Editor's
Note
A place
at the table
RN
leaders are needed in key positions to ensure nursing's voice
is heard
Carol Bradley, MSN,
RN, California Editor
March
26 , 2001
Given
the challenges we face in the nursing profession, our leaders’
strength and presence are critical in ensuring that nursing
has a voice and influence in the health care delivery system.
Far too often, nursing is overlooked. When others step in
to speak on our behalf, they sometimes do more damage than
good.
A simple
example: For the second year in a row, the California Health
Care Symposium will convene in May in San Francisco.
Despite support from the state’s key nursing organizations,
not one nurse is featured on their agenda.
This
year, I was pleased to note that at least they have figured
out there is a workforce crisis in nursing. Ironically,
the speaker chosen to address the topic is not a nurse.
Although he has been generous with his opinion on the subject,
he has not been creating and implementing the solutions
as many of our nursing leaders have. Despite some polite
feedback, the organizers of this meeting apparently don’t
appreciate the value of nursing’s voice in the dialogue
about our health care delivery system.
It is
critical that the California nursing community set an agenda
to place nurses of influence on the boards and in the meetings
where the future of health care is discussed. The importance
of nursing’s presence at the tables of influence is best
demonstrated by looking at what happens when strong nursing
leadership leaves or is diminished in an organization. We
have all seen it and heard nurses describe it. You know
the old saying about missing it when it’s gone.
There
has been some progress worthy of note, however. A nursing
leader now sits as a voting member on the governing board
of the California Healthcare Association. A nurse serves
as chairwoman of the California Wellness Foundation. I know
of several nurses of influence who sit on or even lead governing
boards of health care systems. But, in most cases, nursing
is absent or there only by invitation.
Need
more evidence? Just look at the large health care systems
in California; you will rarely find a nurse in the upper
echelons of these organizations. In contrast, it is almost
a guarantee that there are executives dedicated to finance,
information systems and human resources. No wonder the agenda
for health care in California has been so focused on everything
but patient care in the ’90s.
We can
be confident that some leaders are becoming enlightened,
thanks in large part to the growing shortage of nurses.
However, it is important that nursing’s voice finds its
way to the other sectors of the health care industry, too.
These groups (physicians, payers, vendors) have a vested
interest in the effectiveness and viability of our health
care system. Whether they know it or not, they should care
about the state of nursing in California.
It’s
not that it would be nice to be at the table; it is increasingly
imperative that we are there. Nurses of influence know that
our message will be heard best if it is voiced at the table,
not from the sidelines or on a picket line.
Ironically,
each of us can strengthen the power of nursing’s voice by
supporting our leaders and insisting that our organizations
put nursing at the appropriate point of influence. Imagine
the impact if new graduates insisted on examining the organizational
chart before they chose their employer.
Knowing
that we cannot all be at the table, let’s make sure our
best and brightest are there for us, and that they have
every ounce of support we can muster for them. Believe me,
when the voice of nursing is not there, we miss it!
