Recognizing the contribution of nurses
Nurses comprise the largest segment of the healthcare workforce, and represent an important and unique perspective in health-related matters, especially in giving a voice to patient and family issues. Not only do nurses serve at the center of the patient care experience, having the most contact with patients and families, they also have in-depth knowledge of healthcare delivery, the ability to prioritize problems, and credibility among other healthcare professionals. Yet, only 2% of nurses serve on hospital boards.1
Recognizing the unique contributions nurses can bring to any situation, the Institute of Medicine (IOM) report of 2011, “Future of Nursing: Leading Change, Advancing Health,” called for nurses to take on increased leadership roles to help improve America’s health and healthcare system, including serving on boards and commissions.2 In direct response to the IOM recommendation, 19 leading nursing organizations joined with the Robert Wood Johnson Foundation and AARP in 2014 to create the Nurses on Boards Coalition. Its goal is to place 10,000 nurses on corporate and nonprofit health-related boards by 2020.
Participating organizations have various initiatives aimed at this goal. For example, an American Academy of Nursing task force encourages its members to apply for state and federal appointments. The task force sends Academy fellows the contact information and instructions for how to apply for gubernatorial appointments and state and local committees in their state, then supports member applications with letters. Many organizations also have board training and development programs for their members.
Types & Structures of Boards
People serve as directors or trustees of boards for different reasons. Some serve as a form of civic duty or charitable service, whereas others serve because of a personal interest in the cause identified by the organization. Likewise, there are different types of boards, with varying requirements and commitments. Each type serves a distinct purpose and has certain requirements of board members.Whereas officers and employees of an organization are responsible for executing day-to-day management, the role of a board of directors is setting policy and monitoring the organization on behalf of the members it serves. The board possesses ultimate legal responsibility for the organization; therefore, accepting a position on a board obligates a person to fundamental responsibilities to the organization, as well as a commitment of time and accountability.
The board is made up of people elected as directors for multiyear terms. The number of directors can vary substantially among organizations. Some organizations have large boards, with multiple committees. Chamberlain College of Nursing, on the other hand, has only seven trustees on its board. In the U.S., at least 50% of the directors must meet the requirements of “independence,” meaning they are not associated with or employed by the company.
Before agreeing to serve on a board, a nurse should familiarize herself or himself with the organization, its history and current operations, as well as expectations and responsibilities of board members. Some boards expect their members to also be donors, and/or participate in fundraising for the organization. Some boards pay directors; many pay only expenses. Specific items that may assist in the process of learning about director accountabilities are the articles of incorporation, bylaws, mission statement, policy manual, published periodicals, budgets, vision and goals, and financial statements. Directors should become familiar with state laws relevant to their board.
Increasing the Number of Nurses
Two things will have to take place if the Nurses on Boards Coalition is to achieve its ambitious goal of placing 10,000 nurses on boards by 2020: Healthcare boards will need to regularly consider nurses for open board seats, recognizing the rich and diverse contributions nurses bring that improves the diversity of experience and perspective. Second, nurses need to better prepare themselves for board service, as well as make their interest known.
Responsibility of Healthcare BoardsConnie Curran, PhD, RN, FAAN, co-author of Claiming the Corner Office and founder of Best on Boards, is a vocal advocate for nurses on healthcare boards.3 Curran suggests that CEOs increase nurse participation by finding nurse leaders within their own organizations or from external organizations, including schools of nursing.
A number of organizations help nurses become board members. The Robert Wood Johnson Foundation’s Executive Nurse Fellows program develops nurse leaders with a goal of shaping healthcare locally and nationally. BoardSource in Washington, D.C., provides training about board governance and certification to people from all professions. CEOs and boards can reach out to such organizations for referrals to nurses who have been through board training.
Responsibility of Nurses
The first step in getting appointed to a board is gaining the skills that make you an appropriate appointee. Boards generally look for directors with the range of experiences and skills needed to provide appropriate oversight of the organization’s work, which could include expertise in legal, financial or fundraising activities. A key asset a nurse may be expected to bring to a board is a network of relationships that can help the organization accomplish its goals. Nonprofit boards especially look to board members to provide relationships that aid in raising funds.
Because executives of the organization answer to the board, board members must have experience leading people, projects, programs or companies, and be able to understand and offer suggestions on financial statements. Often those who have specific and specialized experience in a particular field or sector are tapped for boards serving that focus. For example, nurses who have been CNOs have valuable experience to offer a hospital board.
Equally as important as past experiences and knowledge is personal style. Boards prefer directors who are collaborative, able to listen to and respond positively to various viewpoints, and are fair-minded. Finally, board directors must be able to commit the time necessary to fulfill their commitment to the organization. This includes board training, advance preparation for board meetings, attending and actively participating in board meetings, serving on board committees, attending organization events, making fundraising calls, and doing whatever else the organization requires.
The ways in which nurses can convey their interest in board service are numerous. A good place to begin is by volunteering within policy-making groups. States have many government committees that need volunteers. Nurses can peruse their state’s website to apply for committees and boards.
Professional networking can also be important for making connections where nurses can show their abilities and learn about opportunities. LinkedIn and other networks are good sources of referrals. Some executive search firms have divisions dedicated to board searches.
Nurses are focused on communities, health and prevention, quality and safety in healthcare delivery, and on measuring healthcare outcomes. This focus brings to a board the voice of the patient, which should be the cornerstone of any healthcare organization.
- Totten MK. Nurses on healthcare boards: A smart and logical move to make. Healthcare Executive. 2010;May/June:84-87.
2. Institute of Medicine. Future of nursing: Leading change, advancing health. Washington, DC: National Academies Press; 2011.
3. Curran C, Fitzpatrick T. Claiming the corner office. Indianapolis: Sigma Theta Tau, International; 2013.
Susan Groenwald is the national president of Chamberlain College of Nursing. While holding a joint appointment at Rush University and Rush Medical Center, she was elected to the inaugural board of the Oncology Nursing Society and co-led a team that created the first standards for oncology nursing.