December 14, 2020

Nursing Staff Bylaws Convention outlines latest, best practices

More than 170 nurses from across Vanderbilt University Medical Center gathered over Zoom for the biennial Nursing Staff Bylaws Convention, the first to be held virtually.


by Matt Batcheldor

More than 170 nurses from across Vanderbilt University Medical Center gathered over Zoom for the biennial Nursing Staff Bylaws Convention, the first to be held virtually.

The convention is an opportunity for VUMC nurses to participate in Shared Governance, the document that governs how they do their daily work and practice. Nurses appoint the delegates who gather every two years to approve changes to the bylaws. Many of those same delegates worked for hours at a virtual retreat during the summer to draft proposed revisions.

Marilyn Dubree, MSN, RN, left, and Andrea Hughie, MSN, RN, take part in the virtual Nursing Staff Bylaws Convention.

Vanderbilt was among the first health care entities in the country to create bylaws, and 2020 is the 40th anniversary of their creation. Adrienne Ames, MSN, who was associate director of nursing in 1980, spearheaded the creation of the bylaws with associate director Frances Carson, under the leadership of director of Nursing Rosamond Gabrielson. Ames was present at the virtual event.

“It is a very momentous occasion,” said Erin Tickle, MMHC, RN, director of Shared Governance. “It’s just amazing to see that the foundation of what they did and started then is still here 40 years later amidst this growing health system that we now have. Our nurses still have this incredible set of bylaws to guide our practice and hold our profession up to the highest standard.”

VUMC has held conventions during even-numbered years in recent history. The last convention was held in 2018.

“Having this convention every two years assures that the bylaws truly reflect current nursing practice, so this document is ever evolving, just as nursing is as well,” said Katie Brennan, MSN, RN, CDE, NE-BC, co-chair of the Bylaws Task Force, along with Andrea Hughie, MSN, RN, NEA-BC.

The most recent changes to the bylaws included input from delegates representing VUMC inpatient units, clinics and specialties, as well as the Bylaws Task Force.

“Conducting the convention virtually was a public display of the ingenuity, astuteness and flexibility of VUMC nurses,” Hughie said.

There are two main categories of amendments to the bylaws. Editorial amendments are updates to terminology and titles without changing meaning, while substantive amendments change the meaning or function of the bylaws.

The 2020 convention approved five substantive amendments in addition to various editorial amendments that were on the agenda, as well as an amendment that was introduced on the virtual convention floor. The amendments address VUMC’s rapid growth.

Tickle said the most consequential substantive amendment allowed for a fundamental change to how shared governance happens at the unit/clinic level — allowing them the option of a local unit/clinic model, a combined unit/clinic board or unit/clinic shared governance huddles.

The amendment organizes the Medical Center Nursing Board into a new Medical Center Nursing Leadership Council.

Another amendment changes the structure of the nursing delegates, from a model akin to the House of Representatives to a Senate model. The model allows entities have an equal number of delegates regardless of size. This is intended to give more equal representation to the pieces of the sprawling VUMC enterprise.

Also adopted was a floor amendment presented by Rachel Senefeld Kromer, MSN, RN, NPD-BC, NEA-BC, director of clinical education & professional development for Vanderbilt University Adult Hospital. In the interest of making diversity and inclusion intentional, it adds to the philosophy statement of the bylaws, “We are committed to caring compassionately and respectfully for all patients and colleagues, regardless of age, race, ethnicity, religion, gender identity/expression, disability, sexual orientation, socioeconomic status, language proficiency or education.”

For additional information and bylaws resources, visit

The Bylaws Task Force will meet soon to begin implementing the changes.

“As we celebrate 40 years of these bylaws and we make changes, we stand on the legacy of something that is bigger than we are,” said Executive Chief Nursing Officer Marilyn Dubree, MSN, RN, NE-BC. “I think we are all grateful for the foresight and vision to have the input of staff nurses, colleagues, leaders and patients in the work that we do. Over those 40 years we have continued to evolve this work.”