| Course | NR 531 Nursing Leadership in Healthcare Organizations |
|---|---|
| Week | 3 |
| Paper type | Governance structure review |
| Length | About 1,110 words, 3 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | MSN, Nurse Executive |
| Updated | September 2026 |
Free sample paper for NR 531 Week 3
Governance Structure Review: Six Committees Read Through a Year of Their Own Minutes, Sorted by the Verbs They Recorded, With the Two Items the Nutrition Committee Tabled Twice and Never Brought Back
Student Name
College of Nursing, Chamberlain University
NR 531: Nursing Leadership in Healthcare Organizations
Instructor Name
Month Day, Year
Governance Structure Review: Six Committees Read Through a Year of Their Own Minutes, Sorted by the Verbs They Recorded, With the Two Items the Nutrition Committee Tabled Twice and Never Brought Back
Method
This review examines six governance bodies in the 240-bed community hospital where I manage a medical unit, with one question: which of them actually decides things? Charters were not enough to answer it. Several bodies have charters that use similar language, and at least one has a grander name than its record supports. I therefore read twelve months of minutes for each body, from July of last year to June of this year, and counted the verbs used for each agenda item: approved, adopted or ratified on one side, and recommended, received, noted or reviewed on the other. I also counted items tabled at two meetings and never returned. Where the minutes and the charter disagreed, I have said which I believe and why.
The Bodies and Their Record
Table 1 lists each body, the verb its founding document uses and what its minutes show.
Table 1
Six Governance Bodies, July to June
| Body | Founding document says | Items decided | Items passed on or noted | Tabled twice, never returned |
|---|---|---|---|---|
| Medical Executive Committee | Approves protocols, privileges, medical staff policies | 38 approved; 6 returned for revision | 4 received | 0 |
| Policy Committee | Reviews policies for format and conflicts | 61 approved for publication; 9 returned for rewording | 0 | 0 |
| Nursing Practice Council | Approves nursing practice standards | 3 approved | 14 recommended to the chief nursing officer | 2 |
| Nursing Quality Council | Reviews and monitors nursing quality data | 0 | 22 received | 0 |
| Nutrition Committee | Establishes nutrition care standards for the hospital | 0 | 11 received or noted | 2 |
| Board Quality Committee | Oversees quality and patient safety | 2 directed management to act | 18 received | 0 |
Bodies That Decide
Two bodies decide, and one of them is not the one I expected. The Medical Executive Committee approved 38 items, including three protocols that let nurses initiate orders, and returned six for revision. Nothing it considered was tabled indefinitely. Its approvals took effect without further votes. Its charter and its record agree.
The Policy Committee is the surprise. Its charter describes a limited role, checking format and conflicts between policies. Its minutes show it returned nine policies for rewording, and in four of those cases the rewording changed what the policy required, not only how it read. One return removed a nurse's authority to hold a tube feeding without an order. A body described as clerical is shaping practice. I believe the minutes here, because they record the committee's actual edits, and I would describe it as a decision-making body with an understated charter, and one that any proposal should meet early rather than late.
Bodies That Advise Under a Deciding Name
The Nursing Practice Council's charter says it approves nursing practice standards. Its minutes show three approvals in a year, all of unit-level workflows, and fourteen items recommended to the chief nursing officer, including every item that touched another discipline. In practice the council advises and the chief nursing officer decides. The charter and the record disagree, and I believe the record, because the chief nursing officer's signature appears on every final version.
This matters for shared governance. Research across many hospitals found that nurses in hospitals with greater engagement in shared governance reported better job outcomes and better quality ratings, and that their hospitals had higher patient experience scores (Kutney-Lee et al., 2016). Porter-O'Grady (2019) argues that professional governance depends on clear authority for decisions at the point of practice, not on participation alone. A council that recommends while its charter says it approves may be giving nurses the appearance of authority without the substance, and staff can tell the difference.
The Nutrition Committee has the grandest mandate on the list: to establish nutrition care standards for the hospital. In twelve months it met four times of twelve scheduled, recorded eleven items as received or noted and approved nothing. Two items were tabled at two consecutive meetings and never returned. One was a proposal from two years ago for nurse-initiated dietitian consults after a positive malnutrition screen, which is the change I am now pursuing. The committee has, in effect, answered the question about itself. When I asked two members why the proposal never returned, each said the other departments had to agree first. The minutes suggest the reverse: no other department was ever asked, because the committee never resolved to ask them. A body without authority to decide cannot even decide to consult.
Bodies That Watch
The Nursing Quality Council and the Board Quality Committee are monitoring bodies, and their records match that role. The quality council received 22 reports and decided nothing, which is consistent with its charter. The board committee received 18 reports and twice directed management to act, once on sepsis bundle compliance and once on falls. Those two directives show that the board committee can decide when it chooses to. It did not take up nutrition at any meeting, although hospital malnutrition is associated with complications, longer stays and readmissions, and early intervention can reduce them (Tappenden et al., 2013).
What the Review Means for My Change
The review changes where I will take the dietitian consult protocol. I had planned to start at the Nutrition Committee, because its name suggests ownership. Its record suggests the proposal would be noted and tabled again. Instead I will take it to the Nursing Practice Council for a recommendation, to the chief nursing officer for nursing leadership's approval, to the Policy Committee early, so that its wording is settled before the final vote rather than after, and to the Medical Executive Committee for approval. I will ask the Nutrition Committee's chair to co-sponsor rather than approve. I will also recommend that the Nutrition Committee's charter be rewritten to match what it actually does or be given the authority its name implies, and that the Nursing Practice Council's charter say "recommends" where it now says "approves." Accurate charters would help staff direct their energy. A nurse who believes the council approves standards may spend months preparing a proposal for a body that cannot adopt it, and then conclude that shared governance is theater. The review's counts are also a baseline. If the charters change, the same count next year will show whether the change was real.
References
Kutney-Lee, A., Germack, H., Hatfield, L., Kelly, S., Maguire, P., Dierkes, A., Del Guidice, M., & Aiken, L. H. (2016). Nurse engagement in shared governance and patient and nurse outcomes. Journal of Nursing Administration, 46(11), 605-612. https://doi.org/10.1097/NNA.0000000000000412
Porter-O'Grady, T. (2019). Principles for sustaining shared/professional governance in nursing. Nursing Management, 50(1), 36-41. https://doi.org/10.1097/01.NUMA.0000550448.17375.28
Tappenden, K. A., Quatrara, B., Parkhurst, M. L., Malone, A. M., Fanjiang, G., & Ziegler, T. R. (2013). Critical role of nutrition in improving quality of care: An interdisciplinary call to action to address adult hospital malnutrition. Journal of Parenteral and Enteral Nutrition, 37(4), 482-497. https://doi.org/10.1177/0148607113484066
What the NR 531 Week 3 assignment asks for
The Week 3 assignment usually asks you to review the governance structures of an organization, such as boards, medical staff and nursing councils, and to evaluate how decisions are made. Prompts ask for the bodies, their authority and membership, how they relate to one another, how nursing participates and how effective the structure is. Charters alone can mislead, so compare what each body is supposed to do with what its records show it did. Count verbs such as approved and recommended, and note items deferred without return. Where the record contradicts the charter, say which you believe and why. Link findings to shared governance research. Cite sources in APA 7, and describe the organization by type rather than name.
How this NR 531 Week 3 example is built
The review opens with its method: twelve months of minutes for six bodies, verbs counted, deferrals tracked. Table 1 sets each body's founding language beside its decided, passed-on and abandoned items. A section on deciding bodies shows the medical staff committee's record matching its charter and the policy committee changing the substance of four policies. A section on advisory bodies shows the practice council recommending nearly everything and the nutrition committee tabling a consult proposal twice, with shared governance research explaining why that matters. A short section covers the monitoring bodies. The review ends by rerouting the dietitian consult protocol and recommending charter changes that match each body's real role.
Where the points sit in the NR 531 Week 3 rubric
Governance review rubrics generally reward accurate description of structures and their relationships, analysis of how decisions are actually made, evaluation of nursing's role, use of evidence and recommendations. Graders favor reviews grounded in records, such as minutes, over descriptions taken from charters. Counting outcomes and noting deferrals gives the evaluation weight. Saying which source is believed when documents conflict shows judgment. Connecting nursing council authority to shared governance evidence earns credit for application. Recommendations that follow from findings, especially ones the writer will act on, show leadership. A clear table and APA 7 citations support presentation, and a review that names the method used to read the records usually earns credit for rigor as well.
Common NR 531 Week 3 mistakes, and how to avoid them
A frequent problem is a review that restates each body's charter and calls the structure effective without evidence. Read what the bodies did. Another is assuming that a body with a grand name has matching power. Check its record. Students also treat advisory bodies as failures; advising is a legitimate role when the charter says so honestly. The problem is a mismatch. Avoid naming members or quoting identifiable discussion. Do not skip deferrals, since an item tabled twice tells you a great deal. Keep the number of bodies manageable, usually four to eight. Finally, say what the review changes, whether in your own route for a proposal or in a recommendation to leadership.
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NR 531 Week 3 questions, answered
What if I cannot get hold of any minutes?
Work from whatever record exists and say what it is. Published board summaries, accreditation documents, policy pages carrying an approving body in the footer, and newsletters announcing that a group adopted something all leave the same trail in weaker form. Where a section supplies a case, the case is the record. What a review should never do is invent the trail and present it as read.
Is an advisory body a failure of design?
Not at all, and reviews implying it usually overreach. Plenty of groups exist to gather views before somebody else acts, and that is a legitimate purpose when the founding document says so and everybody involved knows it. The problem the assignment is really after is the mismatch: a group told it is deciding, whose record shows it never has, which produces the disengagement rubrics ask about.
How many bodies belong in the review?
Enough to show a structure and few enough to examine properly, which in most sections lands between four and eight. Depth is what earns here. A review of five groups tracing each through a year of its own record marks better than a list of fifteen with a sentence apiece. Where the assignment names a number or a scope, that instruction governs.
Where can I find a free NR 531 Week 3 sample paper?
This page carries the six-committee minutes review, which is the full NR 531 Week 3 sample and can be read in full at no charge. For a review of the bodies in your own organization, tell us what records you can see and a paper built from them can be drafted.
How do I tell a deciding body from an advisory one in NR 531?
Read what its minutes say it did. Bodies that decide record items as approved or adopted; bodies that advise record them as recommended, received or noted. The sample counts those verbs for six bodies across a year.