Board Leaders' Perspectives of the Impact of Nurses on Boards.

OBJECTIVE: The purpose of the study was to explore the impact of nurses on boards (NOBs) from the perspectives of board leaders who are not nurses. BACKGROUND: Research about the impact of NOBs derives from nurses' recall of board experiences. No studies explore the impact of NOBs from perspectives other than nurses. METHODS: Researchers used an exploratory qualitative design with purposive sampling and interviewed 16 participants. RESULTS: According to participants, NOBs impact board governance as boundary spanners within the healthcare ecosystem. The overarching pattern is supported by 6 traversing themes. CONCLUSIONS: Board leaders' perspectives of NOBs as boundary spanners illustrate the far-reaching impact nurses have in the board role and on the direction of healthcare organizations.

A scoping review about nurses on boards: 2016-2022.

BACKGROUND: The momentum to place nurses on boards (NOB) continues to build. An integrative review about NOB was published in 2017 covering 1988 to early 2016. Studies about NOB have been published since but no systematic reviews summarize the research. OBJECTIVES: The purpose of the project was to describe the research about NOB from late 2016 to early 2022 framed within the Conceptual Model for Nurses on Boards (CMNOB). METHODS: A scoping review was conducted using the preferred reporting items for systematic reviews and meta-analyses guidelines for scoping reviews. DATA SOURCES: Databases used in the search included PubMed, CINAHL, ProQuest Central, and Academic Search Complete. Eleven records comprised the sample group. RESULTS: Of the six general purposes for the research about NOB, seven studies aimed to explore nurses' board experiences or preparation for board service. The studies' recommendations were classified within the CMNOB concepts: board composition (n = 8), board effectiveness (n = 3), and organizational performance (n = 2). Several studies' recommendations were classified into multiple concepts of the CMNOB. CONCLUSION: The research about NOB has accelerated since late 2016. Preparing nurses for board service remains central. However, until research demonstrates nurses' impact on board effectiveness and organizational performance, underrepresentation of NOB is likely to continue.

Nurses' Perspectives of Their Impact While Serving on Boards.

OBJECTIVE: The study objective was to identify nurses' perceptions of their impact while serving on boards. BACKGROUND: Nurse leaders serving as voting board members are key experts for board effectiveness and may be associated with stronger performing organizations. Extant research indicates that nurse leaders are qualified for board service; however, no research explores the impact of nurses on boards. METHODS: We conducted an exploratory qualitative study by interviewing 20 nurses serving on boards. Hermeneutic analysis of the data resulted in 1 overarching pattern and 7 traversing themes. RESULTS: Nurses who serve on boards reported leveraging expert knowledge of healthcare and caring wisdom to influence strategic thinking to meet stakeholder needs. CONCLUSION: Nurses promote effective board governance by ensuring that the perspectives and needs of all stakeholders are represented in board processes. We recommend health-related organization executives and board leaders appoint nurses as voting members of their governing boards.

A concept analysis of influence for nurse leaders.

BACKGROUND: To shape priorities for health and health care outcomes, it is essential for nurse leaders to be influential. The application and impact of influence are readily recognized, but not its characteristics. PURPOSE: The purpose of this project was to conduct a concept analysis of influence relative to nurse leaders. METHODS: The Walker and Avant method of concept analysis was utilized. FINDINGS: Attributes of influence include advocacy, communications skills, competency, confidence, credibility, and engagement. Antecedents of influence are authority, collaboration, integrity, and mentorship. Consequences of influence are action, change, commitment, compliance, decision-making, motivation, and resistance. DISCUSSION: By drawing upon a systematic understanding of the concept of influence, nurse leaders are urged to develop and leverage the attributes of influence to drive and achieve collective good for the future of health and health care in society.

Governance education for nurses: Preparing nurses for the future.

The complexities of today's health care environment require organizational governing boards to have deeper understanding of health needs, influences, and outcomes with diverse board leadership. Nurses understand the complexities and demands of health care, but few nurses are engaged on boards of directors and many nurses feel unprepared for the governance leadership role. The nurse of the future requires governance knowledge and competencies to influence organizational policies that will improve health care outcomes and advance health promotion. Governance education is a necessary component of preparing the nurse of the future to influence health care transformation. Until nurses can confidently embrace governance leadership as a part of their professional identity, convincing and expecting non-nurse board leaders to appoint nurses to boards will continue to be a challenge. This paper describes a strategy for incorporating governance competencies into nursing curricula across all education levels by leveraging the American Hospital Association Governance Core Competencies (2009) and the Massachusetts Nurse of the Future Core Competencies©-RN (Massachusetts Department of Higher Education Nursing Initiative, 2016).

Examining the Beliefs of Skilled Nursing Facility Directors of Nursing Regarding BSN Completion and the Impact of Nurse Leader Education on Patient Outcomes.

Research suggests that acute care patients cared for by baccalaureate-educated nurses have better outcomes. Directors of nursing (DONs) in skilled nursing facilities (SNFs) have lower rates of baccalaureate attainment than acute care nurses for unclear reasons. To understand the interest in advancing education, researchers surveyed SNF DONs in Connecticut to examine their beliefs about academic advancement and the impact of DON education on resident outcomes. Nearly 70% of participants with diplomas and associate degrees lacked interest in degree advancement and did not believe a baccalaureate degree is necessary for DONs or that DON level of education impacts resident outcomes. Alternatives to degree completion may include interventions to provide SNF DONs with skills for improving resident outcomes.

The rationale for nurses on boards in the voices of nurses who serve.

BACKGROUND: Inclusion of nurses on boards (NOB) to enhance health care transformation is recommended; however, there is no research-based rationale for NOB. PURPOSE: To articulate the rationale for NOB in the voices of nurses who serve. METHODS: An explanatory sequential mixed methods design was used with priority on the quantitative strand (Delphi method). The qualitative strand was accomplished with focus groups. FINDINGS: Twenty-nine NOB participants (Delphi phase) and nine NOB participants (focus groups) agreed the rationale for NOB is embedded in specific knowledge, skills, and perspectives that nurses contribute for boardroom discussions and policymaking. This study supported anecdotal literature promoting nurses for board leadership. DISCUSSION: Nurses should be appointed to boards of directors based on their knowledge, skills, and perspectives about health care. Board leadership leverages the public's trust in nursing, advances the profession, and positions nurses to influence health care transformation. Further research is recommended.

After the Gap Analysis: Education and Practice Changes to Prepare Nurses of the Future.

AIM: The purpose of the study was to describe the Connecticut Nursing Collaborative-Action Coalition's work in identifying and addressing gaps between nursing education and practice based on the Institute of Medicine's Future of Nursing report. BACKGROUND: Massachusetts Nurse of the Future (NOF) Competencies highlight the knowledge, skills, and attitudes/behaviors required for professional nurses. Integrating these concepts into the educational system will prepare the nursing workforce to respond to current/future health care needs and population health issues. METHOD: Education and practice partners in four regions conducted a gap analysis of the education to practice transition for new graduate nurses using NOF as a framework for assessment. RESULTS: Gaps in competencies were similar across regions. However, each organization uniquely addressed curricular gaps to best prepare nurses of the future. CONCLUSION: Curriculum improvements will provide students the advantage of being prepared for the rapid changes happening in health care.

Nurses on health care governing boards: An integrative review.

BACKGROUND: Nurses are key change agents in health care; yet, nurses have not been sufficiently engaged on boards to shape decision making. Without an equal voice in the boardroom, nurses cannot fulfill their professional obligation to society. PURPOSE: The purpose of this study was to understand the progression in research focus and recommendations over time about nurses on boards (NOB), identify research gaps, and make research/practice recommendations. METHODS: An integrative review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines (2009) for data evaluation and analysis. Eleven studies (six quantitative, three qualitative, and two quasi-mixed methods) were included in the review. FINDINGS: The focus/recommendations of research about NOB have changed from passive observation to action-oriented inquiry that considers nurse expertise and value but lacks a coordinated approach to advance board appointments for nurses. CONCLUSION: A systematic approach to the research is needed to advance NOB as key agents in health care transformation and social justice.

A Feminist Framework for Nurses on Boards.

Nurses' knowledge, skills, and expertise uniquely situate them to contribute to health care transformation as equal partners in organizational board governance. The Institute of Medicine, the 10,000 Nurses on Boards Coalition, and a growing number of nurse and health care scholars advocate nurse board leadership; however, nurses are rarely appointed as voting board members. When no room is made for nurses to take a seat at the table, the opportunity is lost to harness the power of nursing knowledge for health care transformation and social justice. No philosophical framework underpins the emerging focus on nurse board leadership. The purpose of this article is to add to the extant nursing literature by suggesting feminism as a philosophical framework for nurses on boards. Feminism contributes to the knowledge base of nursing as it relates to the expanding roles of nurses in health care transformation, policy, and social justice. Furthermore, a feminist philosophical framework for nurses on boards sets the foundation for new theory development and validates ongoing advancement of the nursing profession.

A Metasynthesis Exploring Nurses and Women on Governing Boards.

OBJECTIVE: The purpose of this article is to present the results of a metasynthesis addressing significant issues relating to board appointments for nurses and women. BACKGROUND: Nurses are rarely engaged as voting board members even though they are positioned to add value. When nurses and women are appointed to boards, their experiences reflect the struggles associated with traditional patriarchal board norms. METHOD: A metasynthesis of qualitative studies was conducted. Seven studies from nursing and business literature were analyzed using the meta-ethnography methodology. RESULTS: Proving worth is the central issue of nurses and women on boards. CONCLUSION: Boardroom parity for nurses and women is an important social agenda with implications for strategic decision making in healthcare and business.