Foundation

Marla E. Salmon, ScD, RN, FAAN

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This profile is funded in part by the Rita and Alex Hillman Family Foundation

  AT-A-GLANCE

University of WashingtonProfessor of Nursing and Global Health  

World Health OrganizationPast Chair, Global Advisor Group for Nursing and Midwifery

U.S. Department of Health and Human ServicesPast Director, Division of Nursing

University of Washington and Emory UniversityEmeritus Dean

Robert Wood Johnson FoundationTrustee & Trustee Emeritus

Grifols, S,A,  – Director

Grifols, Inc. – Director

IESAbroad, Inc.Director

National Center for Healthcare LeadershipBoard Member

Sigma Theta Tau, InternationalBoard Member

American Academy of NursingBoard Member

Fulbright Scholar

Hubert H. Humphrey Institute Leadership Fellow

WK Kellogg National Leadership Fellow

Institute of Medicine Elected Member

Institute of Medicine/American Academy of Nursing/American Nurses’ Foundation Distinguished Nurse Scholar-in-Residence; IOM Distinguished Nurse Scholar-in-Residence Emeritus


What has been the most meaningful aspect of your extensive leadership and board experiences?
The best part for me is being able to shape an organization’s vision and overall strategic approach in ways that shape destiny of that organization and its future. I love helping organizations and enterprises make a positive difference in people’s lives.  

What lessons have you learned from your board experiences that might help others prepare for board leadership roles?
My first board involvement was as the student trustee at the University of Portland when I was an undergraduate, then in a more professional capacity with a non-profit home healthcare organization when I was in my mid-30s. Because neither I nor the organization was sophisticated about governance, I ended up focusing on operational-level issues. While this was helpful to the organization, it did not advance the overall governance of the organization.  I was in the weeds of operations, rather than operating at the strategic overall organizational level.  My understanding of governance grew through a number of subsequent experiences, mentorship, and my own interest in learning more.  Among the most important learnings have been having the privilege of learning from both the example and advice of the many seasoned, outstanding board Chairs, members, and staff I’ve come to know.  I have come to understand that one of the most useful things one can do is consult with seasoned colleagues for insights and suggestions about how to strengthen one’s own board performance and possible strategies for continuing development.

Over the past 20 years, my engagement with governance has focused not only on my own development, but also on fostering the engagement of other women and nurses in leadership and governance. Serving on the Robert Wood Johnson Foundation board gave me an exceptional platform for my cultivating these interests, including have served as Chair of the Nominating and Governance Committee for a number of years.  I have also gained a great deal through learning experiences like those offered through the National Association of Corporate Directors on the foundations of governance.   

What I’ve learned from leadership and governance opportunities I’ve considered is that there is a lot of work to do before you join a board. If you are invited to serve on a board, due diligence is the single most important first step you can take. Know what you’re getting into, where the vulnerabilities and risks are, whether you respect the company and its leadership, and what the board’s role and responsibilities are to protect society, its employees, the organization and the people it affects.   It’s also very important to check out the culture and values of the enterprise (both formal and informal)

If you are invited to join a board, assess why you want to be on that board. If you don’t have a passion for the work or the company, you should consider declining because there is a good chance you will be of little service or feel good about your contributions. Just getting on a board to say you’re on a board is unethical from my perspective. It’s not just something to put on your resume or another check on the checklist of leadership “must do’s”. You accept weighty serious legal, ethical, organizational, and societal responsibilities in these roles. You are entrusted to help make sure that the organization is doing what it’s supposed to do in both the near and longer term.

I think that there are a few “test” questions to answer when joining a board: 1) Is it an enterprise I respect, value, and believe in? and, How is it doing – and what are the strengths and risks? 2) What value will I add? 3) What do I need to/want to learn that will position me to be effective? 4) Can I commit to the time that is actually needed to do the work? 5) What are the risks and benefits to the enterprise – and to me?

Is liability coverage important in both the non-profit and for-profit world?
Answering this question first requires that you understand what your responsibilities and risks are as a board member.  Clarifying this at the onset is crucial.  Boards can have varying responsibilities – for example, some boards are actually advisory rather than actual governing boards.  (This is most often the case in governmental leadership bodies.)

It is also crucial to know what sorts of coverage is provided by the organization – it is important that all organizations carry appropriate liability insurance not only for board members but for other senior officers.  The board itself should ensure that this is in place, both to protect members and the organization.  In many ways, liability coverage provides a supportive environment for board members to act responsibly – and not back away from difficult issues. 

As far as one’s own liability coverage, this can vary depending on both your confidence in the coverage of the organization, as well as your own individual liability coverage.  Discussion with an expert is always useful, as well as consultation with the Secretary of the Board or Chair person.


How is serving on the board of Grifols, S.A., a for-profit global healthcare company, different from your prior board and leadership roles at non-profit and governmental organizations?
I am very fortunate to be associated with a company whose values and practices align closely with what I value and believe in.  Knowing that an enterprise has a strong sense of social responsibility, solid ethical standards, and outstanding business practices provides a strong foundation for board service regardless of corporate status.

I’ve found that there are important commonalities shared by both for- and non-profit corporations.  These relate to the overall responsibilities that boards have for ensuring the present and the future good of the organization, and should focus on vision, strategy, organizational performance, financial “health”, good leadership and management, staff wellbeing and support, and appropriate community engagement.

The differences between for-profit and nonprofit boards start with organizations’ missions.  Non-profits have social missions as their reasons for being.  For-profit companies vary in the focus of their missions, but have the interests of and accountability to their shareholders primary foci.  As such, non-profit boards may be far more focused on social impact, than on financial performance.  For-profit boards have a very strong focus on financial performance, as well as other non-financial areas of concern.

Understanding these key differences are important in general and with respect to the choices that one makes in board service.  In my experience, the social mission of non-profits can sometimes overshadow financial performance considerations to the point of threatening the impact and survival of the organization.  Of equal concern, however, is when for-profit companies do not attend to their social responsibilities.   Having board members with experience in both sectors – and an interest sharing lessons across each – can be a real asset to corporations in either sector. 


What was the path to your current position on the Grifols, S.A. board?
My path has not proceeded in a step-wise fashion. Several factors converged in my development as a nurse that engaged me in governance and leadership across sectors, including: 

Understanding how organizations advance social good.  My early career acquainted me with the power of policy, systems, and institutions in social change. Organizations (regardless of corporate status) can foster or stifle the contributions of individuals, groups, communities and even nations. I came to believe that having organizations that are ethical, perform well, and do good requires leadership at all levels – including the too-often invisible governance level.   

Having expertise and experience does help.  One of the best pieces of advice I ever got with respect to board service was that I really needed to be clear on what I knew and could do that would benefit the company. Any nurse interested in board service needs to be able to identify specific ways in which she or he can add value to the enterprise at a board level This means both industry-relevant knowledge, as well as competence as a board member. My experiences in various leadership roles and on non-profit boards were very helpful, as was my experience in the health sector. However, each organization is different and has different needs – so, being a good match for a board is also about fit in very specific ways. Learning that who you know and how you relate to them matters.  The most important opportunities that have come my way have happened because others helped to make them possible. There is no question that board appointments often reflect “who you know.” 

Having others willing to put you forward for opportunities is often a reflection of two things: 1) what they know about you; and, 2) your own capacity for seeing opportunities that may go beyond your daily scope of activities. 
You have to be a statesperson without a country.  This one may be somewhat controversial. However, I believe that at a board level, it is crucial that members park narrow agendas and disciplinary advocacy at the board room door. While we can each bring experience, perspectives, and resources associated with our disciplines, being the “one horse rodeo” isn’t going to serve the interests of anyone involved. My own board service has evolved in ways that reflect these factors all working together over time – and never in a particularly organized or step-wise fashion. I think that an important part of all of this has been my ongoing belief that good governance in all sectors is crucial to social progress, regardless of where it takes place. And, good governance requires board members who are both committed and capable.


How is your nursing background of value on a corporate board?
I have had amazing opportunities afforded me by nursing – many of which directly contribute to the value that I offer as a board member.  Nursing has given me a wonderful vantage point for understanding the health sector from the vantage point of patients and families, health services institutions and systems, government – in both the US and abroad.   Nursing has also given me leadership and administrative opportunities in which I’ve gained knowledge and experience.  And, the values of that I hold relating to social justice, equity, and caring have been informed and reinforced by my roles and experiences in nursing.  How truly fortunate I’ve been to have this background. In my board service, I’ve found that being a nurse alone is not enough (just as being any other discipline is not enough).   Being good at governance takes knowledge and skills that are both related to governing in general – and to the specific enterprise and industry.  I’ve found that nursing provides a strong foundation upon which to build – but I am also very grateful for additional education and experiences I’ve received beyond our professional boundaries. I think it’s fair to say that the opportunities I have had to make a difference throughout my career have often occurred because I view nursing as my way of making a difference in the broader world. In many ways, this has allowed me to help others understand that nursing is a valuable tool kit that enables me and others like me to make the world a better place. 
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