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Creative Nurses Urged to Lead Change in Health Care by Thinking Like an Entrepreneur

Washam, Cynthia

doi: 10.1097/01.COT.0000406621.59295.72


For every nurse who's ever felt she could build a better medical device, there is opportunity. That was the message of nurses speaking at a panel on “Nurse Entrepreneurs: Turning Innovation into Sustainable Success,” held here at the most recent Oncology Nursing Society Advanced Practice Nursing Conference.

“We have to be entrepreneurs to be sustainable,” said Patricia Friend, PhD, APRN, AOCN, Assistant Professor of Nursing at Loyola University Chicago, who also pointed to the similar message in last year's Institute of Medicine Report, “The Future of Nursing: Leading Change, Advancing Health, which called for increased empowerment and responsibility for nurses (OT 10/25/10). “You still need the credentials and the degree, but that won't keep you in a position. It's about recognizing and exploiting your talents. Everybody needs to think innovatively and creatively.”

The soaring cost of health care has made change inevitable, and APNs are positioned to play a key role in making that change. Whether they work for a big hospital system or as a solo consultant is irrelevant, Dr. Friend explained. Any nurse can promote change by thinking like an entrepreneur.

MARY ANN MORGAN, PHD, ARPN, broke new ground at H

MARY ANN MORGAN, PHD, ARPN, broke new ground at H

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Entrepreneurs and Intrapreneurs

Those who work within an organization call themselves “intrapreneurs,” noted another panelist, Mary Ann Morgan, PhD, ARPN, who relayed her experience in that role at H. Lee Moffitt Cancer & Research Institute. Dr. Morgan broke new ground at the Tampa hospital two years ago when she created Moffitt's program for cancer survivors.

“There's no road map, nobody telling you how to do it — you just do it.”

Since its opening in 2009, Moffitt's survivors clinic has attracted patients both for its clinical services and educational and social and programs, including an annual survivors' day.

The qualities that brought that success are the same qualities essential to nurses who aspire to run their own businesses, added the session's coordinator, Susan Moore, RN, MSN, ANP, AOCN, an independent consultant. “You have to be confident in whatever it is you're selling — whether it's yourself or a product.”

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Communicating a Vision

Dr. Morgan said that once she had developed her idea for Moffitt's survivorship program, she had to persuade administration to accept it.

“We needed to come up with a vision and communicate what that vision of survivorship should be,” she said.

For nurses ready to strike out on their own as entrepreneurs, the rewards are infinite, Ms. Moore said. “There's a much higher level of satisfaction than when I worked for someone else. If you have even a little bit of a creative strategy, become your own boss. Take that ball and run with it.”

But, she warned, learn how to play ball first. She had the advantage, she noted, of having a background in accounting before getting into nursing. She recommended that aspiring entrepreneurs take at least one or two business classes at a community college before opening shop. Nurses looking for more comprehensive training could consider one of a small but growing number of master's degree programs in health care innovation.

For example, programs such as the ones at the University of Arizona and Drexel University in Philadelphia prepare health care workers to create new ideas and bring them to fruition. The Arizona program combines minimal required classroom time with online learning, while Drexel's offerings are entirely online.

PATRICIA FRIEND, PHD, APRN, AOCN: “We have to be entrepreneurs to be sustainable…

PATRICIA FRIEND, PHD, APRN, AOCN: “We have to be entrepreneurs to be sustainable…

“If you have the passion and willingness to face challenges to make change, we can supply you with the tools and techniques,” said Jack Gilbert, EdD, Director of the University of Arizona's Master of Healthcare Innovation Program.

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Test the Waters

Leaving a secure job to launch a business is a huge step, said Ms. Moore, who advises budding entrepreneurs to test the waters while still employed – for example, by starting a part-time business, or by volunteering within a nursing or other professional organization.

“Working to change public policy is a great way for a nurse entrepreneur to move forward and get recognition. ASCO has a very strong public-policy group.”

She related how she fell into self-employment almost by accident when a friend enlisted her help finding the best cancer treatment for his wife. Eventually, Ms. Moore left her job as a hospital oncology nurse practitioner and now advises oncology practices.

With her business background, she realized how much starting a new business would strain her finances – “You need six months of your own personal income in the bank — liquid assets,” she said.

She took no chances: Although she had the savings, she held off her venture until she turned 59, so she could draw on her 401K retirement account. It turned out she never had to. “I encourage people not to get a second mortgage or take an equity loan on their home,” she said.

An area where she sees many nurse entrepreneurs fail is in setting their fees. Here again, a course through the local community college or the Small Business Administration ( can help. “One of the biggest mistakes someone without business savvy makes is charging too little or having a poor system for keeping track of their hours.”

Ms. Moore said that the one big facet of self-employment that caught her by surprise was the demand on her time: “I thought I would do this on less than 40 hours a week, but I found myself getting up at 4 am and going back to work after the kids went to bed at night.”

Seven years after going off on her own, she has fallen into a comfortable pace. She's trimmed her hours down to 35 to 40 hours a week and earns about 40 percent more than what she would working at a hospital, she said.

“The opportunities are there if you can find a niche that isn't occupied by someone else. Start cautiously and protect yourself financially. But don't protect yourself so much that you lose that spark.”

Copyright © 2011 Wolters Kluwer Health, Inc. All rights reserved.
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