Founders and Emeritus Series: Where Are They Now? Marla J. Weston, PhD, RN, FAAN

Both Thomas Edison and Albert Einstein have been attributed with saying, “A vision without execution is just a hallucination.” Throughout my career, I have focused on filling the gap between vision and execution. I have clearly seen the myriad of possibilities that nursing offers the world and have stepped in to build long-lasting structures to bridge the gap between that vision and the current reality.

When the Future of Nursing Report (Institute of Medicine, 2010) acknowledged that nursing expertise was grossly underrepresented on advisory committees, commissions, and boards where healthcare-related policy decisions are made, the ambitious goal was set for 10,000 nurses to serve on boards by 2020.

However, there was no organized infrastructure to make this happen. The Nurses on Boards Coalition (NOBC) was created to answer this clarion call to leadership.

Early in the process, my colleague, Kim Harper, and I recognized that trusted leadership would be needed to navigate relationships and build the NOBC community. We volunteered to serve as the initial leaders.

From the onset, NOBC’s development and growth have been an exemplar for the vision, leadership, team building, strategic thinking, and executional expertise that nurses bring to board service. Of course, the original participating organizations struggled to create clarity of vision, build an operational infrastructure, fund the work, and establish a strong coalition; yet through collaborative commitment to the ultimate goal, NOBC was established and has endured.

From the outset of my career, I recognized that leadership is about preparing others to lead, succeeding you, and even surpassing your own accomplishments. So, in every leadership, advisory, or board position, including that of the NOBC, I think about how to help others succeed.

The seminal moment of recognizing that the strength of any organization lies in having a multitude of capable leaders in various roles occurred early in my career. I was at a party celebrating some significant accomplishment that I had led. When the host asked if the team would like to make any comments to the group, as I prepared to step forward, a nurse leader who managed the operations began to address the crowd. I smiled and settled back, so proud that she rose to the occasion.

This belief that leadership is about supporting others to lead informed my decision not to continue in the role after serving as the initial chair of NOBC. While most people assumed I would serve a second term, I didn’t want the NOBC to become too closely associated with my leadership or with me. I knew that transitioning to other, equally capable leaders would foster strong commitment among others to the Coalition and increase the likelihood of long-term stability and sustainability. In addition, I could serve as a member of the Coalition, providing ongoing support to new leadership and the NOBC mission.

Supporting organizational success and sustainability, and others’ leadership, is a cornerstone of board service in my mind. Because you are unencumbered by the day-to-day, as a board leader, you can see through the “noise” and thus bring a broader, more future-oriented perspective. The real value of board leadership is to partner with the staff to understand changes that need to happen today to prepare for the future.

As I near the end of my career, I remain focused on building nurse leadership. While some of it is one-on-one mentoring or speaking with nurses about the future, much of it is elevating nursing leadership within our hospitals and the health system as a whole. When I think of bringing the unique knowledge, wisdom, and expertise of nurse to the forefront to impact our health system and patient outcomes, I think first of professional governance. Professional governance is a cornerstone of our practice, yet it is often misunderstood or underutilized to bring forth nurses’ expertise in making practice and policy decisions that undergird the quality of care and outcomes we deliver. More than a decade ago, I began focusing on strengthening professional governance in health systems. Working with a research team comprised of practice and research experts, we analyzed existing professional governance structures and behaviors to identify strategies for strengthening professional governance in organizations. By measuring professional governance behaviors (https://nursingpg.com/vpgs), the team has gained a deep understanding of how to support and amplify nurses’ expertise and leadership to improve healthcare outcomes.

Another focus area where I am closing the gap between our vision for the impact of our profession and its reality is in nurse innovation. We have long recognized the intellect and innovation that nurses bring to our practice. Yet, all too often, nurse innovators and entrepreneurs struggle to receive funding to translate their ideas into reality. As a result, with my partner Beth Brooks, I launched Nurse Capital (nursecapital.net), a specialized venture fund, to fill this funding gap. In addition to providing capital, nurse investors support our entrepreneurial colleagues with mentoring, advice, and connections to support nurses as they bring their innovative ideas to market.

Many times, in my career, I was the only nurse at the table. It helped me recognize how underestimated nurses are as capable decision-makers, thoughtful strategists, and just plain, smart businesspeople. Whether it was serving on policy tables in Washington, DC, or as an advisory board member for a healthcare start-up, I have repeatedly seen how my nursing perspective notices something that others in the room miss; something that fundamentally shifts the entire focus. This perspective, this expertise, this knowledge is what NOBC is amplifying by encouraging and supporting nurses in their board service.

Marla J. Weston, PhD, RN, FAAN