From the Bedside to the Boardroom: Why Are Nurses Excluded from Healthcare Leadership?
Ali Fakher, BSN, RN,
UN Nurse & Global Health Innovator | ?? ANHI Lifetime Achievement Award 2025 | ?? NurseHack4Health Winner | Transforming Nursing Leadership & Innovation | Championing Systemic Change
Understanding the Hidden "Biomedical Bias" Limiting Nursing’s Potential
“You’re brilliant—but you’re still just a nurse.”
A colleague said this to me recently, sincerely believing it was a compliment. And maybe it was, in his eyes. But it was also a stark reminder of a hidden, uncomfortable truth that nurses around the world experience daily:
We are perceived as skilled caregivers, yet rarely acknowledged as strategic thinkers and decision-makers.
Pause for a moment and ask yourself:
The answer lies deeper than personal capability or merit—it’s structural.
It’s called the "Biomedical Bias."
?? The Invisible Bias Holding Nursing Back
Imagine a hospital’s executive boardroom: Around the table sit physicians, business executives, financial advisors, and policymakers—all making critical decisions about patient care, resource allocation, and system strategies.
Who’s missing? Nurses-the very professionals who spend the most time with patients and intimately understand healthcare delivery at every level.
The reason nurses are consistently excluded is deeply rooted in the Biomedical Bias—the assumption that healthcare leadership and expertise primarily belong to those with a purely medical, biological, and symptom-oriented perspective.
This bias creates a dangerous misconception:
In short, the healthcare system was built without nurses at the table, and the consequences are profound.
?? The Real-World Cost of Nursing’s Exclusion
Consider this:
This is not just unfair-it's inefficient and dangerous.
Real-Life Example: During the COVID-19 pandemic, nurse-driven interventions in infection control saved thousands of lives globally. Yet, nursing voices were often excluded from the very policy tables setting pandemic responses-resulting in resource mismanagement, burnout, and preventable crises.
Imagine how differently healthcare outcomes could look if nurses had a seat—and a voice—in decision-making rooms worldwide.
?? Why the Biomedical Lens Distorts Nursing
The biomedical model views health primarily through biology and pathology, separating diseases from the holistic context of people’s lives. It’s essential, but incomplete.
Nursing’s perspective is fundamentally different—and deeply necessary:
Yet, because our model doesn’t neatly align with traditional biomedical approaches, nursing is often sidelined as secondary or supplementary—an afterthought rather than a leading force.
This is what we call the hidden “Biomedical Game”—a system designed around medicine that inherently undervalues nursing’s expertise.
?? How We Move Nursing from the Margins to the Center
It's time for nursing to stop asking for permission and start taking its rightful place at the leadership table. Here’s how:
1?? Recognize Nursing as an Independent Health Science
2?? Mandate Nursing Representation at Every Level
3?? Break the Cultural Bias
4?? Standardize a Global Scope of Practice
? The Future Is Nursing—But Only If Nurses Claim It
Imagine healthcare systems built around nursing’s holistic, patient-centered expertise. Imagine the innovations possible if nurses led from positions of authority, with power to allocate resources, guide policy, and drive scientific advancements.
Imagine a healthcare future where nursing doesn’t just execute the vision—it defines it.
That future isn’t out of reach—it’s within our grasp. But it begins when nurses across the globe decide to no longer accept exclusion and step boldly into leadership roles.
We must rewrite our story—on our own terms.
Because nursing isn’t just about caregiving. It’s about leading care, transforming systems, and changing lives.
?? Your Voice Matters
Now it’s your turn:
What do you think holds nursing back from leadership roles? What changes would you advocate to shift this balance of power?
Drop your insights below. Together, let’s shape the future of healthcare—led by nursing.
Nursing Business Expert ? I help nurses create and grow their own peaceful, thriving, and fulfilling businesses.
1 天前With respect Ali Fakher, BSN, RN, - institutional sexism, racism, classism, and heterosexism are not mentioned in this article. From my perspective, these are 4 valid reasons nurses are not advanced into leadership roles. Selected for leadership roles. Offered training for leadership roles. While we can encourage nurses to be at these tables and insist C-suite leaders do their best to invite us - we must also ask “why is this still happening in our institutions?” and look beneath the obvious to the some of the deeper insitutionalized issues we may be afraid to face.
Creator of Yell’o? | Chief Nurse Executive at PereraHealth ~ Making healthcare organizations better places to work for all healthcare team members | Magnet #GutsyNurse | Speaker ????
2 天前Interesting post Ali Fakher, BSN, RN, I am a #nurse and #NurseLeader who has led executive roles for service lines that did not require an RN in the job description. Usually perioperative service lines that included procedural and surgical services. I am very successful in my roles due to the dual degree of a MBA and an MSN and my focus on interprofessional collaboration. In all these roles, a strong nurse leader advocated and supported the decision to hire me. On LinkedIn I am starting to see more nurses ascending to the ranks of hospital COO, CEO, President. I am rooting for them to succeed. We need these trailblazers as advocates and mentors to have more nurses be given the opportunity to show what a difference we can make! ??????
Nurse Leader, Researcher and Educator
2 天前More and more nurses are in key leadership roles including C-suite executive roles. Nursing students do take leadership courses at the undergraduate level. At the graduate level, most programs, including those in CRNA programs, take leadership courses. Some graduate nursing doctoral program are specifically focused on leadership development. While we still have seats to fill, more than 11,000 nurses serve on boards - more that are unaccounted for. The Nurses on Boards Coalition has actively promoted and placed nurses on boards since 2014. Plenty of scholarship, including my own, is dedicated to this topic. Healing Politics is dedicated to preparing nurses for publicly elected positions. We are making tremendous strides in healthcare leadership. And yes, we need to continue to be at all tables where healthcare is on the agenda. Most importantly right now, nurses need to be on the ‘go-to’ lists for media when healthcare issues are being reported on.
Content Writer|| Résumé Writer|| Aspire Leaders Program Alumni || Student Nurse || Public Health and AMR Enthusiast ||
2 天前This is so apt. Nurses to take it upon themselves to upload the nursing dignity and that's not going to be easy.
Educator | Advocate | Building Community & Driving Change
2 天前Nurses are held back by themselves at times … I agree that there are many other reasons but truly, we don’t recognize our worth or put time and effort into ourselves so we don’t believe we deserve to be at the top. When you think about rising up in the workforce, you think supervisor, manager, upper management but never CEO or president. Why? There are very few nurses in these roles, which in turn creates a fear in ourselves… If a nurse isn’t in that role than I guess that is not an area we can branch into. We all know this is wrong clearly but so many think this way. How I would shift this is by providing courses in school about management. We get very little provided yet we may step into a supervisor role within the first year due to staffing. Set people up for success and to show they are capable by providing the education