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professional insights

Progress in the Profession:
Nurses Have Seats at the Table

Nurses' presence on boards has grown — what's next?

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By Carole Jakucs, MSN, RN, PHN
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N
urses are natural leaders given the unique body of knowledge, skills, and education required to thrive in the profession and provide the best care. However, the reality is that nurses’ innovation and leadership skills have largely remained an untapped resource for the healthcare system and subsequently for patients.
“Nurses are historically underrepresented on hospital and other boards, where major healthcare decisions that affect consumers and their families are made daily,” said Susan B. Hassmiller, PhD, RN, FAAN, Robert Wood Johnson Foundation Senior Adviser for Nursing, and special adviser to the Nurses on Boards Coalition (NOBC). The lack of representation of the nursing profession in decision-making roles provided the impetus to create NOBC, said Hassmiller. “Nurses belong in all places where decisions that impact health are made. The NOBC seeks to ensure that nurses — and their front-line perspectives — have a seat at these decision-making tables.”

In addition to providing patient care, nurses can improve the health of their states and the entire nation by serving on boards, said Pam Rudisill, DNP, RN, NE-BC, FAAA, FAONL, Senior Vice President and Chief Nursing Officer at Community Health Systems in Franklin, Tenn., and Chair of the Executive Committee at NOBC. It makes sense for more nurses to serve on boards that impact the health of the country, not only due to the confidence that patients and others place in them but also because of their sheer numbers, said Rudisill. “Nurses represent the largest segment of the healthcare workforce.”

Goal: 10,000 Nurses on Boards

NOBC came to fruition in 2014, when RWJF and the AARP convened 19 national nursing organizations with the key strategy of achieving 10,000 board seats filled by nurses on boards in 2020, said Hassmiller. The coalition reached and surpassed the 10,000 mark in January 2021, said Rudisill. “We now have 10,128 board seats filled by nurses. We’re proud of the collaboration of all groups who helped us achieve this goal.” Achieving the historic milestone means more nurses are in a position to provide their expertise when decisions that impact health are being made, said Hassmiller.
“We now have 10,128 board seats filled by nurses. We’re proud of the collaboration of all groups who helped us achieve this goal.”
— Pam Rudisill, DNP, RN
Even though NOBC reached their benchmark, there are no plans to stop now. “We are not stopping and continue to step up our efforts to increase the number of nurses serving on boards,” said Rudisill. NOBC intends to leverage the milestone to create more new board opportunities for nurses, said Hassmiller. “With more than 22,000 individual nurses registered in NOBC’s database who would like to serve, we want to help each of these nurses prepare and pursue strategic and diverse board opportunities to advance the health of our nation.”

Types of Boards Nurses Serve

NOBC is committed to increasing nurses’ presence and influence on corporate, health-related and other boards, panels, and commissions, said Hassmiller. Because of this, “The NOBC targeted boards with strategic influence to improve the health of communities and the nation.” Nurses are now serving on a variety of boards such as corporate, government, non-profit, advisory or governance boards or commissions that have fiduciary or strategic responsibility, she said. “Some examples of where nurses are serving are boards of health and health systems, Fortune 500 companies, national government appointments, and community boards like parent-teacher organizations, youth sports leagues, neighborhood associations, and places of worship,” Hassmiller said.

Creating Opportunities for All Nurses to Serve

One of several organizations partnered with the NOBC is the National Association of Hispanic Nurses (NAHN). NAHN was founded in 1957 with the primary goals of professional development of Hispanic nurses and improving Latinx health outcomes in the United States, said Adrianna Nava, PhD, MPA, RN, President of the National Association of Hispanic Nurses and an NOBC Board Member. When minority nurses serve on boards it uplifts others, said Nava. “Leadership positions within health care are not commonly held by minority groups, with even fewer Latinos being in top leadership positions. To see a Latino or other minority nurse in a position of leadership is quite inspiring.” Participation on boards allows Hispanic nurses to have a voice on issues they care about and advocate for the health needs of their communities, she said. “It’s also an important way to practice leadership, communication, and decision-making skills along with networking.”

Two Examples of Board Member Achievements

Hassmiller said one of her favorite examples of the value of a nurse serving on a board is that of the late Connie Curran. Curran served on 20 boards before her death. “She was a new board member for a 100-bed community hospital when the administrator suggested shutting down the inpatient pharmacy during weekends to save money,” she said.   Curran immediately thought of how weekend closures would negatively affect the patients who would need medicine on Saturdays and Sundays and voiced these concerns, said Hassmiller. “Connie realized she was the only person on the board who understood how a hospital operates on nights and weekends,” she said. “Because of her input, the board ultimately decided not to close the inpatient pharmacy on weekends. She saved the board from making a decision that would hurt patients.”
“Nurses belong in all places where decisions that impact health are made. The NOBC seeks to ensure that nurses — and their front-line perspectives — have a seat at these decision-making tables.”
— Susan B. Hassmiller, PhD, RN, FAAN
Another example Hassmiller pointed out is Joan Caley. Caley serves on six different boards, including the Vancouver Housing Authority. “Joan was able to link housing to health for other board members by explaining that housing is the stabilizing factor in an individual’s or family’s health – something that was not intuitive to some board members,” said Hassmiller, who is also Director of the Future of Nursing: Campaign for Action and Senior Scholar-In-Residence and Senior Adviser to the President on Nursing at the National Academy of Medicine. Rudisill said NOBC will strategize on ways to capture the achievements of nurses serving on boards. “Our goal is to measure the impact that nurses serving on boards has had on their communities and the nation.”

Some Future Goals

The COVID-19 pandemic has underscored that the future of nursing will be about prioritizing the emotional health of nurses, advancing health equity, and amplifying nurses’ voices, said Hassmiller. “Frontline nurses have spent the last year caring for multiple critically-ill COVID-19 patients. Many are burned out, exhausted, and face significant trauma from seeing so many patients die.” The COVID-19 pandemic has also exposed health inequities, she said. “Nursing home residents have been disproportionately affected. Black, Latino, Indigenous, Pacific Islander, and lower-income populations have fared significantly worse because they are less likely to have access to healthcare, don’t have the ability to work from home, and are more likely to live in homes and communities where social distancing is difficult.” Hassmiller said during the week of May 11, 2021, the National Academy of Medicine will release a new report, “The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity.” The report was underwritten by RWJF and will help the profession chart a path for the nation to build a culture of health, reduce health disparities, and improve the health and well-being of the U.S. population in the 21st century, she said. Due to the pandemic, nurses and nursing have never been more visible, and the profession has gone above and beyond, said Hassmiller. “We need to take advantage of our increased visibility to fight for needed changes — for our own well-being and for the justice and well-being of the people, families, and communities we serve.”
ABOUT THE AUTHOR
Carole Jakucs, MSN, RN, PHN is a freelance writer and diabetes educator. Her background in nursing includes tenures in healthcare management and as a care provider. She has worked in med/surg/telemetry, a pediatric emergency department and college health.