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Wednesday, February 1, 2017

Missing: nurses on governing boards

As a member of my state nursing association, I pay attention to the emails alerting me to legislation that is important to nursing. Recently, I was asked to send a letter to my state representative and senator asking them to endorse a bill that would require the governor to appoint a registered nurse to the Governing Board of the Health Policy Commission. This seems like a no brainer to me.

What I find frustrating is that nurses are not routinely invited to the board which makes policy decisions in health care. Why is that, I wonder?

Two years ago, the home health agency I worked for was integrated into a new Division that included a clinic and the ED. On that board of directors were physicians and physician's assistants. The VNA was 1/3 of this division and yet, the COO of the Division, formerly the VP of the VNA (an RN) and the Director of the VNA (an RN) were not on the board, nor were any Nurse Practitioners from the ED or the clinic.

I found this to be unacceptable, so I wrote to the President of the Division:  "As a home care nurse, I am excited to hear that (division's) goal is to provide “integrated, seamless care". We, in home care, have been trying to overcome working in silos to better serve our patients for quite some time. At (the VNA), we have been working diligently to improve care for our patients and our providers. I would like know why nursing is missing as a colleague at the board of directors? If we are to "achieve our goal as  a team", shouldn't the team be representative of all the service providers? Certainly, our home care division should be represented on this board, I can't imagine why it is not."

His reply: "Your question raises a great point as we build the (Division)  into an organization that focuses on improving the transitions of care in an effort to improve our patients outcomes and care experience.  I want you to know that I feel the Home Care Division will play a very important role in helping us achieve this vision and is currently represented at each Board Meeting.  The COO of the Division and former VP of the Home Care Division is in attendance at each Board Meeting and just recently we have invited the VNA Director to attend all future Board meetings.  Both the Board Chair, and myself will be working closely with (them) to ensure “the voice” of the Home Care Division is heard at our Board meetings and is an integral part of our strategic plans moving forward.
As we continue to build this new enterprise, we will also be looking at the Board structure and its members to ensure it is aligned with the vision we are trying to achieve.    I will certainly carry your suggestion forward as we do this work."

I checked again today, the VNA is no longer under that division and has reverted to its own division, as it was before the changes. I checked all of the Boards that lead the organization, lots of doctors but no nurses to represent the 1,500 nurses within the organization.  Apparently, it must be legislated to get nurses at the table. Excuse me, I believe it's time to email my legislators.

 3/9/17 Update: Today, I received a newsletter from the organization I was referring to in this post. I am thrilled to report, the organization has elected a nurse working at the organization to the board of trustees. Progress is being made!


  1. Awesome and congrats on your work getting a nurse on the board! Do you have a letter template that we can use to email our legislators? - Sarah Mott, RN/President
    Nurse Born Products

  2. Thank you, Sarah. I do have a template I use. I also keep my legislator's contact info in my smartphone so I whip off a letter quickly.
    Here is what I use:
    Mar 4, 2017

    US Senator John Doe
    Senate Office Building, Room XXX
    XXX Constitution Avenue
    Washington, DC 20510-2105

    Dear US Senator Doe,

    Begin on a positive note, thanking them for their efforts and who you are. Example:
    Thank you for all you are doing for the citizens of Massachusetts.
    Today, I am writing you as a Registered Nurse who has worked in
    Healthcare for 40 years. Write a personalized note about what you care about.

    Example: I am writing to urge you to support S. 445, the Home Health Care
    Planning Improvement Act. This legislation would allow advanced
    practice registered nurses - nurse practitioners (NPs), clinical nurse
    specialists (CNSs)and certified nurse midwives (CNMs) to certify
    eligibility to Medicare beneficiaries and make changes to home health
    plans of treatment. I urge you to support APRNs and their home health patients by cosponsoring S. 445, the Home Health Care Planning Improvement Act.

    Thank you,

    Ms. Debbie theNurse, your title
    100 Anystreet Avenue
    City, State zip
    Phone number
    email address

  3. Agree it does take a lot of work to stay involved and active. I am a member of my professional association. We do a lobby day each year Here is the link

    In addition, I also am on the Board of the National Nurse. are very active with good causes.....we are viewed as experts in healthcare so keep up the communication.

  4. Great article! And excellent job on your part. Way to be persistent. I actually had Laurie Benson of the Nurses on Board Coalition as one of the 2017 Art of Nursing speakers. I too, as a nurse who serves on a board, find it extremely important for us to be proactive in these matters. Great article, sharing!!

    1. Thank you, maybe someday I will serve on a board.