HealthApril 27, 2017

Nurses, Get on Board! Essential leadership competencies for nurses

I must admit, when discussions about nurses on boards transpired here in our office, I wasn’t exactly sure what that meant. Nurses provide patient care – it’s what we study, it’s the work we do, and for many, it’s our passion. When I heard the term “nurses on boards,” I immediately thought of managers and administrators. Serving on a board wasn’t something for all nurses to consider, or was it?

A little history

According to the 2014 American Hospital Association governance data, nurses hold only 5% of board seats in health-related organizations and corporations. Shouldn’t we be involved in the decisions that affect our health care system, our organizations, our profession, our patients, and ourselves? One of the key messages of The Future of Nursing: Leading Change, Advancing Health report is “Nurses should be full partners, with physicians and other health care professionals, in redesigning health care in the United States.” As a result of our minimal representation on governing boards and the Future of Nursing report recommendations, the Future of Nursing: Campaign for Action set a goal to get an additional 10,000 nurses on governing boards by 2020.

 

Why nurses need to “get on board”

Earlier this month, Susan Reinhard, RN, PhD, FAAN, chief strategist for the Center to Champion Nursing in America and senior vice president and director of AARP’s Public Policy Institute wrote an excellent piece, Getting nurses on board, for Trustee magazine. In her article, Reinhard addresses the gender gap and other barriers to nurses serving on boards. She also shares her path to the boardroom and the real life stories of other nurses serving on boards and how their service made an impact.

For example:
“The late Connie Curran, R.N., told the story of listening as her 100-bed community hospital proposed saving money by eliminating weekend hours at its in-house pharmacy. Medication orders could be filled Friday evenings, the thinking went. The other board members, she noted, were not being negligent. But she was the only person whose experience working nights and weekends led to a few unasked questions, such as, ‘What about newly admitted patients?’ The pharmacy stayed open.”

Can you imagine working where the hospital pharmacy is closed on the weekends? This is exactly why nurses are instrumental to serving on committees, commissions, and boards where health care decisions are made. This example illustrates our unique experience and the need for us to be present where decisions are being made at the organizational level and beyond.

Overcoming barriers

As nurses, we know about overcoming barriers. We face obstacles in our day-to-day practice that force us to speak up and advocate for those in our care. In 2009, Prybil identified three barriers to nurses serving on boards:

  • Gender – 90% of RNs in the U.S. are women and women are underrepresented on boards
  • Belief that nurses aren’t able to weigh in on safety and quality issues
  • Potential conflict of interest related to placing an employee in a voting capacity

How can we remove barriers and foster collaboration? Let’s focus on what we know about ourselves and our profession. First, nurses represent the largest segment of the health care workforce; there are 3.6 million of us in the United States. We are a female-dominated profession, and that should not affect our representation among the decision makers. We need to work hard to have our voices heard, and remember that we are skilled communicators and problem-solvers.

We also know the issues, especially when it comes to safety and quality care. We face these issues every day. We use the nursing process repeatedly in the clinical setting to assess, diagnose, plan, implement, and evaluate. This framework can be applied for strategically tackling any hospital-wide, local, national, or global issue. Nurses are knowledgeable and skilled and need to have a “seat at the table.”

Additionally, people trust us – that’s been proven time and again. We are on the front-lines, not only in the hospitals, clinics, and offices, but also in schools, the community, and so many other settings. And remember, we are all leaders, no matter the setting or role of our work.

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