Breakthrough Leadership – A Window into the Boardroom: A Descriptive Phenomenology Pilot Study about the Experiences of Nurses Serving on Interprofessional Healthcare Governing Boards

Nurse engagement on healthcare governing boards in the United States is low between two and six percent. The 2010 Institute of Medicine report, The Future of Nursing; Leading Change, Advancing Health, recommends nurses engage as board members and become equal partners with other healthcare leaders to make critical decisions about healthcare design and reform. The Robert Wood Johnson Foundation (RWJF) recently launched an initiative to place 10,000 nurses on boards by 2020. Nursing organizations like Sigma Theta Tau International, the American Academy of Nursing, and the American Nurses Association have partnered with RWJF to bring the initiative to fruition. Considering nurses are at the nexus of patient care, quality, and costs, nursing leadership at the board level is critical. Few research studies examine the issue of nurses on boards. PURPOSE: The purpose of the pilot study was to describe the experiences of nurses on interprofessional healthcare governing boards and to begin a trajectory of research evidence about this topic. METHOD: The research design used was descriptive phenomenology. A purposive sample of three nurse board members from New England participated in the study. The interview statement was, “Please describe to me your experiences as a nurse serving on an interprofessional healthcare governing board. Please describe all your thoughts, perceptions, feelings, and specific examples you can recall and wish to share.” Data were analyzed using Colaizzi’s method of phenomenological data analysis. RESULTS: Data analysis yielded seven themes: 1. Role on the Board: Pusher and Prodder, 2. Nursing Skill Sets: Innovator, Implementer, Evaluator, 3. Composition of the Board: Hats Off to the Person Who Brought Me onto the Board, 4. Voice and Influence: By the Way, I Happen to be a Nurse, 5. Culture of the Board: It was an Old Boys Network, 6. Board Work: Let’s Get Down to Business, and 7. Personal Outcomes: A Fantastic Learning Opportunity. The fundamental structure of the experience is one of breakthrough leadership described in terms of influence, contribution, respect, pride, and personal development. DISCUSSION: Even though challenges were described, serving on healthcare boards allowed the nurse participants to effectively use their voice, knowledge, skills, and expertise to contribute to high-level leadership and decision-making about healthcare. The experiences of the nurse board leaders in this study demonstrated their ability to engage in board level discussions and decision-making as recommended in the IOM report. The experiences of the nurses in the study provide a window into the boardroom. The boardroom is one that few nurses enter. To effectively contribute to the transformation of the healthcare system, it is critical for nurses to engage as leaders in healthcare boardrooms.