The Relation between Shared Decision Making and Organizational Commitment among Nurses

Summary Enhancing nurses' involvement in decision-making has great role on improving nurses' retention on health care organization. Involvement of nurses in decision-making becomes an opportunity for authority distribution and enhancing positive work environment in the health care organization as a long-term strategy, which operates at both individual and unit levels. In addition, it leads to reduced levels of turnover, increase nurses motivation which in turn leads to their commitment to the organization. Therefore, the management has to utilize structural measures such as shared decision making that lead to job satisfaction through the empowerment of nurses in order to reinforce their willing to remain in their work places. The study aimed to assess the relation between shared decision making and organizational commitment among nurses. Research design: Descriptive correlational design was utilized to conduct this study. Setting: The study was conducted in twelve critical care units affiliated to Beni-Suef University Hospital. Subject: The subjects included all available staff nurses (220) who were responsible for providing direct nursing care activities to patients in the above mentioned study setting. Tools of data collection:- The data for the study was collected by using two tools as following: 1) Decisional involvement scale To measure actual staff nurses participation in decision making. It consisted of two parts:- Part (1): Personal data of the staff nurses (age, gender, educational qualification, marital status, department and years of experience). Part (2): It consists of (21) items divided into six main dimension, Quality of Support staff practice (3 items), unit staffing (2 items), quality of professional practice (5 items), Professional recruitment (4 items), unit governance and leadership (4 items) and collaboration/ liaison activities (3 items). Organizational commitment questionnaire: To assess the level of staff nurses' organizational commitment. It consisted of (18) items divided into three main dimension; affective commitment (6 items), normative commitment (6 items) and continuous commitment (6 items). The study has generated the following findings: 1- More than three fifth of staff nurses had low level of shared decision making. 2- More than half of staff nurses had moderate level of organizational commitment. 3- There was highly statistical significant difference between total staff nurses' shared decision making and their working department. 4-There was highly statistical significant difference between total staff nurses' organizational commitment and their working department. 6- There was statistical significant correlation between shared decision making and organizational commitment among studied nurses. In the light of the findings obtained from the present study, the following points are recommended: At nursing level: 1. Nursing manager should create and sustain a culture of nonhierarchical communication and utilization of shared decision making which empower nurses to participate in decisions that affect their work processes. 2. Nursing director should put evaluative measures to be used as standard in choosing nurses managerial and administrative position regarding their skills and abilities regardless their age. 3. Head nurses should encourage staff nurse inputs in critical decisions that affect them to keep their involvement in the process. 4. Conducting orientation program for new nurses about the goals, policies, objectives and regulations of the organization to improve their affective commitment. 5. Hospital administration should improve incentive and promotion system for nursing staff to enhance their continuous commitment. 6. Making a trust relationship between nursing administration and staff nurses and provide them with needed support so they may be more committed to their organization. At educational level 1. Shared decision-making as a theoretical body of knowledge must be integrated in undergraduate and postgraduate curricula to enhance nurses' knowledge regarding it. 2. The hospital should provide training courses to improve decision making ability of nursing staff. Further research:  Identify factors that improve or impede shared decision making among nurses e.g. leadership style, organizational structures, demographic variables.  Conduct intervention studies to examine the effectiveness, cost & benefit of different strategies aimed in increasing shared decision making of nurses and improving their organizational commitment.