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Quality in work comes from people who care about what they do, are consistent, and have a desire to make a difference. This is not something that can be taught, but it can be nurtured. Patient care is the perfect place to start. Nurses participating in a shared practice situation can extend their working system to others. The rewards of quality care are felt by the patient, by the staff, and ultimately by the hospital. The desire to make a difference grows as more people become involved in a system. Developing systems that are positive, goal oriented, and rewarding is the first step toward shared practice. Shared governance then becomes a natural progression in determining the framework in which a nurse functions.
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McDonagh et al. (1989) studied this question.
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