, NEA-BC, Chief Nursing Officer of Patient Care Services, the nursing department was divided into two divisions, Nursing Operations and Clinical Practice. Margaret Ames MPH, RN, Associate Vice President provides strategic and clinical oversight over the operations of the clinical units. Please refer to Appendix SE1-M for a description of her role. The managers were promoted to Directors with additional responsibilities and commitments to enhance the Magnet Philosophy. Please refer to Appendix SE1-N for a description of their new roles. In addition, a new role of Patient Care Coordinators (PCC) was created for each unit. The PCCs whose new role does not include a patient care assignment provide additional support to the nursing staff allowing direct care nurses to be more active in nursing councils and interdisciplinary committees. In addition, the directors and managers further support PCC attendance on councils and committees by providing opportunities for them to be active members of these committees as well. During the 2013 Nursing Strategic Planning Session, the PCC’s played a vital role in defining their role in the Shared Governance process. Please review Appendix SE1-O for more information on the new PCC role.

The new department of Clinical Practice is headed by Associate Vice President Cheryl Owens MSN, RN, DNP(c). Ms. Owens provides strategic and administrative oversight over Shared Governance structure and processes, Magnet activities, and Nursing Practice. Under the leadership of Ms. Owens are the Director of Nursing Research and Evidence Based Practice, Mabel LaForgia MSN, RN, CNL, CCRN, the Director of Nursing Education, Nicole Sardinas MSN, RN, CCRN, and the Director of Clinical Excellence, Claudia Garzon-Rivera MSN, RN, CNL, CCRN. These new directors will assist in enhancing the Shared Governance process by leading various teams and encouraging staff nurse involvement. Please see Appendix SE1-P, SE1-Q, and SE1-R for descriptions of these new roles.

In 2013, a request was made by nursing council members to have all the meeting dates on the same date to further facilitate and enable nurses to attend council meetings. This process will also allow nurse managers and directors to schedule additional staffing to provide coverage for nurses when attending meetings. This process will be effective June 5th. Please refer to SE1-S for evidence of new nursing council meeting dates.