| Course | NUR 651 Advanced Concepts for Nurse Executive Leaders |
|---|---|
| Module | Module 1 |
| Paper type | discussion post on nursing influence in hospital governance |
| Length | About 380 words, 3 pages |
| Format | APA 7 student paper |
| School | Southern New Hampshire University |
| Program | MSN |
| Updated | September 2026 |
Free sample paper for NUR 651 Module 1
Module One Discussion
Nursing Came Up Once, and It Was a Medication Error
Three weeks into my role as chief nursing officer, I attended my first board meeting. The agenda ran nearly three hours: capital projects, a physician group acquisition, bond ratings. Nursing appeared once, when a trustee asked about a medication error in the quarterly incident report. I answered the question, but I left thinking that the board's only picture of our 3,900 nurses was a list of things that had gone wrong.
A decade-defining study of where the profession should go recommended that nurses be prepared to lead change and that health care decision makers include nurse leaders on their boards, arguing that nurses bring knowledge of care delivery that governing bodies otherwise lack (Institute of Medicine, 2011). Our system has no nurse among its trustees. Even without a vote, though, the chief nursing officer shapes what the board sees.
Why does what the board sees matter? Jha and Epstein (2010) surveyed chairs of hospital boards and found that fewer than half rated clinical quality as one of their top two priorities, and that boards at high-performing hospitals were more likely to put quality on every agenda, use a quality dashboard and link executive evaluation to quality. Boards attend to what executives bring them. If I bring only incidents, trustees will see nursing as a source of risk.
The evidence for nursing as an asset is strong. Aiken et al. (2012) surveyed tens of thousands of nurses and patients in the United States and twelve European countries and found that hospitals with better work environments and better staffing had nurses who rated quality and safety more highly and patients who were more satisfied and more likely to recommend the hospital. These are the outcomes trustees care about, and they depend on decisions the board makes about budgets and priorities. My plan is to bring a short workforce and quality report to every meeting, with our own work environment scores next to our patient outcomes, so the board sees the connection.
I expect resistance to adding time to a full agenda, so I will start with ten minutes and one page. My question for peers: what is the single measure or story that has most changed how your leaders or board think about nursing?
References
Aiken, L. H., Sermeus, W., Van den Heede, K., Sloane, D. M., Busse, R., McKee, M., Bruyneel, L., Rafferty, A. M., Griffiths, P., Moreno-Casbas, M. T., Tishelman, C., Scott, A., Brzostek, T., Kinnunen, J., Schwendimann, R., Heinen, M., Zikos, D., Sjetne, I. S., Smith, H. L., & Kutney-Lee, A. (2012). Patient safety, satisfaction, and quality of hospital care: Cross sectional surveys of nurses and patients in 12 countries in Europe and the United States. BMJ, 344, Article e1717. https://doi.org/10.1136/bmj.e1717
Institute of Medicine. (2011). The future of nursing: Leading change, advancing health. The National Academies Press. https://doi.org/10.17226/12956
Jha, A., & Epstein, A. (2010). Hospital governance and the quality of care. Health Affairs, 29(1), 182-187. https://doi.org/10.1377/hlthaff.2009.0297
What the NUR 651 Module 1 instructions ask for
The first NUR 651 discussion commonly asks how nurse executives exercise influence at the highest levels of an organization, sometimes focusing on boards, sometimes on the executive team or on policy. Expect to describe a real or realistic situation, connect it to evidence about governance or nursing's contribution to outcomes and propose what you would do. Opening posts are usually a few hundred words, supported by two or three scholarly sources in APA 7, with replies later in the week. Show the gap between how leaders currently see nursing and what the evidence shows, and propose a specific, modest step that would change the conversation at the table where decisions are made.
How this NUR 651 Module 1 discussion example is built
This post comes from a composite system's new chief nursing officer whose first board meeting mentioned nursing only once, in connection with a medication error. It draws on the Institute of Medicine recommendation that nurses serve on boards, the Jha and Epstein survey showing that boards focused on quality oversee better-performing hospitals and the Aiken multinational study linking work environments and staffing to safety ratings and patient satisfaction. The writer plans a ten-minute, one-page workforce and quality report at every meeting, placing work environment scores next to patient outcomes, and asks peers which measure most changed how their leaders saw nursing. It anticipates the objection that board agendas are already full.
Where the NUR 651 Module 1 rubric puts the points
Discussion grading in NUR 651 generally considers the depth of analysis, application to executive practice, the strength of evidence, writing quality and engagement with peers. The strongest posts connect a specific leadership moment to research about governance or outcomes and propose an action that fits the executive role rather than the unit level. Graders reward posts that use large studies rather than opinion and that anticipate how busy leaders or trustees will respond. A modest, concrete plan, such as a short standing report, reads as more credible than a broad call for nursing to have more voice. Questions that invite peers to share evidence from their own systems support strong replies.
NUR 651 Module 1 help: the mistakes that cost points
Executive discussion posts lose points when they stay at the unit level, when the example is generic, when evidence is limited to professional opinion or when the proposed action is a broad call for recognition. Another gap is ignoring how trustees or executives actually spend their time. Describe a specific moment, cite evidence from large studies and governance research, propose a concrete step suited to the executive role and anticipate resistance. For a prompt about executive team dynamics, policy advocacy or system integration instead, send it with your organization's context and the NUR 651 post will be shaped to that question. Start small so the board says yes.
Get NUR 651 Module 1 written to your instructions
Send the NUR 651 discussion prompt, your organization's context and the rubric. Your post will connect a specific executive moment to governance and workforce evidence and propose a concrete step suited to the board table, within 24 to 48 hours, free the first time. The paper above is an original model document written by our desk, not a submitted student paper and not an official Southern New Hampshire University document.
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NUR 651 Module 1 questions, answered
Where can I find a free NUR 651 Module 1 Discussion sample?
This page carries the full post: a chief nursing officer's first board meeting, evidence on boards and quality and bringing workforce data to trustees.
Did the Institute of Medicine recommend nurses on boards?
Yes. Its 2011 future of nursing report recommended including nurse leaders on boards and preparing nurses to lead change.
Do hospital boards affect quality?
Jha and Epstein found that boards at high-performing hospitals more often put quality on every agenda, used dashboards and tied executive evaluation to quality.
What evidence links nurse work environments to outcomes?
Aiken and colleagues found that better work environments and staffing were associated with higher safety ratings and greater patient satisfaction.
How can a nurse executive change what the board sees?
Bring a short, regular report that places nursing workforce measures next to patient outcomes, so trustees see nursing as an asset.