Nurse leaders in the boardroom: a fitting choice.

Take a look at the makeup of most hospital and health system boards of directors. You might find a community philanthropist, a banker, a partner in a prestigious law firm, several successful business executives, and perhaps a physician. But chances are you won’t find a nurse. While nurses act in leadership roles in many healthcare settings, they remain largely overlooked for board positions—the highest level of organizational leadership. A recent survey of more than 1,000 hospital boards (AHA 2011) found that just 6 percent of board members were nurses; 20 percent were physicians. The reasons behind this omission are worth exploring. After reviewing the board leadership of more than 200 health systems and interviewing many of their members, researcher Lawrence Prybil (2009) theorized that gender bias, the outdated perception that nurses do not have leadership skills, and lack of understanding of nurses’ roles in determining care quality could be preventing decision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. Another factor may be concerns that nurses are largely focused on their profession and will act more as employee representatives than in the interest of their healthcare institution (Prybil 2009), although the appointment of physicians does not appear to arouse such fears. In a field facing an astonishing rate of change, that healthcare systems appear reluctant to welcome nurse leaders in the boardroom is short-sighted. Comprehending that a significant cadre of our nation’s nurses possesses the experience and skills to serve in leadership is one change long overdue. Other research has found the same misperceptions as Prybil’s work did. Opinion leaders in a Gallup poll conducted for the Robert Wood Johnson Foundation reported that they believe nurses are seldom viewed as leaders in the development of healthcare systems and delivery (Khoury et al. 2011). The survey results identified perception as the greatest barrier; the 1,500 opinion leaders polled said nurses were not seen as important healthcare decision makers compared to physicians. However, in the same poll these opinion leaders said nurses should have more influence in reducing medical errors (90 percent agreed), increasing quality of care (89 percent), promoting wellness and expanding preventative care (86 percent), and improving healthcare efficiency and reducing costs (84 percent). Respondents also