Nurses have daily interactions with patients, first-hand experience with clinical care issues, and expertise in health care systems and processes. Despite their skills and experience in these areas, few nurses are in hospital boardrooms. According to a 2014 American Hospital Association (AHA) report, nurses make up only 5% of hospital board seats, while physicians hold 20%.
In reaction to the AHA report, the Nurses on Boards Coalition (NOBC) began working toward a goal of improving the health of communities and the nation through the service of 10,000 nurses on boards and other bodies by 2020.
Here’s a look into why we need more nurses on health care boards and the impact they have on executive-level decision-making.
Nurses have the potential to impact boards on a variety of levels.
1. Financial. Nurses who lead their department are often expected to help establish, monitor, and manage annual budgets in an effort to control costs and maximize spending. They need sharp financial skills in order to forecast year-to-year spending, evaluate potential expenditures such as new technology, and manage staffing levels to control departmental costs.
2. Quality and Safety. Nurses are the front lines of safety and quality processes and outcomes. They are required to understand and develop the skills needed to improve care processes for their patients with a focus on performance and safety.
Laurie Benson, BSN, Executive Director for the NOBC, states, “Quality and safety has profound effects on patients. This is a critical imperative. Including nurses in the conversation doesn’t seem like it should be anything other than obvious.”
3. Patient and Family Experience. Nurses often spend more time with patients and their families than any other health care professional. They are known for and expected to have exceptional relationship-building skills. They have a unique perspective when it comes to issues that affect patients and their caretakers.
There are four types of boards on which nurses can serve.
1. Private and Public Corporate Boards – All corporate industry boards of various structures and sizes, ranging from startups, entrepreneurs and corporate enterprises in all industries.
2. Non-profit Boards – All types of non-profit organizations, regardless of size, that serve the needs of communities, states, our nation and global missions.
3. Advisory Boards – All types of organizations may offer advisory board roles to provide strategic advice, ranging from start-up companies, small businesses and non-profit organizations.
4. Commissions and Appointments – These are varied and may include being appointed by the President, governor, mayor, or legislature to serve on advisory boards, commissions, task forces, or positions. These also include citizen-elected boards (e.g. school boards, county board of supervisors).
Nurses should be encouraged and educated on how to secure appointments on governing boards, and what to do once they’re there. Once appointed to leadership positions, nurses must be prepared to contribute their thoughts and recommendations based on their experiences.
The NOBC places a high value on all types of board service and keeps a database of nurses interested in serving on boards to help executives make the right choice when choosing which nurses should serve on their boards.
Nurses bring patient care experience, leadership skills, and health care systems and processes expertise to governing boards—which could bring health care organizations that much closer to achieving their missions.
“All of the things that nurses do on a regular basis is a collective skill set that most other professions don’t have,” says Kimberly Harper, RN, MS, Chief Executive Officer, Indiana Center for Nursing and Co-Chair, Nurses on Boards Coalition. “Nurses have experience in finance and managing budgets; communications and the ability to work with and lead a team; quality and process improvement for patient care; and for making good decisions, strategic planning and human resources. They bring something very different to the table.”
Patrick Robinson, PhD, RN, FAAN, and dean of Capella University's School of Nursing and Health Sciences, has actively supported the University's initiative to prepare nurses for these kinds of leadership roles. “I'm very proud of the Nurses on Boards initiative because it is a grassroots effort. This is a collaboration by every corner of nursing. The consciousness raised by the Institute of Medicine’s future of nursing report, the new and emerging roles for nurses, and the continuing implementation and the expansion of advanced practice nursing, all of these things now have strong momentum. It is an exciting time to be a nurse.”
Want to learn more about this initiative? Download the whitepaper Nurses on Boards: The Time for Change Is Now, or visit the Nurses on Board Coalition and sign up to serve or be counted.