Being Heard: A Classical Grounded Theory Exploring the Experiences of Bedside Nurses Working in Children's Hospitals with Established Shared Governance Models

This Classical Grounded Theory (CGT) study explored the experiences of bedside nurses working in children’s hospitals where shared governance (SG) has been in place for at least four years. Shared governance is a professional practice model that has been offered as a way to improve nurse satisfaction, decrease nursing turnover, and increase nurse retention by including bedside nurses in the decision making processes affecting patient care, their practice environment, and the governance structure within their hospitals (Burnhope & Edmonstone, 2003; Linnen, 2014). The goal of a CGT study is to explore social processes and develop theory grounded in actual data (Glaser, 1998). Analysis of study data resulted in identification of the substantive theory, Being Heard, the nurses’ main concern. Nurses resolve their main concern, being heard, by a process of voicing consisting of three phases: willingness, engaging, and assessing. Nurses first must be willing to offer their voice, then they can engage by participating in governance processes within the hospital system followed by assessing whether their voice has been heard by observing how their input was received and what happened to their input; the outcomes of their assessment will affect whether they will be willing to participate in the future. The substantive theory, Being Heard, describes the dynamic, interactive relationships between bedside nurses and hospital management and emphasizes the impact of presence and time in the relationships between bedside nurses and hospital management. Hospitals that truly hear nurses, invite their input, and respond, are able to tap into an important source of information that can improve patient outcomes, enhance nurse retention, and improve the hospital’s financial status. The substantive theory, Being Heard, suggest that hospitals where nurses are not heard deprive themselves of important information, they demonstrate lack of respect and trust for their nursing staff; ultimately their financial status will be impacted by nursing dissatisfaction and nurse turnover, which can affect patient satisfaction and outcomes. The substantive theory, Being Heard, that emerged from this CGT study reflect the experiences of bedside nurses who practice in a SG environment and can inform healthcare administrators, nursing directors, and managers who are utilizing, or plan to implement, a SG model.