Kentucky’s nurses want effective leadership from their governing board
The Kentucky Nurses Association needs to answer members questions, two advocates say. (Getty Images)
Across Kentucky, a troubling pattern is emerging. Whether in healthcare, education, or non-profit organizations, board decisions are increasingly being questioned — not simply because difficult decisions are being made, but because stakeholders are asking how those decisions are being made.
Recent events involving boards governing Fayette County Public Schools, the University of Kentucky, and the Kentucky Hospital Association, demonstrate a broader trend: the public is demanding greater transparency, stronger governance, and meaningful accountability from those entrusted with leadership.
However, one major nonprofit board remains largely silent about a decision impacting more than 93,000 Kentucky nurses. Six months after the departure of Delanor Manson — a nationally acclaimed nurse executive who served as the organization’s CEO — the Kentucky Nurses Association (KNA) Board of Directors have failed to provide a transparent, public accounting of the departure decision. This prolonged silence fuels uncertainty and erodes confidence in leadership.
Nurses are taught that silence is not a virtue when patient safety is at stake. The landmark Silence Kills research reinforced a core professional value: speaking up is an ethical responsibility. That same principle should extend beyond the bedside and into the boardroom. Board leaders cannot expect transparency from frontline nurses while exempting themselves from the same accountability. Six months of limited communication regarding significant leadership decisions does not strengthen confidence in governance — it weakens it.
While each situation is unique, there are common issues facing board governance in Kentucky that are strikingly similar to KNA board leadership, including:
- Oversight vs. overreach: Boards must govern strictly at the policy level rather than micromanaging daily operations.
- Transparent communication: Stakeholders expect leadership choices to be explained openly while balancing essential legal boundaries.
- Due process: Abrupt executive departures spark valid concerns about whether established evaluation and disciplinary policies were followed.
- Fiduciary duty: Directors owe a legal duty of care, loyalty, and obedience to keep decisions aligned with the core mission.
- Absolute independence: Boards must resist external pressures from political figures, lobbyists, or donors, protecting objective deliberation from outside agendas.
Nurse leaders are increasingly asking the question whether boards are receiving sufficient education and mentoring. Individuals often join boards because they are respected leaders in their professions, but expertise in medicine, nursing, education, business, or law does not automatically translate into expertise in board governance. The success of an organization depends on board leaders who embrace mentorship and recognize the value of the wisdom from previous leaders. Their historical perspective, institutional knowledge, and lived experience provide invaluable insights that inform sound decision-making, strengthen governance, and support the organization’s long-term success.
The larger concern is not simply the performance of Kentucky’s nonprofit boards. It is the growing expectation that boards uphold their fiduciary responsibilities with unwavering fidelity to the missions they serve – and the public’s diminishing tolerance when they do not.
Non-profit and member-based organizations, such as the Kentucky Nurses Association, perform vital work that strengthens our communities. Their success depends on boards that embrace transparency, respect due process, and recognize that their ultimate responsibility is not to themselves, but to the mission and the members they have been entrusted to serve.
Equally important is the independence of board decision-making. Directors have a fiduciary obligation to exercise independent judgment that places the organization’s mission and the interests of its members above external pressures. Whether those pressures come from special interest groups, political leaders, lobbyists, influential donors, business partners, or other outside stakeholders, board members must remain steadfast in their duty of loyalty to the organization they were elected or appointed to serve.
Decisions influenced by outside agendas rather than objective deliberation undermine public confidence, create the appearance of conflicts of interest, and erode the trust that is essential to effective governance. Trust is built through transparency. And transparency begins with boards that understand accountability is not something to be feared—it is the very essence of good governance and strong organizations.
Kentucky nurses who are members of professional nursing organizations have every right to expect that board decisions are made with integrity and based on facts, sound judgment, ethical principles, and the organization’s governing documents including member approved policies, procedures, and bylaws — not on political influence or the preferences of those with the loudest voices or greatest access.
The time for silence has passed. Trust is restored not by silence, but by truth, accountability, and transparency. Adopt strategies such as our Safeguarding Association Fiduciary Excellence (SAFE) efforts and attend board meetings and demand the answers all stakeholders deserve.