Nurse Leader Honored for Public Service Work

Jun 24, 2014, 9:00 AM

Human Capital Blog: Congratulations on receiving the Ben Shimberg Public Service Award from the Citizen’s Advocacy Center! What does the award mean for you and for your work at the National Council of State Boards of Nursing (NCSBN)?

Kathy Apple: It is quite an honor for both NCSBN and myself, as this recognition comes from an independent, objective organization that advocates for the public interest, effectiveness, and accountability of health care licensing bodies. It confirms that NCSBN is on the right track in supporting its members, the nurse licensing boards in the United States.

HCB: The award is named for a man who is considered the “father” of accountability in professional and occupational licensing. How are you carrying out his mission at NCSBN?

Apple: Dr. Shimberg was an expert on competency testing and challenged all licensing boards to ensure competence assessments meet the highest psychometric and ethical standards. He urged licensing boards to continuously examine how to improve testing procedures. Dr. Shimberg challenged licensing boards to improve communication to applicants and consumers, to keep data and accurate records on all board business, and be accountable for their own performance.  He advocated for licensing boards to conduct research in all aspects of regulatory functions. He encouraged collaboration between and among licensing agencies. He challenged all regulators to have and follow their own code of ethics. Dr. Shimberg really was incredibly insightful and visionary regarding the role and work of licensing boards.

HCB: The award recognizes your work to promote best practices in nursing regulation and to spur boards of nursing to evaluate and improve their performance as protectors of the public interest. Can you tell us about your work at NCSBN in both areas?

Apple: Evidence-based regulation has been a part of the strategic initiatives of NCSBN for almost two decades. NCSBN commits considerable resources to support research in the area of nursing regulation to build the scientific body of evidence in this discipline. Our efforts were so successful that NCSBN was able to publish the Journal of Nursing Regulation to disseminate research outcomes. These efforts have provided boards of nursing with the data needed to make sound policy and operational decisions.

Specific to individual board of nursing performance, NCSBN developed, through the expertise of its members, a continuous performance data collection and benchmarking process. The Commitment to Ongoing Regulatory Excellence (CORE) project has allowed states to compare their performance with nationally aggregated performance data. It has also identified promising practices from high-performing boards of nursing. Boards of nursing have then been able to make changes to improve their performance.

HCB: The Institute of Medicine’s future of nursing report recommended better data collection on the nursing workforce. What impact has that recommendation had?

Apple: NCSBN was very excited about this recommendation as it supports the direction of our own organizational efforts. NCSBN believes it has a major role to play in providing national workforce data through its national licensure database, Nursys®. Currently, this database contains licensure and discipline data from all but four state boards of nursing. The licensure data are processed in a way to provide an unduplicated count of how many actively-licensed nurses are in the country.

In addition, NCSBN has worked with boards of nursing to add the minimum supply data set developed by the National Forum of State Nursing Workforce Centers to all licensure renewals. This project will feed back to states their data on an as-needed basis and ultimately will provide a continuous national picture of nursing workforce supply data once all boards of nursing are participating. 

HCB: You spent the first part of your career in clinical and management positions. Why did you decide to shift into regulatory work?

Apple: Two values I have carried throughout my life have been curiosity and the desire to learn new things. Looking back over my career, I think I have been lucky enough to recognize and grab opportunities when they have presented themselves. When I was offered my first regulatory experience, I had never worked in government. I remember thinking that not only would I learn, I would be giving back in service of the public good. I have never regretted that decision.

HCB: Did your earlier work as a clinician and manager prepare you for your current role as CEO of NCSBN? If so, how?

Apple: Certainly any management experience translates into other management positions. My clinical background was in psychiatric-mental health nursing. I found my knowledge and education in this area invaluable in everything I have done and had to do. I believe so much of our work is based on good relationships, and certainly psych-mental health gave me those skills.

HCB: You are an alumna of the RWJF Executive Nurse Fellows program. How did that experience shape your work at NCSBN?

Apple: The RWJF Executive Nurse Fellows program was one of the best experiences of my life!  I could talk about this for hours! Suffice it to say that the network that I was exposed to in the program allowed me to do more for NCSBN than I would have been able to do if I had not participated. I came away with so many new skills, different ways to see and analyze issues, and a new optimism that there is no challenge too big to tackle. I am a better CEO because of the RWJF Executive Nurse Fellows program!

This commentary originally appeared on the RWJF Human Capital Blog. The views and opinions expressed here are those of the authors.