Nurse Spotlight

AT-A-GLANCE

• Cedars-Sinai Health System – Vice President, Chief Nursing Officer
• American Organization of Nurse Executives – President
• American Academy of Nursing – Past-President
• National Black Nurses Association – Past-President
• Robert Wood Johnson Foundation – Member, Board of Directors
• Case Western Reserve University – Trustee

Why were you invited to serve on the Case Western Reserve University Board?

Leadership is a practiced art. When board nominating committees are seeking new individuals, your track record of what you’ve been able to contribute to society in general and not just to a specific organization is important. Practicing leadership across different venues leaves a very visible trail that others can see and that makes them wonder, ‘Is it possible we could engage this individual on our journey?

I was invited to serve on the Case Western board after former Congressman Louis Stokes recommended me to the university’s interim president. At the time, Case Western was reeling from some not positive changes. My track record of helping educational, health care and social institutions, and governmental entities reach their express goals is what made them seek me out even though I’m not from Ohio and didn’t graduate from Case Western Reserve University.

Congressman Stokes and I had previously worked together, while he was in Congress, on a variety of initiatives to close the gap in health disparities, improve public health and ensure that health care systems in the U.S. are more inclusive in caring for people of color. We have a great deal of mutual respect for each other, the same set of core values. 

How would you describe your main focus on the Case Western Board?

I’m co-chair of the Academic Affairs & Student Life Committee, which is charged with looking at how students and faculty work to achieve the institution’s goals and how their work affects the Cleveland community. We focus on how this university can be used as a resource to improve the status of our region from a health and social perspective. Case Western has done a fabulous job of engaging the very diverse community in Cleveland and Northeast Ohio.

My ongoing focus on diversity at Case Western and throughout my career isn’t about counting how many people of particular backgrounds are present in a given setting. Instead, it’s about accountability for opening the door wide so everyone can come in and have an opportunity to be part of the work we’re doing. It’s about making room at the table for diverse voices in the dialog about the allocation of resources.

You have served on several boards. What have you found most valuable about these experiences?

The many opportunities to learn and grow, the breadth of board members’ experience and expertise, the networking and the ability to make connections and introductions. These interactions are an important part of how business gets done.

Any insights you would like to share with nurses who are interested in new board or leadership roles?

If you are invited to serve on a board, make sure that organization’s work is important to you. If it’s not important, you’ll just be a person sitting in a seat. You won’t reach into yourself to do your very best. Ask the person who invites you, ‘What do you think I can contribute? Why are you asking me?’ Consider that person’s response, and reflect on whether you have the time and the will to meet the commitment they’re asking you to make.

Some people are wary of a board role if they’re unfamiliar with areas such as finance, policies and procedures. You can learn about those. Find out whether a board has educational programs or mentors for new members. 

Who has most influenced your interest in board service and philanthropy?

My number one (influence) is my mother. She was always engaged with her church and often actively served on three or four different committees. As the oldest of twelve children in my blended family, I wanted to make sure my sisters and brothers knew that besides their father and mother, they were loved. I learned the value of people helping people.

I have always given to others ever since I was twelve years old. That’s who I am. The amount is not what’s important. It’s the gift, the expression of love and caring. What drives me is the need to feel that people know they are loved and cared about. 

Many board positions include an expectation of personal philanthropy. How have you met those expectations?

Board governance also comes with an obligation to give or get. You either give personally, or if you don’t have the means, you get other individuals organizations to give on your behalf. You don’t have to have financial resources to be on a board. If you think that organization’s work is important and you want to be part of it, there are other ways to contribute.

Recently, I made a $100,000 capital campaign commitment to Case Western’s Frances Payne Bolton School of Nursing because its goals are aligned with what’s important to me. The university has a new vice president for Inclusion, Diversity and Equal Opportunity. And the School of Nursing is working to increase the number of African Americans, Latinos and men who graduate with doctoral degrees.  

That’s not my first major gift. Here at Cedars-Sinai, I endowed two scholarships, one in my mother’s name and another in the name of a physician who was a dear friend.  I have also established an endowment at the National Black Nurses Association.

The theme that connects all this is supporting organizations whose missions are aligned with my own ‘true North,’ my core value of caring for people. 

At-A-Glance

• Texas Health Presbyterian Hospital Dallas - Chief Nursing Officer
• Texas Hospital Association - Nurse Executive Trustee
• American Organization of Nurse Executives - Board member, Region 7 Representative

When did you first advocate for a nurse presence on your hospital’s board

Before my first job interview I did research that helped me position and advocate for the nursing competency on our board. I learned that in the 46 years of this hospital’s existence, there had never been a nurse on its board. The board is constructed on a competency model to achieve well-balanced oversight by lawyers, business people, non-profit leaders, physicians and a minister. So I knew it would be useful to ask whether the hospital’s current employment base, 55 percent of whom are nurses, was reflected in the composition of the board. During my job interview, I asked whether they had ever considered having a nurse on the hospital’s board. They said that while they didn’t have a nurse on their board, they felt the CNO who attended their board meetings, not as a voting member, was actually serving in that capacity for the board. My follow up question for the board of trustees was, ‘Are you open to having a nurse on the board?’ They were. So I also asked them to share what capabilities they would want in that nurse. This information helped me fulfill my responsibility as the newly hired CNO to identify, vet and recruit nurse board member candidates for board approval.

What is your advice to CNOs who are searching for good board candidates?

It’s important for a CNO to be the active point person to find, vet and propose nurses who are suitable candidates for board service — especially since you want to identify someone with whom you can work effectively. Non-nurses may not have the network, knowledge or understanding of the subtle conflicts of interest that can occur.

When I joined the Texas Health Presbyterian Hospital Dallas as CNO, I reviewed my list of contacts among nurses in the community and began to informally vet board candidates. I invited people to lunch or dinner to see where they were in their careers, explore whether they were open to board service and identify possible conflicts of interest.

It can be difficult in a small community and even in a large community to find someone without a conflict of interest that makes them ineligible to serve on your board. A board member cannot work for a competing health system or be an employee of your hospital or health system. Even a nurse in academia may have a potential contract or connection to a particular health system that makes them ineligible to serve.

As part of my informal vetting process, I asked Stephanie Woods, RN PhD, Associate Dean at Texas Women’s University, who later became our first nurse board member, to co-facilitate a regional access meeting for the Institute of Medicine’s Future of Nursing Report. That was my chance to see her as a leader and to understand where we may have alignment or differences in our philosophies. After that I knew Dr. Woods was the right person to serve as the first nurse on our board of trustees. She was exemplary at building professional and social relationships on the board through which she had real impact. I also identified and recommended her capable successor, Lola Chriss, who is worldwide occupational health manager at Texas Instruments.

What are some of the measurable impacts of having a nurse on your board?

The board chair appointed Dr. Woods, as the board leader, to work closely with staff and physician leadership to investigate and potentially make a recommendation that the hospital pursue a Level II trauma center certification and designation. As the staff leader on this blue ribbon panel, I witnessed first-hand how effectively Dr. Woods assessed, influenced and led our hospital’s pursuit of this important goal. We spent three months intensively researching strategies and tactics, return on investment, and staffing, equipment and physical space needs; eventually our recommendations were approved by the board. Our hospital’s trauma center began operating in 2014. In September 2016, the American College of Surgeons made a site visit that resulted in no deficiencies and myriad strengths in the survey. According to this assessment, we were the first to create such a quality and comprehensive program in just two short years, an impressive achievement.

Today, we are serving a vulnerable population of trauma patients in North Texas with excellent outcomes in large part due to the leadership of a nurse on our board who understood the clinical, financial and important mission value of pursing this goal. An initial startup investment of around $5 million saw a return on investment in less than two years. This program has continued to meet and exceed our initial projections for quality and adds significantly to net revenues annually.

How has having a nurse on your board helped you achieve your goals as CNO?

It has been an accelerator for me to have a strategic partner on the board who helps us achieve excellence in patient care and nursing outcomes. Texas Health Dallas is a third-time designated Magnet hospital, the global hallmark of nursing excellence. Dr. Woods served on our board during our second magnet designation and Lola Chriss was a board member during our third designation. Their leadership participation was among several key factors in our ongoing improvements in outcomes, best practice, research and leadership.

Our hospital’s employee engagement is at 98 percent, putting us in the top 2 percent of hospitals in the nation. Having someone on the board who recognizes the challenges we face as nurses truly makes a difference as they can offer ideas based on nursing experience and expertise about what we want to look at or change to ensure that we provide the highest caliber care to our patients and a premier practice environments for all employees, especially nurses.

If a board is resistant to having a nurse as a full voting member, what strategy do you recommend?

CNOs often say that board members ask them, ‘Why should we have a nurse on the board?’ I suggest trying to change the frame. Respond with: ‘Can you share with me why you think we should not have a nurse on the board?’ This changes the paradigm and opens an important conversation through which you can identify and assess barriers, issues and concerns to overcome so a nurse could serve on that board.

A hospital or healthcare organization that doesn’t have a nurse on its board is missing representation of their work force, and doesn’t benefit from nursing’s understanding of complex situations and keen awareness of the patient perspective. Nurses’ potential contributions are sometimes underestimated because we are clinical: the board might not be aware of nurses’ business acumen, and how involved we are in strategy, finance and business.

Can you recommend ways for a nurse who’s not a CNO to effectively request that a nurse be added to the board of their hospital or health system?

Direct care nurses may not realize that the board plays such an enormous role in quality, finance, strategy and selection of leadership for the facility, as well as being the final credentialing body for medical staff. Once you educate yourself and others on the impact of the board on hospital strategies and even operations, it becomes clear that nursing should be represented as a voting member of the board to reflect the demographics of the workforce. The board is the highest governing body in the organization that impacts and influences all aspects of the facilities. Having a nurse on the board creates equity, can flatten hierarchies, bring patient advocacy more fully to the table and increase sensitivity to operations, along with systems thinking and the business and clinical acumen that many nurses possess.

In terms of advocacy, I would ask all nurses to work closely with their CNO and their senior leadership team to create a compelling case for a voting nurse on the board that describes the value they see in being represented at the board level.

AT-A-GLANCE

• Morris Heights Health Center - counsel and compliance officer
• The Brooklyn Hospital Center - co-vice chair, Board of Trustees
• Rita & Alex Hillman Foundation - trustee
• BRIC - member, Board of Trustees, former chair
• New York University School of Law - J.D., NYU Division of Nursing BSN

On which boards do you currently serve?

I have served on five boards so far though not at the same time and currently serve on three. I first served on the board of the Brooklyn Museum and BRIC, a Brooklyn arts organization. I chaired the BRIC board for six years, and continue to serve on this board. I also served on the board of St. Ann’s School, which my children attended, and have since stepped down from board service for the Brooklyn Museum and St Ann’s.

After I completed my nursing degree, the chair of The Brooklyn Hospital Center board, who knew me because we live in the same neighborhood, invited me to serve on that board. I was delighted. This was the first time I joined a board that dovetailed with what I do professionally.

I am co-vice chair of the Brooklyn Hospital board and recently helped lead the hospital’s search for a new president and chief executive officer. That process took the better part of 2015. The search committee and the search firm we engaged held town hall meetings and listened to what doctors, nurses and staff at all levels were concerned about and were looking for in a new leader. It was important to hear the perspective and have the buy in of the hospital community. That hiring decision was made by the full hospital board, and was informed by our search committee’s recommendation. Brooklyn Hospital’s new president and CEO, Gary Terrinoni, began in mid-November.

In 2014, I became a trustee of the Rita & Alex Hillman Foundation, which is devoted to nurse-led innovation. Serving on a grant-making organization that promotes nursing education and strengthens the profession’s impact upon healthcare is a terrific experience for me.

How do you balance board and work responsibilities, and what is the value of doing both?

When I decided to work for Care for the Homeless I negotiated a four day work week because I had just been named board chair at BRIC. I like to think Care for the Homeless made out well on that one. I work hard and am grateful for the flexibility. I direct my nonprofit governance time into one day a week, Thursdays. I continue to use that day to prepare for board meetings, read board materials, attend meetings and occasionally attend to work responsibilities from home.

Board service is a chance to see things from a different perspective. You have the responsibility to oversee but not actually do the running of the organization. So you gain insight into the mechanics by which any organization works. Through my board service, even on boards that aren’t health-related, I’ve found a lot of useful insights for my own work. If you can make time for it and have the opportunity, serving on a board is a great learning experience.

What do you bring to board service as a nurse that you feel is valuable and demonstrates the importance of having nurses in positions of influence?

I am the first nurse to serve on Brooklyn Hospital’s board, even though it is the oldest hospital in Brooklyn. I bring the perspective of what patients need and the bedside experience to deliberation and decisions about the well-being of the hospital. I think this has been validating for the nurses who are the hospital’s largest employment sector. I’m grateful to have the chance to help represent the nursing perspective at the board level.

Nurses tend to be able to think beyond one particular patient to the broader impact that patient care and patient experiences have on next of kin, their families and communities. That wider perspective was very much part of my NYU training, and has informed my board service. The ability to analyze broader ramifications is what comes to mind as the most important feature of the nursing perspective. Nurses also tend to use their time efficiently, and are engaged and consistent, traits that are very important in board service.

My advice, in a nutshell, is that they will be good at it. They will enjoy it and will help fly the flag for the profession a little higher. Nurses in board leadership roles will do a great job and will consistently be advertisements for the incredible power of the nursing profession.

Board service is an opportunity to see many of the same challenges and issues you grapple with professionally from a new perspective — overseeing those who are grappling with those changes as opposed to doing the work directly. What you bring to a board will be informed by your professional life and vice versa. I would encourage nurses who are interested and have the capacity time-wise to look for opportunities for board service.

What have been some of the greatest challenges you’ve worked on during your years of board service?

I’m consistently reminded that change is hard. I know that from a workplace that has accommodated change and from being a board member overseeing organizations struggle with and then embrace change. Whether it’s a head of school leaving or the head of hospital changing, change is destabilizing. If reimbursement formulas are changing and how we provide care is changing, that is difficult.

Working through, understanding, and being sympathetic to how difficult change is, being able to communicate how important change can be, and seeking buy-in and partnership by the people who will be most affected by change is challenging and can be very rewarding. The story of any time, any era, and any place is one of inexorable change. We need to understand how people can work together to embrace and adapt to change.

How would you suggest nurses seek and prepare for board service?

If there’s an organization that interests you, check its website to see who’s on the board. Read board member profiles. Don’t hesitate to indicate interest, particularly if you happen to know someone or know someone who knows someone on that board. Many organizations have committees that are open to non-board members. That can be a great way to get involved and may lead to new board opportunities and another circle of people who can recommend you for board service. Boards are always looking for fresh blood, new insights, new perspectives and new people.

This is not like applying for a job. I wouldn’t recommend sending in a resume to a board chair and saying, ‘I want to be on your board.’ What you want to communicate is that you’d like to understand the organization better and learn more about ways to get involved. That’s a way to get in on the conversation. If you do that sort of thing, in time you’ll find yourself approached and even fending off interest from organizations.

How do you approach expectations for philanthropic contributions by board members??

One way to help more nurses serve on nonprofit boards would be to have them not feel personally encumbered by the giving expectations that often come with board service. Nursing has not traditionally been a lucrative profession. I would like to suggest that the nursing profession find means and ways to support nurses sitting on boards of nonprofit organizations, and make funds available to seed their board member donations. We could make a pool of funds available to underwrite board service.

My circumstances are somewhat anomalous because of my legal background and my husband’s profession as a lawyer. We view board service as an important way to give back to a community that we’ve been lucky to be part of. While some nurses have the wherewithal to donate and are very generous, that may be more the exception than the rule. Supporting nurses who are in turn supporting organizations through board membership is a very real way the profession as a whole can cultivate nurses in positions of influence.

How does your board service inform your work, and vice versa?

Much of what I do on the Brooklyn Hospital board as chair of the outpatient services committee is directly applicable to my job as director of health services at Care for the Homeless, which provides health care and social services to homeless people where they are sheltered and where they congregate. At Care for the Homeless we too often see medically underserved people who have had to rely on emergency rooms and inconsistent care: we encourage them to seek care from us on a consistent non-emergent, non-acute basis. Similarly, at Brooklyn Hospital, like many hospitals, we see increasingly that we can care for people well in an outpatient setting. We want that habit of care to be formed around a voluntary ambulatory outpatient experience that the patient principally drives. We want patients to know that you don’t need to be sick or in great stress to seek care.

There’s a tremendous shift now under the Affordable Care Act, which incentivizes keeping people out of hospitals by emphasizing high quality care and monetarily rewarding outcomes — not sheer numbers of procedures or patients cared for. Seeing this shift in the world where I work as well as in the world I oversee gives me more insight, broader opportunities to understand what’s going on and a greater influence on the patient experience.

Who inspired your interest in board service, beyond and within the nursing profession?

My father served on a number of boards and showed me there are tremendous rewards for the time one puts into board service. It’s not quite like a personal relationship or a professional setting. It occupies a different category. Getting an opportunity to watch other people run something well is very rewarding and worthwhile.

The dean of the NYU College of Nursing when I was there, the late Diane McGivern, PhD, RN, FAAN, had an incredible career including serving on the Board of Regents of New York State, which oversees the state public school system. She was an early influence who was always on my radar because she lived in Staten Island, the same borough of New York City in which I grew up. I also had a terrific advisor at NYU, Madeline Naegle, PhD, PMHCNS-BC, FAAN. She, like Dr. McGivern, was very involved in all sorts of committees and aspects of the profession and the university. Dr. Naegle is an articulate promoter of the nursing profession, and helped reshape and rethink the NYU nursing program for someone like me who had an undergraduate degree and a law degree. I graduated from nursing school when I was 45, and was a lot older than most of my fellow students and many of my professors.

What inspired you to change careers from law to becoming a nurse?

In the later years of my legal career I wrote for a legal publication about computer law, intellectual property and technology law. What really started to catch my attention involved the intersection of health, technology and law. I soon realized I was interested in a health career. I thought about getting an MBA in health care administration, and then decided on a career in nursing. Instead of thinking about what patients needed, I thought it would be far better to get practical hands-on training and really interact with patients.

When I began nursing school, I had a 12, 8 and 5-year-old triplets who were starting kindergarten. My husband had the pleasure of living with 6 students! I pursued the nursing degree part-time while I continued to work as a lawyer. Obtaining a nursing degree took me four years, the duration of an undergraduate degree except that I already had one. I was stunned when I finished. Those were busy years. I have always been sure I made the right decision. I realize now how flexible a nursing career can be in terms of the many ways a nursing degree can be used.

What questions should someone ask before accepting an invitation to a board?

When you evaluate board service you’re not just evaluating what the organization does, you’re evaluating what you’re expected to bring to it. It’s important to be very clear and candid about expectations on both sides so people can jump into the work of being a board member and not find out later than they didn’t understand something to begin with. It’s important to ask questions such as: the number of meetings each year you’re required to attend, the number of committees you’re expected to serve on, and what you are expected to give — is that a ‘get’ or is that a ‘give,’ is it about your dollar contribution or the expertise you have to offer? What are the typical terms? How is board service evaluated?

AT-A-GLANCE

• Indiana University School of Nursing – University Dean Emerita, Distinguished Professor
• Institute of Medicine – Elected Member
• Sigma Theta Tau International – Past-President
• National Advisory Mental Health Council, Alcohol, Drug Abuse, and Mental Health Administration – Member
• American Academy of Nursing – Past-President
• National Advisory Committee – Member and Chair, Robert Wood Johnson Foundation’s Nurse Faculty Scholars Program
• Indiana University Health Board – Member, Quality and Patient Safety Committee chair

Why did you want to serve on the Indiana University Health (IUH) board?

This was a natural progression of my career-long focus on the interface between service and education. I had spent a professional lifetime with women and nurses not being at the main tables of discussion. Yet the highest levels of decision-making require nursing’s global clinical and systems perspective, our focus on patients, and our awareness of all the supports people need in a hospital and clinic setting, as well as when they return home.

What has been the best part of serving on the board?

It has been exciting to shape policy with meaningful impact on practice throughout our 18-hospital system, Indiana’s largest and most comprehensive healthcare provider. During my tenure on the board, IUH has won a number of awards for quality and safety, areas in which I have worked with the clinical leadership to establish ambitious and important initiatives.

What has been the hardest part?

When I was younger, if I had 10 good ideas, I wanted to pursue all of them. I have since learned that you have to be strategic about what you take on. On a board, this requires listening to people, working with people, and defining the biggest conceptual and policy issues that need to be addressed to help an organization move in a positive direction.

Where do you feel you’ve had the most influence?

I have chaired the Quality & Patient Safety committee for more than a decade. We focus on attaining and exceeding national goals for quality and safety required for reimbursements, and on important priorities such as a new initiative to standardize best practices for pain management system-wide. We began by working to manage post-operative pain better, which led to improved patient satisfaction scores. Currently, we’re working to improve inpatient management of acute pain for people with a history of chronic pain, a complex undertaking due to risk factors for addiction. Next, we’ll work to improve management of chronic pain. 

What’s your advice for nurses just beginning or midway through their careers?

Develop your personal expertise. Share that skill in a volunteer capacity so you become a known authority in that area as early in your career as possible.  Begin cultivating your leadership capabilities within nursing organizations, then get involved inter-professionally because that’s the context in which most big decisions are made. That’s also a great way to become known among physicians, social workers, psychologists and hospital administrators. As you demonstrate your expertise and ability to work well with others, they’ll think of you for future leadership opportunities.Hospital boards don’t tend to appoint people who work for the organization as board members. So if you work in a clinical facility and would like to build your leadership skills, look for opportunities to serve on an advisory committee for another hospital within the same chain.

What relationships and experiences paved the way for you to serve on the Indiana University Health (IUH) board?

As soon as I became dean, I worked to bring nursing education and service closer together. I served on the foundation board of a hospital that later joined the IUH, and made philanthropic contributions to that hospital. I also worked to make sure nursing was visible and represented within the IUH’s new leadership structure during consolidation of the hospitals in the 1990s. For example, I lobbied to become an ex officio member of the medical council, which helped me become more visible and networked among physicians. After my deanship, I spent a year as scholar-in-residence at the Institute of Medicine. Soon after, I was invited to serve on the IUH board. In short: I made connections, got involved, achieved distinction in my career, and established myself among board members as a known and respected person. Then, when a board slot came open, the question was, ‘Why not Angela?’

What gave you the courage to step into leadership as your career progressed

While I pursued the requisite education and experience for professional advancement, feeling like an imposter was a factor for me in my younger years until I began to notice this pattern. Each time I took a new position I felt some trepidation about whether I would be adequate to the task. At the beginning, I worry whether I can do it. I am committed to trying. I do my best and then generally things work out well. Some of that initial worry is just to get my energy level up and is useful. The kind of worry that is counter-productive is more limited now. Knowing that I have been effective in so many different circumstances has helped me to anticipate success with self-knowledge and confidence.I have also come to realize that if you’re not brilliant on a certain occasion, all you have to do is go back and say, “I don’t think I handled that well. Let me try again.” When you do that, people tend to find you pretty agreeable to work with.

What did you bring to the board as a nurse that you feel was uniquely valuable and demonstrates the importance of having nurses in positions of influence?

Our system had three different accreditation visits while I was on the IUH board. Each time, the nurse accreditors were thrilled that our board includes a nurse. My presence on the board has also had a profound effect on staff nurses who appreciate that their interests are represented at the highest levels. With the Accountable Care Act, we need expert teams instead of teams of experts who sometimes just do parallel play. We need expert teams in which the wisdom of the whole is bigger and better than any one person. That’s where nurses can shine.  We’re boundary spanners who see the interlocking pieces. We know how to coordinate people working together for a common purpose. The issue now is whether nurses are willing to accept the challenge out there for us to be the leaders we need to be (and that others want us to be) in a changing health care system.

AT-A-GLANCE

• University of Washington – Professor of Nursing and Global Health  
• World Health Organization – Past Chair, Global Advisor Group for Nursing and Midwifery
• U.S. Department of Health and Human Services – Past Director, Division of Nursing
• University of Washington and Emory University – Emeritus Dean
• Robert Wood Johnson Foundation – Trustee & Trustee Emeritus
• Grifols, S,A,  – Director
• Grifols, Inc. – Director
• IESAbroad, Inc. – Director
• National Center for Healthcare Leadership – Board Member
• Sigma Theta Tau, International – Board Member
• American Academy of Nursing – Board Member
• Fulbright Scholar
• Hubert H. Humphrey Institute Leadership Fellow
• WK Kellogg National Leadership Fellow
• Institute of Medicine – Elected Member
• Institute of Medicine/American Academy of Nursing/American Nurses’ Foundation Distinguished Nurse Scholar-in-Residence; IOM Distinguished Nurse Scholar-in-Residence Emeritus

This profile is funded in part by the Rita and Alex Hillman Family Foundation

What has been the most meaningful aspect of your extensive leadership and board experiences?

The best part for me is being able to shape an organization’s vision and overall strategic approach in ways that shape the destiny of that organization and its future. I love helping organizations and enterprises make a positive difference in people’s lives.

What lessons have you learned from your board experiences that might help others prepare for board leadership roles?

My first board involvement was as the student trustee at the University of Portland when I was an undergraduate, then in a more professional capacity with a non-profit home healthcare organization when I was in my mid-30s. Because neither I nor the organization was sophisticated about governance, I ended up focusing on operational-level issues. While this was helpful to the organization, it did not advance the overall governance of the organization.  I was in the weeds of operations, rather than operating at the strategic overall organizational level.  My understanding of governance grew through a number of subsequent experiences, mentorship, and my own interest in learning more.  Among the most important learnings have been having the privilege of learning from both the example and advice of the many seasoned, outstanding board Chairs, members, and staff I’ve come to know.  I have come to understand that one of the most useful things one can do is consult with seasoned colleagues for insights and suggestions about how to strengthen one’s own board performance and possible strategies for continuing development.

Over the past 20 years, my engagement with governance has focused not only on my own development, but also on fostering the engagement of other women and nurses in leadership and governance. Serving on the Robert Wood Johnson Foundation board gave me an exceptional platform for my cultivating these interests, including have served as Chair of the Nominating and Governance Committee for a number of years.  I have also gained a great deal through learning experiences like those offered through the National Association of Corporate Directors on the foundations of governance.   

What I’ve learned from leadership and governance opportunities I’ve considered is that there is a lot of work to do before you join a board. If you are invited to serve on a board, due diligence is the single most important first step you can take. Know what you’re getting into, where the vulnerabilities and risks are, whether you respect the company and its leadership, and what the board’s role and responsibilities are to protect society, its employees, the organization and the people it affects.   It’s also very important to check out the culture and values of the enterprise (both formal and informal)

If you are invited to join a board, assess why you want to be on that board. If you don’t have a passion for the work or the company, you should consider declining because there is a good chance you will be of little service or feel good about your contributions. Just getting on a board to say you’re on a board is unethical from my perspective. It’s not just something to put on your resume or another check on the checklist of leadership “must do’s”. You accept weighty serious legal, ethical, organizational, and societal responsibilities in these roles. You are entrusted to help make sure that the organization is doing what it’s supposed to do in both the near and longer term.

I think that there are a few “test” questions to answer when joining a board: 1) Is it an enterprise I respect, value, and believe in? and, How is it doing – and what are the strengths and risks? 2) What value will I add? 3) What do I need to/want to learn that will position me to be effective? 4) Can I commit to the time that is actually needed to do the work? 5) What are the risks and benefits to the enterprise – and to me?

Is liability coverage important in both the non-profit and for-profit world?

Answering this question first requires that you understand what your responsibilities and risks are as a board member.  Clarifying this at the onset is crucial.  Boards can have varying responsibilities – for example, some boards are actually advisory rather than actual governing boards.  (This is most often the case in governmental leadership bodies.)F

It is also crucial to know what sorts of coverage is provided by the organization – it is important that all organizations carry appropriate liability insurance not only for board members but for other senior officers.  The board itself should ensure that this is in place, both to protect members and the organization.  In many ways, liability coverage provides a supportive environment for board members to act responsibly – and not back away from difficult issues. 

As far as one’s own liability coverage, this can vary depending on both your confidence in the coverage of the organization, as well as your own individual liability coverage.  Discussion with an expert is always useful, as well as consultation with the Secretary of the Board or Chair person.

How is serving on the board of Grifols, S.A., a for-profit global healthcare company, different from your prior board and leadership roles at non-profit and governmental organizations?

I am very fortunate to be associated with a company whose values and practices align closely with what I value and believe in.  Knowing that an enterprise has a strong sense of social responsibility, solid ethical standards, and outstanding business practices provides a strong foundation for board service regardless of corporate status.

I’ve found that there are important commonalities shared by both for- and non-profit corporations.  These relate to the overall responsibilities that boards have for ensuring the present and the future good of the organization, and should focus on vision, strategy, organizational performance, financial “health”, good leadership and management, staff wellbeing and support, and appropriate community engagement.

The differences between for-profit and nonprofit boards start with organizations’ missions.  Non-profits have social missions as their reasons for being.  For-profit companies vary in the focus of their missions, but have the interests of and accountability to their shareholders primary foci.  As such, non-profit boards may be far more focused on social impact, than on financial performance.  For-profit boards have a very strong focus on financial performance, as well as other non-financial areas of concern.

Understanding these key differences are important in general and with respect to the choices that one makes in board service.  In my experience, the social mission of non-profits can sometimes overshadow financial performance considerations to the point of threatening the impact and survival of the organization.  Of equal concern, however, is when for-profit companies do not attend to their social responsibilities.   Having board members with experience in both sectors – and an interest sharing lessons across each – can be a real asset to corporations in either sector. 

What was the path to your current position on the Grifols, S.A. board?

My path has not proceeded in a step-wise fashion. Several factors converged in my development as a nurse that engaged me in governance and leadership across sectors, including: 

Understanding how organizations advance social good.  My early career acquainted me with the power of policy, systems, and institutions in social change. Organizations (regardless of corporate status) can foster or stifle the contributions of individuals, groups, communities and even nations. I came to believe that having organizations that are ethical, perform well, and do good requires leadership at all levels – including the too-often invisible governance level.

Having expertise and experience does help.  One of the best pieces of advice I ever got with respect to board service was that I really needed to be clear on what I knew and could do that would benefit the company. Any nurse interested in board service needs to be able to identify specific ways in which she or he can add value to the enterprise at a board level.  This means both industry-relevant knowledge, as well as competence as a board member. My experiences in various leadership roles and on non-profit boards were very helpful, as was my experience in the health sector. However, each organization is different and has different needs – so, being a good match for a board is also about fit in very specific ways. Learning that who you know and how you relate to them matters.  The most important opportunities that have come my way have happened because others helped to make them possible. There is no question that board appointments often reflect “who you know.” 

Having others willing to put you forward for opportunities is often a reflection of two things: 1) what they know about you; and, 2) your own capacity for seeing opportunities that may go beyond your daily scope of activities. You have to be a statesperson without a country.  This one may be somewhat controversial. However, I believe that at a board level, it is crucial that members park narrow agendas and disciplinary advocacy at the boardroom door. While we can each bring experience, perspectives, and resources associated with our disciplines, being the “one horse rodeo” isn’t going to serve the interests of anyone involved. My own board service has evolved in ways that reflect these factors all working together over time – and never in a particularly organized or step-wise fashion. I think that an important part of all of this has been my ongoing belief that good governance in all sectors is crucial to social progress, regardless of where it takes place. And, good governance requires board members who are both committed and capable.

How is your nursing background of value on a corporate board?

I have had amazing opportunities afforded me by nursing – many of which directly contribute to the value that I offer as a board member.  Nursing has given me a wonderful vantage point for understanding the health sector from the vantage point of patients and families, health services institutions and systems, government – in both the US and abroad.   Nursing has also given me leadership and administrative opportunities in which I’ve gained knowledge and experience.  And, the values of that I hold relating to social justice, equity, and caring have been informed and reinforced by my roles and experiences in nursing.  How truly fortunate I’ve been to have this background. In my board service, I’ve found that being a nurse alone is not enough (just as being any other discipline is not enough).   Being good at governance takes knowledge and skills that are both related to governing in general – and to the specific enterprise and industry.  I’ve found that nursing provides a strong foundation upon which to build – but I am also very grateful for additional education and experiences I’ve received beyond our professional boundaries. I think it’s fair to say that the opportunities I have had to make a difference throughout my career have often occurred because I view nursing as my way of making a difference in the broader world. In many ways, this has allowed me to help others understand that nursing is a valuable tool kit that enables me and others like me to make the world a better place. 

AT-A-GLANCE

• Ralston Center – President, Board of Directors  
• University of Pennsylvania School of Nursing – Retired former interim dean, Edith Clemmer Steinbright Professor in Gerontology, former Faculty Senate Chair, former director Adult Gerontology nurse practitioner program (first-round funding recipient, John A. Hartford Foundation Institute for the Advancement of Geriatric Nursing), and recipient of Lindback Award for Distinguished Teaching
• American Academy of Nursing – Fellow
• Foulkeways at Gwynedd Continuing Care Retirement Community –Member, Board of Directors
• Established scientific basis for restraint-free care as a standard of practice through decades-long research, publications, Congressional testimony and work with professional organizations and regulatory agencies.

What was your path to the Ralston board presidency?

I spent much of my career at the University of Pennsylvania’s School of Nursing leading large groups of people, doing strategic planning and dealing with large budgets. My nursing knowledge and gerontology expertise combined with my extensive administrative experience feels like optimal preparation for leading this particular organization at this time. In one way or another, the work I’ve done all my life has prepared me for this board leadership role.

When I joined Ralston’s board in 2007, the organization provided homecare services, transportation, and health and wellness programs. When the board’s prior president stepped down in 2011, I was named as the successor president by the board. Soon after, our CEO died unexpectedly. In the wake of this tragic loss, my leadership role very quickly shifted to the search for a new CEO and evolved to define who we are, what we are and where are going. It took us six months to find a new CEO.

How much time do you spend as president of the board?

I attend every finance meeting, every development meeting, every strategic planning meeting, every pension and personnel meeting, all our events and frequent meetings with donors. Leading this board currently feels like a half time job, which I combine with my consulting practice. On average I probably spend 10 to 12 hours a week on Ralston.

What have you found especially gratifying about leading this board?

I love Ralston’s mission to improve health and quality of life among older adults in Philadelphia. Soon after I was named president, I urged the Ralston board to consider adding a new direction. Our board and staff learned about what was meant by the World Health Organization’s commitment to create more age-friendly environment. We worked with consultants and received input from more than 40 organizational stakeholders in partnership with the Mayor’s office, the Philadelphia Corporation for Aging and many community groups to identify and prioritize the most pressing needs of older West Philadelphians. 

We decided to work to make West Philadelphia better for older adults’ health, well-being and ability to age in place. I’m very excited about our initiatives, launched in 2016, to make West Philadelphia a model age-friendly neighborhood. We’re working to: make public parks and public places such as bus shelters safer and more inviting; increase access to aging resources and supports, and alleviate social isolation; and improve access to fresh food and strengthen social connections through communal cooking.

As an experienced leader, what key lessons have informed your tenure as board president?

Leading a nonprofit board is like running a family. You have to be mindful of everyone’s issues. You need exquisite interpersonal skills so you don’t offend people and so everyone feels like they’ve contributed.

It takes a while to get people to trust you to take even well-defined, organizationally valid strategic risks. Despite the fact that I have wonderful relationships with the board and was aware of this dynamic beforehand, I can’t just plow my way through and say, “This is what we’re going to do.” 

There are important yet complex tensions between boards and staff. We have a very fine small professional staff comprised of seven full-time people. The board’s role is strategic and fiduciary; and operations are the staff’s responsibility. There are lines between those roles. This has turned out to be more complicated than I realized.

What nursing-related values and skills do you bring to board leadership?

Values I’ve honed personally as a nurse and among the nurses I’ve trained include above all respect for people, and a willingness to listen, compromise and make decisions. These are all values of nursing and of any committed health professional.

Some of my nursing-related skills include consensus-building, strategic planning, organizational leadership, knowledge of the elderly, and strong networks of connections cultivated over decades among colleagues at many community-based organizations involved in elder services in Philadelphia. These longstanding relationships helped Ralston develop its more expansive mission and service-focused partnerships.

What’s on your wish list for an effective board member?

We’re a small nonprofit with a big mission and we expect a lot of our board members in terms of their contribution of time and expertise. As board president, I helped Ralston develop a more professional board structure with revisions so our bylaws now include term limits, a nine-year term that can be renewed just once. As people cycle off the board, we look for new board members with needed expertise. Our board now provides Ralston with expertise in core areas such as finance, architecture, construction, law and marketing. We’re currently looking for new board members with capabilities in development and public relations. 

Key traits for new board members include: eagerness to be an advocate for the organization’s mission, willingness to participate and bring expertise to the board, readiness to make a financial commitment at whatever level they can, and desire to encourage and link us to others who might be interested in contributing. 

Leadership readiness is also important. Board presidents truly shape organizations; and this leadership role can’t just be handed off to the next person in line. Every board should do leadership succession planning. You can’t and shouldn’t do this work forever! After we conclude our 200th anniversary celebrations, my next focus will be to identify and groom a successor board president who will continue to revitalize the Ralston Center.

Catholic Health Initiatives (CHI), a nonprofit, faith-based health system based in Englewood, CO, has a longstanding and deep commitment to nurse leadership in the boardroom. CHI is one of the nation’s largest health care systems, with 105 hospitals, plus community health services organizations, accredited nursing colleges, home health agencies and other facilities in 19 states.

As part of the Foundation’s Nurses on Boards initiative, The American Nurse talked with three CHI leaders about the value of nursing perspectives and rising opportunities for nurse leadership on boards. Highlights of their remarks follow.

This profile is funded in part by the Rita and Alex Hillman Family Foundation

How have nurse board members played a role in shaping CHI’s policies and culture?

Kevin E. Lofton, FACHE, CEO: Going back to the founding of CHI in 1996, we’ve always had a large number of nurses and women religious on our board, from deans of nursing schools to midwives to nurse practitioners. The role that they have played has been not just from the clinical side. They also have brought the perspective of what we were all about as an organization.

To be specific, the role nurse board members have played around our focus and improvement on quality of patient safety initiatives across CHI has been paramount. In the earlier days of CHI, we put major focus on quality at the local governance level. We have really progressed and worked on developing our quality initiatives from a system perspective. Our board’s Quality and Safety Committee, which is chaired by a nurse who is on our board and also includes two other nurses, has direct involvement in overseeing that for the whole organization. On the safety side, input from nurses was instrumental in putting in a program we call Safety First, which focuses on everything from fall initiatives to hospital-acquired conditions.

Nurses have helped in global governance to make sure that we’re putting metrics and measures in place from the national board that would fall accountable to the local boards.

From a CNO perspective, does having nurse board members make a difference to nursing leadership and decision making at CHI?

Kathleen D. Sanford, FACHE, CENP, DBA, RN, Senior Vice President and CNO: Yes. CHI has an overall belief that nurses need to be in all high-level leadership positions, including the board and on committees. They’re subtly educating people. They are business-oriented, they understand strategy and health care regulations, which most board members don’t have, as well as what’s going on at the bedside. Nurses are so well informed about what it takes to change the culture or move the organization in a different direction. They’re careful to jump in about holding nursing—not just medicine—accountable for quality and safety. They’re very non-silo people. They understand the continuum of health care probably better than anybody on the board. 

How has being on boards benefitted your professional growth and ability to effect change to policies and practices?

Antoinette (Toni) Hardi-Waller, MJ, BSN, RN, Vice Chair, Board of Stewardship; Chair, Quality and Safety Committee; and CEO, Strategic Health Transformations: Initially, the boards that I was a part of were geared to my profession. My background is in the post-acute, home care arena. To broaden my expertise and experience in the field, I became very active in our state association, the Illinois Home Care Council, and our national association, the National Association for Home Care. That expanded into governmental roles with the Illinois Department of Public Health and as an advisor for our home care division. A little later, I got active with the National Association for Health Services Executives, which is an organization of African-American health care leaders and people within the field.

The benefit was tremendous. I’ve learned so much from others who were in industry as well. I also got an opportunity to develop relationships with policymakers, with regulators, and to have some influence on that based not only on my background and my work but the relationships that I was able to develop. I saw an opportunity to really be able to have an impact in our industry, first and foremost, and be an advocate, especially for the communities and very high-risk, underserved population that my company served. In addition to that, there was opportunity to really look at policy around how that care was provided.

How do you encourage nurse leaders in your system to pursue board roles?

Kathleen D. Sanford: I try to do it on three different levels: community boards, professional organizations, and national boards. I talk to my own nurse executive council and ask them what they’re doing on boards in the community. As we move into the next era of health care, we need to do a better job of keeping the community healthy. One of the best ways to know what’s going on in your community, and knowing how the profession is going to have to change, is being involved on boards and organizations within the community.

I also do public speaking on this subject with the Northwest Organization of Nurse Executives (NWONE). I talk about how important it is to get onto boards, to bring our voice to boards, to be involved at whatever level you choose to be, whether it’s in your community or professional organization or a specific health care board.

What advice would you give to nurses interested in serving on a board?

Antoinette (Toni) Hardi-Waller: First and foremost, I think the key is being really clear about what your own passion is in your field, where your advocacy is, and what changes you’d like to see happen. You have to have that clarity to be able to identify where a board has similar values that align with yours.

The other is participating in committee work, which is key to getting a chance to learn more from the inside out about organizations that you might want to further commit to for governing board seats. Not only is it a good opportunity for you to learn more about the organization and its culture and values, it also positions you to increase your visibility within the organization for an opportunity on the board.

What advice would you give to other health care organizations interested in diversifying their boards with more nurses?

Kathleen D. Sanford: Boards are changing. It used to be that we’d say, “This is a slot for a banker. This is a slot for a lawyer.” Now there are more slots for people like nurses who are well rounded and can speak to more than one issue.

Kevin E. Lofton: It’s fairly common to have physicians on boards. But nurses have a different perspective, different experiences, different backgrounds and training and education. I’d recommend laying out a grid first to assess the types of competencies, capabilities and experiences that your existing board members have and then, more importantly, prospectively to look at the areas where you have voids that you would want to fill. I would say for sure that having nurses as one of the key competencies that we would want to have represented would be one of those areas. For our corporate board, I would be looking for people that have administrative and executive experiences in addition to the nursing experience.

At CHI, for example, the viewpoint of advanced nurse practitioners brings the perspective, ultimately, of the people we take care of to the table and helped us design a system of care and tracking mechanisms. As a result of that leadership, we now publish a book every six months that literally goes across every single hospital in our system. We’re improving in terms of providing the same information to other than acute-care hospitals. We’re able to do a lot more with benchmarking across the board in terms of knowing who’s at the top and who’s at the bottom and making resources available to those that need some help.

At our local boards, direct care experience would be more valuable because they’re the ones that are overseeing credentialing of medical staff and the direct delivery of care. Depending on the size and scope of the organization, there’s room for differentiating the type of nurse that you would be looking for to serve on your board.

At-A-Glance

• Children’s Hospital of Philadelphia (CHOP) - President and CEO
• Comcast Corporation member - Board of Directors
• Federal Reserve Bank of Philadelphia - member, Board of Directors
• Chamber of Commerce for Greater Philadelphia - member, Board of Directors
• Children’s Hospital Association – member, Board of Trustees
• Leonard Davis Institute of Health Economics at the University of Pennsylvania - member, Governing Board
• Children’s Hospitals’ Solutions for Patient Safety - member, Board of Directors
• Villanova University - B.S., Nursing
• University of Pennsylvania, M.S. - Organizational Dynamics
• Philadelphia College of Physicians - fellow

How did you navigate the journey of joining a corporate board?

In situations like these, you come to appreciate the value of networking. Companies often find board members through people who know someone already on the board or in management. I also think that boards first and foremost look for specific competencies and diversity. There are not many women CEOs, unfortunately, so that provides an opportunity for me to bring my many years of experience and a different perspective to the table.

When I look back, it took decades to get where I am today. Corporate boards typically want somebody who not only has CEO experience, but also has a high profile in their region or at the national level, and it takes a long time to build those skills and competencies, create a network and become known in the community or in one’s industry or area of expertise.

You serve on a number of boards. How do you balance board service with your own job responsibilities?

I have been clear that my day job (President and CEO at Children’s Hospital of Philadelphia) is my absolute priority. I limit my board service to a reasonable number of boards and a reasonable time commitment without a lot of travel because I want to give my full time and attention to my primary job. When I do turn down positions for other boards I try to help them find another capable person, often another capable woman.

I serve on the Federal Reserve Board of Philadelphia. Our meetings are within a mile or so of my office, and are limited to a few hours on a particular day. To serve on the Comcast board here in Philadelphia and the Children's Hospital Association board in Washington, DC, as well as my other nonprofit boards, is similarly convenient.

How does your board service inform your work and vice versa?

The variety of boards I serve on has been helpful to my understanding of the governance process. Many times, in our own board meetings, I will call upon and recount insights from my board service to inform how we approach specific issues. This shows the CHOP board that I understand the governance process at other organizations of different sizes and scopes and can apply this learning to CHOP.

At Comcast, a global company, my fellow board members are incredible strategists. The Comcast board’s approach to strategy and understanding of how to operate in different countries is really helpful for me because CHOP serves patients from around the world. The level of competency of their management team has deepened my understanding of the types of skills I might want to look for when I hire people and of ways to approach challenges at CHOP, such as managing risk and cyber security. For me to have this window into a Fortune 50 company with worldwide reach is obviously a valuable learning experience.

There are many reasons to join a board, and learning is just one of them. The most important thing about joining a board is the value that you bring to the company and to the shareholders. Whenever I'm in the board room, I always understand that my job is to think about the shareholders and other stakeholders, and to represent them both. I think what's most important is to understand the value you're bringing to the table.

What have you learned on the Comcast board that has made you a better CEO?

Understanding what is involved in running a publicly-held corporation is helpful for me as I think about different partnerships that we might develop with various industries to commercialize CHOP IP (intellectual property). Awareness of corporate governance and how corporations and publicly traded companies operate is helpful.

Where do you feel you've had the most influence as a member of the Comcast board?

Healthcare is a major expense for every company. As the CEO of a large healthcare organization, I certainly bring the perspective of where healthcare is moving in the future and how employers and providers can improve patient outcomes and reduce costs. That's an important perspective to bring to the board.

With my operating experience and experience as a CEO, I also know what it's like to run an organization and to make big strategic and financial decisions. And I certainly have the perspective of being a woman, so I bring some diversity of thought and experience. I sit on the audit committee and the governance committee and am engaged in both of those activities in my own organization and on other boards. I can certainly reflect on and bring perspective to some of the top issues boards deal with, such as succession planning, cyber security and enterprise risk, based on my own experience.  

How do you approach risk oversight as a board member?

The Enterprise Risk Management (ERM) plan is the first thing to ask for when joining a corporate board because it is always important as a board member to understand any risks that the organization faces, how management is responding and what your role is as a board member. Most organizations have an ERM plan that assesses the top risks to that organization and includes the risk plan and mitigants developed for each to manage that risk, or to prevent that risk from occurring. The ERM is how management and the board come together to look ahead at risks associated with running the company.

This is an important area where I think shareholders want to know that somebody is in the boardroom thinking about potential organizational risk. It's a good way to know how the organization is reflecting on its industry and the factors that might impact it. For example, there are the regulations in virtually every industry that can impact organizations, and often those are cited as risks in the ERM plan. In our own enterprise risk plan at CHOP, we are always looking at what new regulations might impact our hospital.

What guidance would you offer to nurses who feel ready to serve on corporate boards?

The most important thing you can do if you want to serve on a corporate board is to enhance your own leadership capabilities and scope of experience. Develop your skill sets to manage people, manage operations, make big decisions and especially have financial acumen, because when you're on a board you have to understand the finances of a company. Being able to operate at the executive level is probably the most important consideration for joining a corporate board, especially a Fortune 500 board.

Some people advise serving on a nonprofit board. I think that's helpful in that you certainly develop an understanding of the governance process. However, I don't think you always get points for the number of nonprofit boards you sit on if you want to serve on a corporate board. I would certainly say that nonprofit board experience has been extremely important to me, but those skills aren't 100 percent transferrable to a corporate board.

How would you recommend people develop skills relevant to serving on a corporate board?

I think, in general, that advancing your career into the C-suite (CEO, CFO, COO) is really important. I also recommend that you pursue some kind of a continuing education. Women Corporate Directors offers continuing education. Also, many universities offer courses and conferences on corporate governance. I participated in a program called Women on Board in Philadelphia before I was approached by Comcast. I also took a three-day course at Stanford University, the Directors’ Consortium, that was incredibly helpful to me.

It’s really important to seek out opportunities to understand what board service means so that if you are approached — and oftentimes you're going to be approached unexpectedly, as I was —  you understand what it means to serve on a corporate board and what you would be expected to do. If you do your homework, you can give an answer in that moment versus saying, “Let me go back and do my homework.” I think the key is that you never really know when a conversation will lead to an opportunity, so be prepared in advance.

What are some capabilities and attributes beyond those related to healthcare that nurses bring to the business world?

The versatility of what nurses have to do in the course of a day builds character and the ability to function at a very high level. Nurses develop the ability to routinely assess crisis situations, take in a variety of different data points as team members, decide when to call in somebody with a different skill set and accomplish tasks within time constraints. These abilities align well with being a capable executive and board member.

Being empathetic to our patients and families is also a really strong skill for nurses. For board service, this translates to being empathetic to customers, shareholders and other stakeholders, and being able to put yourself in their shoes.

What advice would you offer to other nurses about the value of board service?

I think that board service is a really good way to build your skill set and your network, which is important to your organization and your own professional development. I also think it's a really good way to give back the skills that you already have. For many nurses like me who've ‘grown up’ in hospitals and health systems in the nonprofit world, it's a way to show your value outside of where you've spent your career. For me, this reinforced that nursing is a really versatile career that allows you to build on everything you learned at the bedside.