Short staffing, increased violence, and unreasonable demands make it a grueling time to be a nurse. And as nice as an occasional pizza party can be, it doesn’t make up for the job’s challenges.
More than 138,000 registered nurses (RNs) and licensed practical/vocational nurses (LPN/VNs) left the workforce since 2022 and about 40% plan to leave or retire in the next five years, according to the National Council of State Boards of Nursing’s 2024 National Nursing Workforce study, which surveyed about 880,000 RNs and LPN/VNs. Those who leave before retirement age are often motivated by stress and burnout, according to the survey.
Staffing company AMN Healthcare’s 2025 Survey of Registered Nurses echoed this, finding only 39% of about 12,000 RNs planned to remain in their current positions.
So, health systems are pulling out all the stops to address this workforce issue. One increasingly used tool is creating a formal structure where bedside nurses can bring concerns and work together with leaders from other departments to make decisions around things like staffing, resources, and new equipment purchases. It’s known as shared governance.
“We are seeing some improvement in terms of overall how nurses are feeling…and I think these shared governance structures are part of the reason for that,” Angelo Venditti, chief nursing executive of staffing firm AMN Healthcare, told Healthcare Brew.
AdventHealth advances
Shared governance, a concept widely introduced in 1985, is required in order to join the American Nurses Credentialing Center Magnet Recognition Program, a designation for hospitals that meet the “gold standard” of nursing excellence.
AdventHealth’s Central Florida division, which employs about 10,000 nurses, employs a similar concept it calls professional governance.
“Professional governance is a broader term to encompass interprofessional collaboration since this group includes other positions besides nursing. It also includes different levels of nursing, from bedside to leadership positions,” Cathy Stankiewicz, chief nursing officer of AdventHealth in Central Florida, told Healthcare Brew.
The division has unit practice councils of employees who come together to discuss how to improve their units, and campus-level councils, where different units come together to discuss ways to improve their hospital campus as a whole.
In 2022, it added a nine-member nursing advisory panel that brought those campus voices together, leading to improvements in the nursing license renewal process and nursing feedback process, according to a press release.
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Then in May this year, AdventHealth upgraded its panel to a bigger professional governance group, including 40 nurses and other team members. The group meets monthly during work hours and makes decisions by majority vote for Stankiewicz to then green-light.
“Getting it to the system level—with a higher ability to leverage the voices of our nurses and influence healthcare differently—has been a really exciting opportunity,” Stankiewicz said.
Group member Beth Biele, a nurse of 20 years who currently works as part of the AdventHealth emergency room float pool, told us before the group’s first meeting in mid-May that she plans to focus on stopping burnout among younger nurses.
“We’re finding that new graduates are lasting a very short amount of time, which is frightening. They’re lasting maybe a year, two at the most,” Biele said. “We need to get to the bottom of that.”
Gretchen Martinez, an ICU nurse at AdventHealth Winter Park, told Healthcare Brew she feels similarly empowered by the panel. “[The panel] is showing to us that we do matter. Our voices do matter,” she said.
The group is divided into four subcommittees: nursing operations, workforce and professional development, quality and safety, and informatics and innovation.
A ways to go
But shared or professional governance is still a work in progress.
It was hard for some hospitals to keep shared governance structures intact during the pandemic when burnout hit record highs, according to a 2020 analysis in the journal Nurse Leader. Cleveland Clinic, for instance, had to revive one of its unit-level shared governance councils after the pandemic reduced participation.
Other hospitals have created workshops to help nurses be better leaders, and some have revamped their governance councils after nurses said they didn’t feel the groups had been impactful.
“It is how you use the information and take action that really matters. If we’re just having a meeting for two hours and nothing comes of it when we leave, then the results speak for themselves. But organizations, I believe, are taking this feedback very seriously,” Venditti said.