Types of Boards

Exploring the types of boards where a nurse may participate may feel overwhelming at first. There are several types, and the purpose of each — as well as members’ roles, responsibilities, and even their naming conventions — isn’t always consistent. What follows is an overview of the various kinds of boards.

First, though, let’s start with a pair of basics: A board is a body whose members are elected or appointed to oversee the activities of a nonprofit, corporate, or government entity. Boards of directors are required for corporations and nonprofits; other kinds of boards are formed in response to the need to shape or direct an organization as it grows and changes.

Second, let’s define governance. Governance is the establishment of policies and monitoring of their proper implementation by a board. These include the mechanisms required to balance the powers of the members and their primary duty to enhance the prosperity and viability of the organization.

In most cases, a board’s actions are governed by some outside authority — most often bylaws created by the organization itself — that controls its powers, duties, and responsibilities. Bylaws typically govern how many members can serve on the board, how they’re chosen, how often they meet, and other details.

For a nurse considering a directorship, boards fall into five different types:

1. Professional Nursing Organization

The nursing association to which a nurse belongs is likely to have local, state, regional, and national chapters, any one of which offer excellent opportunities for board service. Nurses considering board service who are not already members of their local chapter should consider joining, which affords the opportunity to volunteer for a committee assignment and — once the RN is more familiar with the organization and its mission — consider moving into a board position at the local level.

2. Advisory Boards

As its name implies, an advisory board provides advice — input and mentorship to the management of a corporation, organization, or foundation. Its members are “advisors,” not “directors”; the body itself may be called a “council.” While its informal nature gives this kind of board greater flexibility in structure and management than a traditional board of directors, it also lacks the authority to vote on corporate matters or bear legal fiduciary responsibilities. Think of an advisory board as a think-tank: Many new or small businesses create one in order to benefit from its advisors’ collective knowledge without the expense or formality of a traditional board of directors.

Start-ups, nonprofits, or organizations testing or seeking feedback on new initiatives often choose to create advisory boards, whose members are unpaid. Bringing direct experience with the public and an inherent ability to think creatively, an RN can provide a valuable perspective to an advisory board.

3. Nonprofit Boards

More complex, a nonprofit board serves a charitable organization — a 501(c)(3), approved as tax-exempt by the IRS — that is not (and cannot be) organized or operated for the benefit of private interests. Nonprofits can be member-serving, such as a trade union or industry associations, or community-serving, which focus on providing services to the local or global community. A “nonprofit” designation doesn’t mean the organization doesn’t intend to make a profit; rather, it means it has no owners, and that any money it makes will not be used to benefit them.

Nurses who serve on nonprofit boards are essentially making a commitment to a cause. Most are unpaid volunteers, and will often will be asked to make a financial donation in addition to serving on the board; practices vary with each nonprofit. A nurse’s seat on a nonprofit board should reflect his or her alignment with the cause, and they should be prepared to spend a portion of their time taking part in fundraising activities.

There are currently more than 22,000 nonprofits in Oregon, including a host of health-related causes. Nurses seeking to join a nonprofit board are likely to find many that qualify; RNs with particular interest in an aspect of health care need only do a little research. The Secretary of State’s website, sos.oregon.gov, is an excellent source for Oregon nonprofit data.

In general, service on a nonprofit or advisory board can be a powerful starting place for a nurse’s path to a private or corporate board directorship. Nurses with even a small amount of board service experience can excel on a nonprofit board, although personal alignment with the cause itself is crucial. In her book, Nurse on Board: Planning Your Path to the Boardroom, author Connie Curran explains: “The pathway to a corporate board role for nurses will likely progress from a nonprofit or advisory board to a startup and then to a corporate role. There are important lessons to be learned and experiences to be gained along the way.” Even as gaining experience on an advisory board can be a natural progression to joining a nonprofit board, there is no prescribed order or hierarchy as long as the nurse is closely aligned with the organization’s mission and vision.

4. Private Boards

While most boards are set up as public, some are created to be private. These include corporations and nonprofits of all sizes, from start-ups to family businesses to large, established organizations. For a privately held for-profit company, a board’s main function is to help grow the company.

Though they may lack a business background, nurses are perfectly qualified to be directors on private boards. A start-up company that’s come up with a new healthcare technology or health-related app, for example, would be well served to have an RN on its board. Besides experience, nurses bring a human perspective — from service to a diverse audience, clinical expertise, and organizational, and leadership expertise to such highly specialized companies. A director’s seat on a start-up board can be exciting…and occasionally intense.

No matter the size of the company, becoming a corporate board member is a powerful introduction to board service and should be undertaken with an understanding of the work it requires. While private corporate board members are often paid for their service, sometimes in stock options or shares of the company, board service may call for many hours of time and commitment.

4. Corporate Boards

To start with, let’s clear up a common misperception: that because a nurse hasn’t acted as a CEO or CFO, he or she lacks the necessary experience to serve on a for-profit board. That’s not true. The truth is that many, many nurses bring a unique and valuable perspective and can provide key benefits to a corporate board.

As Connie Curran states in Nurse on Board:

Nurses can position their backgrounds and experiences in other ways:

Many nurse executives manage budgets that may be equivalent of the budget of a small corporation. It is not unusual for a nurse manager to have responsibility for dozens of employees.

The financial and human resource skills needed to manage units, hospitals, and clinics are appropriate skills for board positions. Nurses who serve as deans and association executives have the financial, human resource, and customer service experience necessary for corporate boards.

Nurses have deep knowledge about something that is critically important to a business. Pediatric nurses, for example, know about baby formula and diapers. They have interacted with hundreds or even thousands of parents, and they have been privy to their perspectives. Diaper or formula companies could receive significant benefit from those insights.

A director’s position on a corporate board isn’t something to be taken lightly. But experienced RNs need never disqualify themselves from considering the job because of their own supposed lack of experience. Nurses often undersell themselves.

Serving on a corporate board typically requires a significant commitment of time. Nurse or not, a director must spend hours preparing for meetings, attending them, and preparing for and attending the many committee meetings that occur between regularly scheduled board meetings. Events, galas, dinners — a director has frequent opportunities to spend more time in support of the company.

Part of the benefit of this, of course, is that most companies compensate board members for their service; but directors are also expected to meet unexpectedly should a crisis arise, open their network to the company, and maintain full participation at all times. In addition, they have fiduciary responsibilities to the company’s shareholders, which carries the risk of liability, especially in organizations that don’t prioritize oversight. But the truth is that the right corporate board is a great place for a nursing professional to make a powerful impact with an organization, its leadership, and the customers and community it serves.

Whatever its purpose, nearly any board can be improved with the addition of a nurse to its membership.