Nurses' Perspective Missing from the Boardroom

    • April 21, 2010

A recent study of the demographics of health systems’ boards of directors finds that 22 percent of voting board members are physicians, while just 2.4 percent are nurses. The study conducted by researchers at the University of Iowa is the subject of an April 6 column from the senior managing editor of HealthLeaders Media, featuring an interview with Susan Hassmiller, Ph.D., R.N., F.A.A.N., the Robert Wood Johnson Foundation (RWJF) senior adviser for nursing and director of the RWJF Initiative on the Future of Nursing at the Institute of Medicine.

Hassmiller tells columnist Rebecca Hendren the story of convening a national meeting of nursing leaders several years ago, as RWJF sought input on how to improve the nation’s health care system by advancing nursing. “One of their number one priorities was that [nurses] need to have a stronger voice at the committee and board level,” she said.

Afterward, Hassmiller conducted her own mini-study, looking at the boards of the nation’s top ten organizations overseeing quality, top ten hospitals and health systems, and top ten peer-reviewed non-nursing journals, and counting the number of nurses on each of the organization’s boards. The results were not promising: no more than 4 percent of board spots were taken by nurses.

“How can an organization that is all about delivering high-quality patient care not have a nurse on the board?” the article quotes Hassmiller asking. “It’s great they have all these… people representing the community—but to not have one nurse to say what’s going to work on the frontlines, it just boggles the mind.”

RWJF created its Nurse Leaders in the Boardroom project to facilitate relationships between health care organizations and nurses at the board level, and to encourage nurse leaders to consider board leadership and take the necessary steps to prepare themselves. The Foundation believes that the presence of nurses on health care organization boards—where their insight and skill can shape policy—will ultimately improve the quality of health care in this country.

The view that nurses should have more influence on health policy, planning and management is shared by the nation’s opinion leaders, according to a first-of-its kind survey conducted by Gallup on behalf of RWJF. Released in January, the survey found that a strong majority of opinion leaders—insurance, corporate, health services, government and industry thought leaders as well as university faculty—say nurses should have more influence than they do now on increasing the quality of care, promoting wellness, improving efficiency and reducing costs. More than half of these opinion leaders (56 percent) identify not having a single voice in speaking on national issues as a barrier to nurses’ influence.