Nurse Staffing and Staff Nurse Involvement in Hospital Staffing Governance: Explorations of Policy and Practice

Researchers have identified links between adequate nurse staffing in hospital settings and patient outcomes for decades. However, nurse staffing continues to be a prevalent issue within nursing and healthcare communities, with nurses citing inadequate staffing as a reason for leaving hospital settings. There are several factors to consider when staffing nurses for quality patient care in hospital settings. However, supporting nurse autonomy over staffing decision-making is a means by which multiple staffing factors can be addressed. This dissertation explores how staff nurses describe involvement with hospital staffing decision-making and their experiences with this phenomenon in practice through a specific means for involvement, nurse staffing committees (NSCs). For staff nurses, involvement with staffing decision-making largely depended on whether they had access to mechanisms for involvement (Chapter Three), an effective means of involvement (Chapter Four), and a workplace culture that valued their contributions (Chapters Three and Four). This dissertation identified that performative, inauthentic shared governance practices from hospital leaders could contribute to nurse dissatisfaction and less involvement with staffing-decision making. There are opportunities to strengthen staff nurse involvement with hospital staffing decision-making through NSCs. Still, the nurse perceived value of NSCs is contingent on how well NSCs function and whether nurses feel their efforts and recommendations to improve staffing are valued.