1. Disch, Joanne PhD, RN, FAAN

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From early in my career, I recall two leadership adages being frequently, and somewhat paradoxically, cited: "Information is power" and "It's not what you know, but who you know, that counts." Through my own experiences, I now know that these adages are inadequate. Instead, "Information may be power, but relationships are the key," and "It's not who you know, but who knows you that matters." In this column, I'll reflect on two leadership experiences I've held and some insights about becoming a board member, and eventually serving as chair or president, of several major organizations. These lessons can apply to nurses interested in serving on boards of any nature.


The two organizations vary greatly in size, mission, and individuals served, yet both relate to health care and consumers of care. AARP, formerly known as the American Association of Retired Persons, has almost 38 million members; is based in Washington, DC; and has as its mission to "help people turn their goals and dreams into real possibilities, strengthen communities, and fight for the issues that matter most to families." Although membership targets individuals 50+ years old, AARP helps others such as extended family members and caregivers of all ages. Aurora Health Care is the largest hospital system and private employer in Wisconsin, with 15 hospitals, 150 clinics, and 32,000 caregivers. Based in Milwaukee, Wisconsin, but with a large footprint in eastern Wisconsin, their mission is, "We help people live well."


As different as these two organizations are, the responsibilities of board members are similar, namely, develop and review the strategic direction of the organization, serve as financial stewards, and act faithfully in the best interests of the organization. Obviously, the scope and complexity of the work differ greatly. I've described elsewhere the path I took in getting on the AARP board and my view of the behaviors of effective board members (Disch, 2007). In comparing my journeys in getting onto both of these boards, however, I've found some important similarities that underscore the foundational importance of networks and relationships-and sometimes those that began decades ago. Again, those are lessons that can be used by any committed nursing leader.


First, with AARP, a colleague suggested that I apply for an open seat on the board. Reading the materials and talking with individuals who were familiar with AARP, I felt that my nursing background had prepared me well for a board seat so I initiated the process. With Aurora, a physician on the senior leadership team observed that Aurora should have a nurse on the board. In neither case, did I know anyone directly connected with the process, but in both situations, extensive vetting was done about my background, experiences, leadership style, and manner. With AARP, community leaders with whom I had worked on different projects in Minnesota gave a positive report. With Aurora, two nursing colleagues from years earlier did the same when the CEO inquired as to who might be a strong nursing leader to invite on the board. In both situations, collegial relationships that I had established years before were recalled and used to support my consideration.


Second, my background in nursing and diverse experiences in health care equipped me with an exceptional foundation in understanding health care-and a national network of friends and colleagues to call on for help or advice. The basic strength that most nurses possess is what I call "the nursing lens," or a viewpoint from which someone sees things holistically in the context of the individual, family, or community. Because of this viewpoint, nurses are able to effectively and quickly establish relationships, size situations up, create pragmatic solutions, and secure needed resources. This is an obvious asset when thinking about a health system board, but it was also relevant when dealing with issues on the AARP board. Nurses understand how systems operate and can propose solutions that will work. In a related way, my skills at organizing committee work, running a meeting, reading nonverbal cues from board members, pursuing consensus, and reconciling differing points of view were recognized as being essential. This contributed greatly to my being eventually asked to be the chair of the board for both organizations.


A third area that took some practice for me was in learning to speak articulately, in a focused way, to the issue at hand. I learned from wise mentors such as Claire Fagin (former Dean of the University of Pennsylvania School of Nursing and interim President of the University) who admonished me to not phrase everything in terms of what's best for nursing, but what works for the organization (which was often what highlighted nursing's strengths anyway). I learned from Dr. Marguerite Kinney at the University of Alabama in Birmingham to ask for what you want but take what you can get. From other mentors and colleagues, I learned to not always be the first to speak up (actually, at times, to not speak up at all), to praise the work of others, to gain insights from individuals with whom I strongly disagreed, and to maintain a sense of balance and humor.


In conclusion, drawing on the relationships and networks developed over decades can come full circle to shape present opportunities. Furthermore, the knowledge, skills, and values that we nursing leaders have developed over our careers certainly enrich our own career paths-and they also offer much needed wisdom and pragmatic assistance to the boards of directors of organizations far beyond traditional nursing circles.




Disch J. (2007). Extending your influence: Serving on the AARP board. In Mason D. J., Leavitt J. K., & Chaffee M. W. (Eds.), Policy and politics in nursing and health care (5th ed. pp. 778-781). St. Louis, MO: Saunders Elsevier. [Context Link]