Nurses’ Perspectives on Professional Autonomy and Shared Governance in Contemporary Healthcare Systems: A Comprehensive Review

Abstract

Background: The global nursing shortage presents a critical challenge, with the World Health Organization projecting a need for nine million additional nurses and midwives by 2030. Enhancing professional autonomy among nurses is vital for improving recruitment and retention, thereby establishing a sustainable healthcare workforce.

Methods: This integrative review synthesizes literature on professional autonomy in nursing, focusing on its impact on workplace dynamics and patient care. A comprehensive search was conducted across databases including CINAHL, PubMed, Scopus, and PsycINFO to identify relevant studies that explored the components and determinants of nurses' professional autonomy.

Results: Findings reveal that professional autonomy is multifaceted, encompassing clinical decision-making, self-governance, and accountability. Key determinants identified include shared leadership, supportive management, personal competency, interprofessional collaboration, and a healthy work environment. Nurses who experience greater autonomy report higher job satisfaction and improved patient outcomes. Conversely, hierarchical management structures and unclear organizational policies are detrimental to nurses' autonomy, limiting their ability to act on their professional judgment.

Conclusion: Fostering an environment that enhances nurses' professional autonomy is essential for improving job satisfaction and retention rates. Implementing shared governance models and supportive leadership is crucial in empowering nurses to contribute effectively to patient care. Future research should explore the evolving dynamics of professional autonomy in the context of digital health innovations, ensuring that nurses remain integral members of the healthcare team.