CNA346: Reflective Essay on Nursing Practice, Governance & Theory

This essay reflects on the author's nursing practice, emphasizing the importance of shared governance, clinical governance, and self-governance. The author highlights the significance of excellent communication and interpersonal skills within shared governance, referencing experiences working under senior nurses and actively participating in patient care planning. The essay also discusses clinical governance, focusing on the author's adherence to hand hygiene protocols to prevent nosocomial infections, aligning with NMBA standards for safe nursing practice. Furthermore, the author explores self-governance, emphasizing the ability to work under pressure in the emergency ward by effectively managing professional and personal life, while also acknowledging the supportive role of colleagues in preventing workplace bullying. The essay integrates theoretical knowledge with practical experiences, demonstrating an understanding of nursing governance frameworks and regulatory standards.

Running head: NURSING
Nursing
Name of the Student
Name of the University
Author Note

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Shared Governance: Excellent communication skills and interpersonal skills
Shared Governance is a framework where the professional ideals of nursing translate
into realities of structuring of the organizational and environmental design that enables
comprehensive participation of the nurses by increasing the provision of autonomy,
empowerment, leadership, decision-making process and accountability (Ott & Ross 2014).
Under shared governance, the main practice that I would like to highlight in excellent
communication skills and the interpersonal skills. During my clinical experience, I was
working under a senior nurse. My main responsibilities were to assist the senior nursing
professionals in delivery the care to the patients. My excellent display of both verbal and non-
verbal communication skills helped in establishing a healthy relationship with my senior
colleagues. Moreover, my excellent communication skills helped me to participate fully in
the process of planning, organising and delivery of patient care. According to Parker et al.
(2014), the concept of shared governance highlights improvement of the organizational
culture by working effectively under the negative work-environment by setting goals and
establishing healthy relationships with the team mates. My effective interpersonal
communication skills helped to generate a friendly relationship with by seniors and thereby
helping me to deliver work in pressure under their (seniors) guidance. Effective
communication skills and interpersonal communication skills falls under the scope of the
standard 2 of the registered nurse standard for practice made by the Nursing and the
Midwifery Board of Australia (NMBA) (2019). According to the standard 2, a nurse must
engage in therapeutic and professional relationships in order to improve the overall outcome
of care.

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Clinical Governance: Contribute to Safety and Healthy Working Environment
The concept of the clinical governance is slowly emerging in Australia under the
framework of safe systems thinking. It is cohesive approach for the management of risk. It is
important for the nursing professionals to understand where the framework of the clinical
governance has rise and why it is important under the nursing practice (Travaglia et al. 2011).
According to the Australian Commission on Safety and Quality in Healthcare (2018), the
main standards of the clinical governance includes governance of safety and quality in
healthcare service; partnering with consumers; prevention and controlling of the healthcare
associated infections, medication safety., proper identification of patient and procedure
matching, production of clinical handover; managing blood and blood products; preventing
and managing pressure injuries; recognising clinical deterioration and prevention falls. Under
of framework of the clinical governance, I would like to highlight my clinical experience
when I was assisting one senior registered nurse under emergency settings. I was asked to
check the blood pressure of the few accident victim patients. Both before and after checking
of the blood pressure, I would always wash my hands with proper disinfectant in order to
prevention cross-contamination through hand leading to noscomial infection. This practice of
mine coincided with the Nursing and Midwifery Board of Australia (NMBA) (2019) standard
one, which states that a nurse must think critically and analyse the proper nursing practise. I
delivered proper nursing practice under this context by thinking critically about the process of
execution of hand hygiene and thereby increasing the quality and safety of the healthcare
service (Twigg, Duffield & Evans 2013).
Self-Governance: Ability to work under pressure
The term self-governance is used to describe how the nursing profession governs
itself. In order words, it is used to describe how a nurse manages his or her own professional

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development (Adrian & Chiarella 2015). In order to promote my own professional
development, one of the important traits of mine that I want to highlight is my ability to work
under pressure. During my clinical practice experience in the emergency ward, I was asked to
assist one nurse at a time due to shortages of the trainees. I was assigned to note the vital
parameters of the patients and to report to the nursing professionals. I maintained the
capability of the nursing practice (Standard 3 of the NMBA) by effectively managing my
professional and personal life. I provided proper emotional labour while working under
double shifts in order to manage the feelings in a comprehensive manner by creating a
publicly observable facial and the bodily features. My approachable body image and a
positive facial expression helped my patients to interact spontaneously with me. Moreover,
my positive attitude towards work and my ability to differentiate my personal life with my
professional life helped me to work effectively work under pressure. I would also like to
highlight that shared governance framework for ability of work under pressure is also
attributed to my senior colleagues. My colleagues and my team mates were very supportive
as a result I never became a victim of the vertical and horizontal nursing bullying in the
workplace. Moreover, I was also aware of the concept of the workplace bulling. Awareness
about workplace bullying helps in self advocacy, generating a sense of self-determination to
work under pressure and positive identity (Karimi et al. 2014).

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References
Adrian, A. & Chiarella, M. 2015. ‘Transition into practice: the regulatory framework for
nursing’. Transitions in Nursing-E-Book: Preparing for Professional Practice, ch. 21,
pp.329.
Australian Commission on Safety and Quality in Healthcare. 2019. ‘Quality and Safety’.
Access date: 3rd Feb 2019. Retrieved from: https://www.safetyandquality.gov.au/
Karimi, L., Leggat, S.G., Donohue, L., Farrell, G. & Couper, G.E. 2014. ‘Emotional rescue:
The role of emotional intelligence and emotional labour on well‐being and job‐stress among
community nurses’. Journal of advanced nursing, vol. 70, no. 1, pp.176-186.
Nursing and the Midwifery Board of Australia (NMBA). 2019. ‘Registered nurse standard
for practice’. Access date: 3rd Feb 2019. Retrieved from:
https://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/professional-
standards/registered-nurse-standards-for-practice.aspx
Ott, J. & Ross, C. 2014. ‘The journey toward shared governance: the lived experience of
nurse managers and staff nurses’. Journal of nursing management, vol. 22, no.6, pp.761-768.
Parker, V., Giles, M., Lantry, G. & McMillan, M. 2014. ‘New graduate nurses' experiences in
their first year of practice’. Nurse Education Today, vol. 34, no. 1, pp.150-156.
Travaglia, J.F., Debono, D., Spigelman, A.D. & Braithwaite, J. 2011. ‘Clinical governance: a
review of key concepts in the literature’. Clinical Governance: An International Journal, vol.
16, no. 1, pp.62-77.

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Twigg, D.E., Duffield, C. & Evans, G. 2013. ‘The critical role of nurses to the successful
implementation of the National Safety and Quality Health Service Standards’. Australian
Health Review, vol. 37, no. 4, pp.541-546.