Self Governance Increases Staff Morale

Friday, 25 July 2014

Ron Billano Ordona, RN, MSN, FNP
Patient Care Resources, University of California, Davis Medical Center, Sacramento, CA


The University of California, Davis Medical Center (UCDMC) Patient Care Resources (PCR) staff is in a unique position because they float into different specialty units and assume care of patients in diverse settings.

Through a survey, staff identified need for consistent peer support and training to improve competency and proficiency in delivery of patient care.

The goals of the unit based practice council (UBPC), a professional governance unit of the department, included (1) promotion of a framework for unit identity; and (2) improvement of staff level of competency and proficiency in the delivery of patient care. 


To promote a framework for unit identity:

  • Implement and maintain the Peer Advocacy Leadership Support (Pals) program, promoting peer support of new hires.
    • Match new hires each month with volunteer peers of the department.
    • Manage the Pals program by making personal contact with participants.
    • Provide pre and post surveys to measure effectiveness of the program.
    • Collect, review, and disseminate data findings.
    • Highlight staff accomplishments and achievements on the department website
    • Promote department bonding through:
      • Annual celebration for staff that graduates (i.e., Bachelor's, Master's; NPs, and the like).
      • Annual summer get-together.
      • Annual holiday 
  • To promote competency and proficiency in the delivery of patient care:
    • Support skills day (in conjunction with unit administration)
    • Promote and expand use of PCR department website as a means of communication among staff
    • Improve communication between leadership and staff by creating a centralized department email
    • Improve divisional information dissemination through unit council participation 


Staff morale and commitment in the department is high as shown by the 2012 Morehead Survey results. PCR staff excels above benchmark (as compared to the medical center-wide score) in all of the domains measured. 

PCR staff demonstrated excellence in three different domains: (from a scale of 1 as lowest to 5 as highest): organizational 4.25 vs. 3.9 benchmark; manager 4.37 vs. 3.98 benchmark; employee 4.33 vs. 4.03 benchmark; and commitment 4.59 vs. benchmark 4.24 indicators.

New hires expressed that peer support enhanced their assimilation into the department. More than 50% of new hires completed the 12-month Pals program. Staff reported an increased sense of unit identity via survey data collected from the PCR Pals program post-survey.


Self-governance results in high morale and fosters a stronger commitment among staff of a float pool department. Peer support and communication are effective avenues to achieve a strong sense of unit identity despite the challenges of a unique department such as the float pool.