A Nurse's Voice in Governance Matters
In the 4 years since the Institute of Medicine's 2010 report titled "The Future of Nursing," there has been much discussion regarding the role that nurses can, should, and must play in the governance of our nation's health care system. Today, even though it is mostly anecdotal, nurse leaders seem to share the view that we have made some real progress in advancing the role nurses play in governance across a range of settings, including health systems, health insurance and medical product companies, and health-related fields in academia.
Unfortunately, we lack reliable industry-wide data that would tell us the number of nurses on health system boards, the critical roles they play, and the influence they are exerting on priorities and the strategic direction of health care within our country. The need for this data will only grow in the coming years, making this a great research question for an enthusiastic doctoral student. As health care becomes more value-based and committed to patient engagement, the voices and perspectives of nurses within boardrooms will become an increasing priority for our profession.
WHY A NURSE?
Historically, hospital boards have been solidly grounded in finance and business. The voice of the physician trustee added a much needed connection to patient care and brought with them the perspective of independent and affiliated medical staff. The value of physicians serving on hospital boards is now well established and accepted. Thus in recent years, governing boards have increasingly included a more balanced set of competencies. Nurse executive leaders have typically been included along with their chief executive officers and administrative colleagues in governing board deliberations, but not as actual board members. So, most boards have not had the benefit of an elected nurse trustee who can consider matters through the lens of a caregiver and provide the unique perspective of a nurse.
There are exceptions however. Two governing board leaders at Children's Hospital Los Angeles describe the board's reasons for electing the hospital's vice president of patient care services and chief nursing officer to a trustee position. They generously agreed to contribute to this issue of Nursing Administration Quarterly to help us understand why the voice of a nurse is uniquely different than that of our physician colleagues. Not surprisingly, both are needed.
WHY NOT YOU?
Over the past few years, there have been numerous headlines and cover stories focused on the need for nurses within the governance structures of health care institutions. Prominent nursing leadership organizations (eg, The Northwest Organization of Nurse Executives) have sponsored programs to recruit and prepare nurse leaders for governance roles. It is now time for nurses in senior leadership roles to strongly encourage their health system boards to elect a nurse trustee from among the many talented nurse leaders in this country. Those of us in operational leadership roles can insist that current and potential vendors and business partners seriously consider the many advantages of including a nurse leader on their governing boards.
Regardless of role or position, all nurses should look closely and understand where the voices of nurses exist within the senior leadership and governance structures of their organizations. In addition, there are many important and worthwhile community organizations that would benefit from a nurse's voice. Go find them, volunteer and then represent our profession with passion and pride! We all stand to benefit.
-Carol Bradley, MSN, RN, CENP
Senior Vice President
Chief Nursing Officer
Legacy Health
Portland, Oregon
-Donna Gage, PhD, RN, NE-B
Chief Nursing Officer
Veterans Health Administration
Washington, DC