Nurses in the Boardroom
Through the years, discussions have centered on improving the quality of care. Actions were devised to ensure the accessibility of care to all and that care remains cost-effective while continuing to progress. Nurses and other members of the health team are not the only ones discussing this, but this also become the topics for discussion within the four walls of the boardroom. But these boardroom conversations and decisions most often happen in the absence of one important health profession in the room, which are the nurses.
A spot in the Board
Through the years, nurses have slowly crept their way into board memberships. However, the number of nurses in the boardroom continue to be low. It is important to further raise the awareness of the issue among healthcare system CEOs and trustees to create an upsurge of interest and urgency to include nurses in healthcare-related decision-making roles.
While nurses act in leadership roles in various healthcare settings, they remain generally unheeded for board positions, which are considered as the highest level of organizational leadership.
According to Betbeze (2007), nurses represent the largest group in the healthcare workforce in hospitals and health systems and have a crucial role in ensuring quality care and patient satisfaction. Furthermore, the Institute of Medicine (2004) reported that nurses, as the largest and most visible segment of the healthcare workforce, were critical to efforts for patient safety and reducing medical errors. However, studies show that nurses represented only 2-4 percent of all board positions and 22 percent of the voting members on those boards were doctors.
Studies have explored the factors as to why this happens. It may be due to gender bias, the outmoded perception that nurses do not have leadership skills, and lack of understanding of nurses’ roles in determining care quality could be preventing decision makers from considering nurses as board members. Moreover, nurses are viewed to be mostly focused on their profession and will act more as employee representatives than in the interest of their healthcare institution.
Are nurses up for the challenge?
As frontliners of healthcare delivery, nurses possess a set of qualities that render them qualified to be part of the board. It is important to understand that front-line, patient care expertise can be an important part of the decision-making process for healthcare delivery. Nurses can also help develop better systems of care that offer better patient outcomes at reduced cost.
Furthermore, nurses are educated in areas of healthcare administration, financial management, quality improvement and information technology. They are also likely to possess less tangible, but still important characteristics that provide value to a board. Examples of which are the willingness to be highly engaged in the decision-making process, expert facilitation skills, the ability to get along with others and strong relationships within the community.
Increasing nurses in the boardroom
Various campaigns and actions have been launched to boost the number of nurses in the board. Nurse Leaders in the Boardroom, for example is a move by the Robert Wood Johnson Foundation (2009) that was created to develop relationships between healthcare organizations and nurses leaders, and to train future nurse leaders for these positions.
Many Action Coalitions are also currently working to increase the number of nurses on boards, including the Virginia, Rhode Island, and New Jersey Action Coalitions, all of whom have seen increases in the number of nurses on boards in their states.