Letter to the Editor by Nurse Involvement on Boards to topic "Healthcare Reform: Nurses Impact Policy"

Healthcare Reform: Nurses Impact Policy

Response by Nurse Involvement on Boards to OJIN topic "Healthcare Reform: Nurses Impact Policy," (May 31, 2017)

Dear Editor,

We are writing in response to the Topic: Healthcare Reform: Nurses Impact Policy. We firmly believe that nurses, as front-line care providers, should have a significant influence on healthcare decision-making and to positively impact patient care (Mullinix, 2011). One way to do this is through service on boards and commissions that influence health. However, little is known about nurses’ current involvement on boards nor the desire of other nurses to serve on boards. Two of us, (Drs. Mullinix and Walton), co-founded the North Carolina Nurses Association Nurses on Boards 2020 Council in an effort to meet our state’s target of 287 nurses on boards by 2020. We conducted a descriptive correlational study, in May and June 2016, using a 20-item electronic survey of 122,562 registered nurses with email addresses obtained through the North Carolina Board of Nursing. Demographic information was assessed regarding who was currently serving on boards and to gauge interest of those in serving on boards.

A total of 4,096 nurses (3.5% response rate) completed the survey. Issues identified that contributed to the low response rate were lack of compensation, competition with another statewide email survey of the same population, and surveys going to Spam folders. The majority of our respondents were white female registered nurses (RNs) with a bachelor’s degree who had greater than 10 years of experience. Only 622 (15%) participants reported serving on a board. More years of age, higher levels of education, APRN status, and greater years practicing nursing were significantly associated with board participation (P-for-trend ≤.001). Participants who reported their race as mixed/other had a 106% lower likelihood (95%CI=36%-313%) of participating on a board than those who self-identified as being black or white.

This initial survey provided valuable insight about the issues involved with survey administration. Future research that involves survey administration should provide some type of compensation, be distributed by a source that minimizes the chances of being quarantined by a Spam filter, and be distributed during a time no other surveys are administered to the intended respondents.

Surveys of characteristics of those serving and interested in serving are helpful to inform interventions focused on increasing nurses’ participation on boards and we need nurses to participate in board service across the country. As of this writing at the start of 2020, the Nurses on Boards Coalition met 70% of its goal of 10,000 nurses on boards by 2020 (Nurses on Board Coalition, 2020). States need to understand why they have not met their goals. This survey attempted to acquire information on whom is serving and who wants to serve on boards, but encountered barriers to obtaining data. We hope our experience and suggestions will aid other states in understanding who is and who wants to serve. Nurses are a valuable resource for gaining insight on how to improve patient care, and by including nurses as board members, we will gain this valuable perspective.


AnnMarie Lee Walton, PhD, MPH, RN, OCN, CHES

Amanda Lucas, MSN, RN

Connie Mullinix, PhD, MBA, MPH, RN

Jimmy T. Efird, PhD, MSc


Mullinix, C. F. (2011) Making nurses full partners in redesigning healthcare in North Carolina. North Carolina Medical Journal, 72(4), 314-316.

Nurses on Boards Coalition. Retrieved https://www.nursesonboardscoalition.org/