case study of successful private nursing enterprise

Chatting with home healthcare guru Pamela Taylor got me thinking. What does it actually take to start your own private duty nursing business? In our chat, Pam compares and contrasts private duty nursing with home health businesses. While each business model differs, Pamela helps her clients at NorthStar Medical Consulting figure out which business model suits their needs best and gives them a blueprint to success. 

If you’re thinking about starting a private duty nursing business, then take heed of this step-by-step process that will help you build a profitable home healthcare business. 

• Do your research. 

Psychographics and demographics play a crucial role in your success. Who’s hiring private duty nurses in your area? Is there a need for reliable home care services?  Are there any substantial competitors that would make breaking into the business a challenge?

• Figure out your niche.

While your private duty business should offer general services, there are many niches that you can focus on, depending on demand and preferences. Some of these niches include: 

• In-Home Medical Care 
• 24-Hour Home Care
• Homemaker/Companion Services 
• Therapy (Speech, PT, etc.) 
• In-Home Nutrition
• Know the competition 

Unless you live on a deserted island, I’m willing to bet that you probably have a little bit of competition. Whether it’s Hospice or another small business you should have an understanding of standards of care for your competitors. This can also help you with budgeting. 

• Franchise? 

A lot of entrepreneurs decide to affiliate with a well-known franchise. This has pros and cons. On the one hand, you’ll have brand recognition, on the other, franchises are extremely expensive, and you don’t have the freedom to do everything the way you want. I recommend starting from scratch, even though it might take more effort in the beginning. 

• Be realistic about challenges. 

There are many challenges that new business owners face. Some of these challenges include competition, expenses, marketing, government policies, and more. 

• Choose the right legal entity. 

From LLCs, C Corps, S Corps, etc. there are several routes you can take that can impact future growth. Do your own research and if you’re still not sure, it may be beneficial to get some legal device. 

• Brand development. 

Once you’ve got your business model mapped out, it’s time to start laying the groundwork to grow your brand. This can include logo creation, website development, social media marketing, and other brand development services. Note that it’s a good idea to hire a professional(s) to help with brand development. 

• Protecting your intellectual property. 

Do you need a patent? What about trademarks or copyrights? Protect your brand by protecting your intellectual property first. Not sure where to start? Hire a lawyer or consultant to give you a hand. 

• Professional certifications. 

If you’re starting your own private duty nursing business then you need to arm yourself with the appropriate professional certifications. Failure to procure the proper certifications can result in criminal charges. Applicable certifications may include: 

• Registered nurse and Licensed practical nurse certificate
• AADNS Certification
• QAPI Certified Professional (QCP)
• Director of Nursing Services–Certified (DNS-CT)
•  Legal documents 

You cannot start a legal and functional business without the proper legal documentation. This included a business license, business plan, state permit, and a range of other necessary documents that ensure your company is legal and ready to operate. 

• Get the capital you need to succeed. 

Much like any other startup, private duty nursing businesses are an expensive venture. But to make, you’ve got to have the capital. Whether it’s through loans, grants, or savings, you need to make a financial investment in your own business before getting up and running. 

• Finding the right location. 

Are you looking for an office to act as headquarters? Maybe your community doesn’t have the right demographics to provide you with business? Location is important and starting your business in the right geographical area can make or break your business in those early months/years. 

• Get some manpower. 

If you’re not a one-man/woman operation, then take some time to find the right employees. Don’t rush into hiring someone just because you need the numbers. A lot of time and consideration should go into finding the right workers– your business is only as successful as your weakest link! 

• Create a solid marketing plan. 

Creativity is key when it comes to developing a successful marketing plan. From digital marketing, social media content, networking, and more, set aside some of your budget and time for marketing your new business. 

• Develop a corporate identity. 

This last and final step may take some time. But as you continue to market your business and win clients, you’ll find that your brand will start growing on its own. 

To learn more about how Pamela Taylor can help you start your private duty nursing business visit https://northstarmedicalconsulting.com/ or check out our chat here .

For more tips & tricks subscribe to my YouTube channel: https://www.youtube.com/channel/UCClxsnpX_wN-4ESGilioyeQ  

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Nursing entrepreneurship presents as a viable and attractive approach for nursing practice that serves to reinstate professional autonomy, advance nursing professionalism, and to participate in health system transformation. And yet, in countries such as Canada where universal healthcare funding has most nurses working as employees for state-funded health service providers, few nurses are self-employed. This thesis sets out to explore the possible contributions of nurse entrepreneurship in Canada. According to the International Council of Nurses (ICN, 2004), nursing entrepreneurship reflects a return to nursing's traditional right to independent practice while engendering professional empowerment and health care transformation. During the late 19 th and early 20 th century, the majority of Canadian graduate nurses practiced independently as private duty nurses (McPherson, 1996). Private duty nurses were responsible for acquiring their own patient cases and defining the conditions of their work in relation to their patient's health care needs. Remuneration for nursing services came directly from the patient or the patient's family and nursing care was usually delivered within the patient's home or the hospital, as a form of supplementary care (McPherson, 1996; Whelan, 2012). The private duty nurse assumed complete care of the patient while enjoying a high level of professional autonomy (Whelan, 2012). Following World War II, substantial recurrent government funding was made available for hospital capital and operating costs and the supply of private duty nurses could no longer meet the service demands of the growing number of medical institutions (McPherson, 1996, Whelan, 2012). Eventually, hospital administrations abandoned private duty nursing, opting to hire registered nurses in staff positions that were institutionally controlled and under physicians' authority (McPherson, 1996; Wall, 2013b; Whelan, 2012). During the late 20 th century, administration of the Canadian public health system assumed an efficiency-focused approach (Armstrong & Armstrong, 2008; Wall, 2013a). Today, nurses are increasingly required to participate in corporate interests that support an agenda of efficiency rather than the provision of care that is congruent with the profession's values (Wall, 2013a). Nursing entrepreneurship - often termed private practice, independent practice, independent contractor, and self-employed practice - sees the nurse as "a proprietor of a business that offers nursing services of a direct care, educational, research, administrative or consultative nature. The self-employed nurse is directly accountable to the client, to whom, or on behalf of whom, nursing services are provided" (ICN, 2004, p.4). It is important to note the distinction between nurse entrepreneur and advanced practice nurse (APN) i.e. nurse practitioners, nurse midwives, clinical nurse specialists and nurse anesthetists. The International Council of Nurses (2003) asserts that nurse entrepreneurs are not necessarily APNs and the majority of APNs are not entrepreneurs. Within nursing scholarship, there is a paucity of research regarding contemporary nursing entrepreneurship performed by registered nurses. In Canada, as with many other countries with universal healthcare funding, the literature predominantly consists of anecdotal, motivational, or editorial narratives. Wall (2014, 2013a; 2013b) conducted a qualitative inquiry using focused ethnography to study 20 nurses in independent practice within a western Canadian province. From the data, Wall extracted themes that relate to the innovative possibilities of nurse entrepreneurs as change agents in the quest for professional advancement and health system transformation. Wilson, Averis, and Walsh (2003) surveyed 54 private practice nurses in Australia (with a similar health system) using a two-round Delphi technique to ascertain the reasons for nurses going into business and their respective experiences associated with being entrepreneurs. In addition to compiling a list of the various independent nursing practices, common influences for pursuing nursing entrepreneurship such as professional autonomy and barriers to practice such as lack of remuneration, a viable referral system, and recognition of their respective nursing services were identified. Drennan et al., (2007) conducted an integrative review to investigate the scope of entrepreneurial practice assumed by nurses, midwives and health visitors in the United Kingdom and the factors influencing this mode of practice. From the integrative review, only three empirical studies emerged. These studies explored the experiences of nurse entrepreneurs and revealed findings similar to those of Wilson et al. (2003). The grey literature is largely comprised of a handful of dissertations related to nursing entrepreneurship along with professional practice guidelines and handbooks for the self-employed nurse published by various provincial, national and global nursing organizations, interest groups, and regulatory bodies. Overall, the research supports the common anecdotal evidence and motivational literature that identifies nursing entrepreneurship as an opportunity for the advancement of professional nursing practice while meeting the needs of clients that otherwise risk falling into gaps present within the current health system (Wall, 2014; Wall, 2013a; Wall, 2013b; Wilson, Whitaker & Whitford, 2012). Likewise, national and global nursing organizations encourage nurses to engage in health system transformation that seeks to broaden health care beyond hospitals and other institutional settings while ensuring nurses work to their full scope of practice (CNA, 2012; ICN, 2004). In departing from the organizational constraints that serve to erode nursing professionalism, nursing entrepreneurship affords a level of professional autonomy that supports and exemplifies the profession's values and goals (Wall, 2013a). Global estimates indicate that approximately 0.5% - 1% of working nurses are nurse entrepreneurs (ICN, 2004). No readily available statistics specific to self-employed nurses in Canada were identified as their numbers are often embedded within the generic category "other" which often captures employed nurses in practice areas such as education, research, occupational health, and private insurance companies. Practicing along the margins of the profession, it is surmised that the number of self-employed nurses in Canada likely reflects the global experience (Wall, 2013a). So, why the limited uptake? Using an interpretive description approach, the aim of this qualitative study is to acquire the perspectives of practicing Canadian nurse entrepreneurs to guide the development of national and provincial policies that support nursing entrepreneurship. In conjunction with these perspectives, national nurse leaders will be recruited to participate in qualitative interviews regarding policy formation strategies that seek to promote the expansion of nursing entrepreneurship in Canada. A research approach specifically developed to reflect a nursing orientation, interpretive description (ID) is a qualitative methodology that seeks to describe and interpret a phenomenon through the lens of those who live it (Thorne, Reimer-Kirkham & MacDonald-Emes, 1997). Thorne et al. (1997) stress that ID "ought to be located within the existing knowledge so that findings can be constructed on the basis of thoughtful linkages to the work of others in the field" (p. 173). Through the use of a scaffolding metaphor, Thorne (2008) emphasizes the significance of establishing a solid platform to guide the research investigation. In the case of nursing entrepreneurship, the scholarly literature, although very sparse, reflects common findings. Themes related to nursing professionalism, autonomy, and the provision of nursing care that reflects the values embraced by the profession are woven throughout the literature identified. Also common within the literature, is the need for viable client referral and remuneration systems for nursing entrepreneurs and institution of public credibility. From this platform, further investigation is warranted regarding the experience of nurse entrepreneurs to illuminate current economic, political and legislative factors that impact the uptake of nursing entrepreneurship in Canada. Seeking to draw upon the expertise of this unique form of practice, a purposive sample consisting of 8-12 nurse entrepreneurs from across Canada will be invited to participate in telephone or in-person interviews. Participants will be practicing self-employed nurses with a minimum of two years of self-employment experience. This investigation will comprise the first stage of this two-stage research project. As interpretive description "responds to the imperative of informed action" (Thorne, 2008, p. 26), 4-6 national nurse leaders will be invited to explore policy formation strategies using the findings from stage one with the intent to increase uptake of nursing entrepreneurship within Canada. Thematic analysis will be employed to develop a composite picture of nurse entrepreneurship in Canada and corresponding policy formation strategies. Interviews will be audio recorded and transcribed verbatim. Data will be coded using a dynamic process, providing the opportunity to consider the data from multiple "angles of vision" (Thorne, 2008, p. 147). This poster will introduce nursing entrepreneurship as a means of effecting professional advancement and health system transformation. An interim report on preliminary findings and possible implications for future policy formation will be included. In conclusion, nursing entrepreneurship can serve to advance professional nursing practice while meeting the needs of nursing clients that otherwise risk falling into health system gaps. As gaps within the public health system continue to widen in the pursuit of efficiencies, more entrepreneurial opportunities for health care delivery services will likely arise. If registered nurses do not position themselves as entrepreneurs, this work will be assumed by others whose primary objective may not include the provision of safe, ethical, effective health care. Engagement in policy formation is essential for nursing entrepreneurs to establish public credibility and legitimate recognition by provincial and national nursing associations and regulatory bodies for this innovative form of nursing practice.

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Nursing entrepreneurship presents as a viable and attractive approach for nursing practice that serves to reinstate professional autonomy, advance nursing professionalism, and to participate in health system transformation. And yet, in countries such as Canada where universal healthcare funding has most nurses working as employees for state-funded health service providers, few nurses are self-employed. This thesis sets out to explore the possible contributions of nurse entrepreneurship in Canada. According to the International Council of Nurses (ICN, 2004), nursing entrepreneurship reflects a return to nursing's traditional right to independent practice while engendering professional empowerment and health care transformation. During the late 19 th and early 20 th century, the majority of Canadian graduate nurses practiced independently as private duty nurses (McPherson, 1996). Private duty nurses were responsible for acquiring their own patient cases and defining the conditions of their work in relation to their patient's health care needs. Remuneration for nursing services came directly from the patient or the patient's family and nursing care was usually delivered within the patient's home or the hospital, as a form of supplementary care (McPherson, 1996; Whelan, 2012). The private duty nurse assumed complete care of the patient while enjoying a high level of professional autonomy (Whelan, 2012). Following World War II, substantial recurrent government funding was made available for hospital capital and operating costs and the supply of private duty nurses could no longer meet the service demands of the growing number of medical institutions (McPherson, 1996, Whelan, 2012). Eventually, hospital administrations abandoned private duty nursing, opting to hire registered nurses in staff positions that were institutionally controlled and under physicians' authority (McPherson, 1996; Wall, 2013b; Whelan, 2012). During the late 20 th century, administration of the Canadian public health system assumed an efficiency-focused approach (Armstrong & Armstrong, 2008; Wall, 2013a). Today, nurses are increasingly required to participate in corporate interests that support an agenda of efficiency rather than the provision of care that is congruent with the profession's values (Wall, 2013a). Nursing entrepreneurship - often termed private practice, independent practice, independent contractor, and self-employed practice - sees the nurse as "a proprietor of a business that offers nursing services of a direct care, educational, research, administrative or consultative nature. The self-employed nurse is directly accountable to the client, to whom, or on behalf of whom, nursing services are provided" (ICN, 2004, p.4). It is important to note the distinction between nurse entrepreneur and advanced practice nurse (APN) i.e. nurse practitioners, nurse midwives, clinical nurse specialists and nurse anesthetists. The International Council of Nurses (2003) asserts that nurse entrepreneurs are not necessarily APNs and the majority of APNs are not entrepreneurs. Within nursing scholarship, there is a paucity of research regarding contemporary nursing entrepreneurship performed by registered nurses. In Canada, as with many other countries with universal healthcare funding, the literature predominantly consists of anecdotal, motivational, or editorial narratives. Wall (2014, 2013a; 2013b) conducted a qualitative inquiry using focused ethnography to study 20 nurses in independent practice within a western Canadian province. From the data, Wall extracted themes that relate to the innovative possibilities of nurse entrepreneurs as change agents in the quest for professional advancement and health system transformation. Wilson, Averis, and Walsh (2003) surveyed 54 private practice nurses in Australia (with a similar health system) using a two-round Delphi technique to ascertain the reasons for nurses going into business and their respective experiences associated with being entrepreneurs. In addition to compiling a list of the various independent nursing practices, common influences for pursuing nursing entrepreneurship such as professional autonomy and barriers to practice such as lack of remuneration, a viable referral system, and recognition of their respective nursing services were identified. Drennan et al., (2007) conducted an integrative review to investigate the scope of entrepreneurial practice assumed by nurses, midwives and health visitors in the United Kingdom and the factors influencing this mode of practice. From the integrative review, only three empirical studies emerged. These studies explored the experiences of nurse entrepreneurs and revealed findings similar to those of Wilson et al. (2003). The grey literature is largely comprised of a handful of dissertations related to nursing entrepreneurship along with professional practice guidelines and handbooks for the self-employed nurse published by various provincial, national and global nursing organizations, interest groups, and regulatory bodies. Overall, the research supports the common anecdotal evidence and motivational literature that identifies nursing entrepreneurship as an opportunity for the advancement of professional nursing practice while meeting the needs of clients that otherwise risk falling into gaps present within the current health system (Wall, 2014; Wall, 2013a; Wall, 2013b; Wilson, Whitaker & Whitford, 2012). Likewise, national and global nursing organizations encourage nurses to engage in health system transformation that seeks to broaden health care beyond hospitals and other institutional settings while ensuring nurses work to their full scope of practice (CNA, 2012; ICN, 2004). In departing from the organizational constraints that serve to erode nursing professionalism, nursing entrepreneurship affords a level of professional autonomy that supports and exemplifies the profession's values and goals (Wall, 2013a). Global estimates indicate that approximately 0.5% - 1% of working nurses are nurse entrepreneurs (ICN, 2004). No readily available statistics specific to self-employed nurses in Canada were identified as their numbers are often embedded within the generic category "other" which often captures employed nurses in practice areas such as education, research, occupational health, and private insurance companies. Practicing along the margins of the profession, it is surmised that the number of self-employed nurses in Canada likely reflects the global experience (Wall, 2013a). So, why the limited uptake? Using an interpretive description approach, the aim of this qualitative study is to acquire the perspectives of practicing Canadian nurse entrepreneurs to guide the development of national and provincial policies that support nursing entrepreneurship. In conjunction with these perspectives, national nurse leaders will be recruited to participate in qualitative interviews regarding policy formation strategies that seek to promote the expansion of nursing entrepreneurship in Canada. A research approach specifically developed to reflect a nursing orientation, interpretive description (ID) is a qualitative methodology that seeks to describe and interpret a phenomenon through the lens of those who live it (Thorne, Reimer-Kirkham & MacDonald-Emes, 1997). Thorne et al. (1997) stress that ID "ought to be located within the existing knowledge so that findings can be constructed on the basis of thoughtful linkages to the work of others in the field" (p. 173). Through the use of a scaffolding metaphor, Thorne (2008) emphasizes the significance of establishing a solid platform to guide the research investigation. In the case of nursing entrepreneurship, the scholarly literature, although very sparse, reflects common findings. Themes related to nursing professionalism, autonomy, and the provision of nursing care that reflects the values embraced by the profession are woven throughout the literature identified. Also common within the literature, is the need for viable client referral and remuneration systems for nursing entrepreneurs and institution of public credibility. From this platform, further investigation is warranted regarding the experience of nurse entrepreneurs to illuminate current economic, political and legislative factors that impact the uptake of nursing entrepreneurship in Canada. Seeking to draw upon the expertise of this unique form of practice, a purposive sample consisting of 8-12 nurse entrepreneurs from across Canada will be invited to participate in telephone or in-person interviews. Participants will be practicing self-employed nurses with a minimum of two years of self-employment experience. This investigation will comprise the first stage of this two-stage research project. As interpretive description "responds to the imperative of informed action" (Thorne, 2008, p. 26), 4-6 national nurse leaders will be invited to explore policy formation strategies using the findings from stage one with the intent to increase uptake of nursing entrepreneurship within Canada. Thematic analysis will be employed to develop a composite picture of nurse entrepreneurship in Canada and corresponding policy formation strategies. Interviews will be audio recorded and transcribed verbatim. Data will be coded using a dynamic process, providing the opportunity to consider the data from multiple "angles of vision" (Thorne, 2008, p. 147). This poster will introduce nursing entrepreneurship as a means of effecting professional advancement and health system transformation. An interim report on preliminary findings and possible implications for future policy formation will be included. In conclusion, nursing entrepreneurship can serve to advance professional nursing practice while meeting the needs of nursing clients that otherwise risk falling into health system gaps. As gaps within the public health system continue to widen in the pursuit of efficiencies, more entrepreneurial opportunities for health care delivery services will likely arise. If registered nurses do not position themselves as entrepreneurs, this work will be assumed by others whose primary objective may not include the provision of safe, ethical, effective health care. Engagement in policy formation is essential for nursing entrepreneurs to establish public credibility and legitimate recognition by provincial and national nursing associations and regulatory bodies for this innovative form of nursing practice.

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21 great business ideas for nurse entrepreneurs.

In this article, we will take a look at the 21 great business ideas for nurse entrepreneurs. If you want to skip our detailed analysis, you can go directly to 5 Great Business Ideas for Nurse Entrepreneurs .

Courtney Adeleye: A Case Study

Nurses may highly benefit from entrepreneurship throughout their nursing career. On  August 24, 2023, Yahoo Finance covered the story of a registered nurse, Courtney Adeleye. In 2013, Adeleye embarked on looking for a solution to treat natural hair. She was unable to find any good products on the market, which eventually pushed her to start her own business. She started mixing ingredients at home, such as vitamins, nutrients, and other healthy ingredients. She recorded her entire routine to show the world on YouTube. Soon after, she became a recognized hair care provider across the globe, claiming to have sold products worth $10 million from the comfort of her home within the first three years of business. She later partnered with over 60,000 retailers across the United States, contributing to $100 million in sales by 2019, and growing her following to 805,000 followers on Instagram, currently. Adeleye then launched Olbali, her own health and wellness direct-selling venture. Not only can users purchase coffee, organic PH-balancing sanitary products, and multivitamins, but they can also sell their products by becoming a direct selling associate of the brand. You can also take a look at the countries that need nurses the most .

Must-Have Platforms for Nurses

Like Adeleye, if you are a nurse looking to start your business,  Alibaba Group Holding Limited (NYSE: BABA ), Intuit Inc.'s (NASDAQ: INTU ) Mailchimp, and Wix.com Ltd. (NASDAQ: WIX ) are among the few companies that may help you in your entrepreneurial journey. Let's discuss some recent updates and offerings from these companies. You can also take a look at the highest paying states for nurses .

Alibaba Group Holding Limited (NYSE:BABA) is one of the best business-to-business marketplaces to source products. Nurses can create an account on Alibaba Group Holding Limited (NYSE:BABA) to source veterinary supplies, surgical supplies, physical therapy supplies, and other medical equipment. A box of 100 6Mil Medical Gloves is priced somewhere between $0.01 to $0.03. Nurses must order at least 10,000 pieces. Alibaba is home to more than 200,000 suppliers providing all kinds of products. To get started, nurses must register, create an account, find products, and select a supplier. Nurses can also take a look at the best alternatives to Alibaba to source products .

Nurses willing to set up their own nurse staffing agency or private clinic must have a strong email automation functionality. Intuit Inc. (NASDAQ:INTU) is a large technology company home to multiple automation software. Mailchimp, a product of Intuit Inc. (NASDAQ:INTU), is one of the best email automation platform providers. Nurses can use Mailchimp to personalize and automate emails for their patients or hospitals. The free version is available for users with up to 500 contacts and only offers pre-built templates and provides email support for 30 days.

Online businesses demand a strong online presence for success and brand image. Having a prominent website enhances the credibility of a business. Wix.com Ltd. (NASDAQ:WIX) is a leading web development company. Nurses can build their website using the free tools on Wix.com Ltd. (NASDAQ:WIX). Once done, nurses can enhance their website's ranking on search engines using its SEO tools. Nurses can also host their websites for free and enjoy 500MB storage and 1GB bandwidth, along with a free Wix domain. To get started, nurses can pick a template, edit the template using the Wix editor, and then manage the billing. Wix also allows nurses to create logos.

Now that we have discussed the entrepreneurial landscape for nurses, let's take a look at the 21 great business ideas for nurse entrepreneurs. You can also read our piece on the best cities for nurses adjusted for cost of living .

Our Methodology

To gather a list of the 21 great business ideas for nurse entrepreneurs, we consulted over 10 rankings and reports on the internet. We picked the business ideas that appeared in 50% of our sources and then ranked them.

21. Public Speaker

Health events, such as conferences, are conducted on a regular basis, demanding the need for keynote health speakers. Nurses can start their own series of webinar conferences to save costs. These webinars can be set up for general topics based on audience demands, or be directed at a specific niche.

20. Nurse Staffing Agency

Being a nurse comes with the benefit of a large network of fellow nurses. Nurse entrepreneurs can benefit from their public relations and set up a staffing agency to connect nurses with the perfect job roles based on their experience, required pay, and job specifications.

19. Yoga Instructor

Nurse practitioners can start a yoga training agency. The health benefits of yoga are extremely well-known among people. Such suggests why it is one of the best business ideas for nurse entrepreneurs.

18. Sell Medical Products

Medical products can be sold on any of the e-commerce platforms such as Amazon, Lightspeed, or Alibaba. The Rollator Walker with Seat is one of the best-selling items on Amazon. It is priced at $64.99 and is rated 4.5, as of March 24, 2024. More than 10,000 items of the product were sold in the past month.

17. Health Coach

Health coaches provide advice and coaching on nutrition and fitness. As people push for more healthier lifestyles, the demand for health coaches will constantly rise. According to a report by Precedence Research, the global health coach market is expected to grow from $15.44 billion in 2022 to $29.12 billion by 2032 at a compound annual growth rate (CAGR) of 6.6%.

16. Nurse Author

Nurse entrepreneurs can also become authors. They can publish books based on their medical knowledge for a specific niche such as childbirth, senior care, or fitness. Some nurses can also cover their day-to-day activities or nursing tips and publish them as books.

15. Childbirth Educator

A lot of people lack information on childbirth. Nurses can look into providing education to people looking into childbirth, going through childbirth, or having already gone through childbirth. If nurses are targeting young adults, they may educate them using social media, and YouTube on the side.

14. Health Blogger

Health blogging is an interesting business idea. Nurses can also look into setting up their own health newsletter. 2% with Michael Easter is a health and performance newsletter on Substack. It has over 47,000 subscribers. It is available for $6.87 per month, or $68.7 per annum.

13. Fitness Nurse

Starting a fitness nursing business is one of the best ideas for nurse entrepreneurs. Nurses can provide customized fitness training to people by applying their medical knowledge. These sessions can also be provided virtually to save costs. While Instagram is home to a lot of fitness influencers, the number of nurse trainers is low. This is an area that aspiring nurse entrepreneurs could penetrate.

12. Massage Therapist

A massage therapist can earn somewhere between $25 to $40 per hour, according to data available on Glassdoor. According to a report by Future Market Insights, the global massage therapy service market is expected to be valued at $65.23 billion in 2024. The global massage therapy service market is projected to grow to $146.13 billion by 2034 at a compound annual growth rate (CAGR) of 8.4%.

11. Care Provider

A care provider may earn somewhere between $38,000 to $65,000 per annum, or $30 to $45 per hour, according to data on Glassdoor, depending on the years of prior experience. Nurses can also establish a care agency to provide services to people in need within their community.

10. Nurse Influencer

A nurse influencer is a great option for nurses looking for a side business. Nurse Blake has almost 1 million followers on Instagram. He educates his audience on important health issues using humor. He also performs stand-up comedy which he markets on his social media.

9. Legal Nurse Consultancy

Starting a legal nurse consultancy business is one of the best business ideas for nurse entrepreneurs. Nurses can earn somewhere between $20 and $70 by providing nursing consultancy on Upwork. The site has several jobs displayed for full-time nursing consultancy positions that go up to $250,000 per annum.

8. Health and Wellness Podcast

Nurses can start a podcast to give important insights from the health industry about current diseases. Andrew Huberman has over 5.2 million subscribers on YouTube. The podcast is one of the best health podcasts.

7. Medical Spa

A Medical Spa is a type of spa that provides services for the skin and body. To save costs, nurses can start by providing spa and skin care services to patients directly in their homes.

6. Nurse Freelancing

Nurse freelancing is one of the best businesses nurse entrepreneurs can start. There are multiple projects available on Upwork. Nurses can earn $80 for a 4,000-word nursing blog project or $70 for a brochure or website copy.

Click to continue reading and see 5 Great Business Ideas for Nurse Entrepreneurs .

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Disclosure: None. 21 Great Business Ideas for Nurse Entrepreneurs  is originally published on Insider Monkey.

The business case for optimizing the nursing workforce

In this special section, “Preparing the Workforce—Today and Tomorrow,” you’ll find trends, practical strategies, and food for thought. The articles are designed to help nurses in all specialties and at all levels who face myriad workforce challenges, ranging from a growing older population to the impending retirement of many experienced nurses.

For my own contribution, I’d like to focus on the business case for an optimal nursing workforce. A critical success factor for healthcare organizations is the efficient use and retention of a talented workforce contributing to clinical and operational excellence.

Laying the groundwork for success

Leading performance organizations use a multidisciplinary team whose members understand the urgency of addressing current workforce issues, such as staffing and scheduling systems, professional development, innovative work design, and recruitment and retention programs centering on multigenerational challenges.

A successful future demands implementation of proven people, processes, and technology solutions to improve operational and clinical performance. These include:

• organizational strategies that align with licensure and labor regulations, to ensure deployment of the right staff at the right time for the right patient
• nurse manager roles that are optimized for patient and employee experience oversight; for example, automation of staffing and scheduling responsibilities
• use of workforce data to develop long-term clinical improvement strategies.

Making the business case

Labor remains the largest expense for healthcare organizations. But labor’s ability to affect a hospital’s success extends far beyond the bounds of a profit-and-loss statement. A growing body of evidence supports the workforce’s impact on physician, staff, and patient satisfaction—and ultimately, on revenue and quality of care. Optimizing workforce management also promotes operational and clinical excellence in ways not always considered, such as staff morale improvement to promote quality of care.

Here’s a closer look at the data and research findings related to business aspects of three key workforce elements: the link between overtime and both turnover and injury, the impact of agency nursing, and the need to free managers from outdated systems.

Overtime reality

For most hospitals, nursing overtime is the rule, not the exception. According to industry surveys, more than 50% of full-time nurses work an average of 7 hours of overtime each week, and 15% of part-time nurses work an average of 5.4 hours of overtime weekly. With this pattern, 7% to 10% of total worked hours are overtime hours. From a business perspective, overtime has several negative consequences.

Increased turnover

Turnover is an ongoing challenge. Nurses who work more than 12 hours in a shift and 40 hours in a week are prone to job dissatisfaction and quitting. Nurses who work shifts longer than 12 hours are nearly 1.5 times more likely to leave their positions within a year than nurses who don’t. Because 12-hour shifts are becoming the norm and with nearly half of full-time nurses logging overtime, unmanaged overtime can accelerate costly turnover.

What’s more, replacing nurses who leave is expensive. In research initially published in the Journal of Nursing Administration in 2008, researcher Cheryl Bland Jones, PhD, RN, FAAN, outlined what is now considered valid data and used as industry norms related to the cost of RN turn­over: $82,032 per experienced registered nurse (RN) and $88,006 per new RN.

Staff injuries

Working in jobs with overtime schedules is associated with a 61% higher injury hazard rate than working in jobs without overtime. Working at least 12 hours per day is linked to a 37% increased injury rate—and with 50% of full-time nurses falling into overtime buckets, hospital exposure to injuries increases. Alarmingly, healthcare workers’ injury rates are almost twice those of the norm, and injury costs hit the organization’s bottom line.

Patients in jeopardy

A deep body of literature has established a significant link between overtime and patient safety. Currently, most organizations are unable to track these correlations. As nursing shifts lengthen, so do the chances of medical errors. An often-cited study by Rogers, et al. found that the odds of making an error are three times higher when nurses work more than 12.5 hours.

A multistate study by Bae confirmed the greater likelihood of errors in nurses who surpass a 40-hour work week. These nurses were 3.71 times more likely to make medication errors. Clearly, such incidents are linked to decreased quality of care. Based on average costs and incidence, financial exposure stemming from medical errors runs upwards of $30 million per year for a 300-bed hospital, much of it unreimbursed.

Use of agency nurses

On average, agency nurses represent 5% to 10% of the entire nursing force and may earn 50% to 75% more per hour than the average nurse. Annually, a 300-bed hospital is likely to spend more than $4.5 million for agency staff. Although agencies fill a critical need, many organizations have been able to dramatically reduce their use of agency nurses through electronic scheduling systems and their own per-diem pools. Limiting use of agency nurses also can help improve staff satisfaction and, ultimately, patient satisfaction. (See The business case for nurse satisfaction .)

Freeing nurse managers

Scheduling and bed management are complex and time-consuming for managers. A recent KRONOS study found nurse managers spend up to 80% of their day on staffing, scheduling, and bed management, done mostly with paper-based systems. This time competes with efforts to raise quality, prevent harmful events, manage costs, and improve the patient experience. Across a typical 300-bed hospital, liberating nurse managers from an outdated scheduling process can free up to 6,000 nurse-manager hours annually. Nurse managers can repurpose this time for higher-order professional activities, such as mentoring, teaching, and interfacing with patients and their families to ensure highly reliable and consistent care.

Only the beginning

I’ve only made a dent in the data related to the business case for optimizing the nursing workforce, but I hope it’s enough for you to see that a top-notch workforce makes good business sense.

Lillee Gelinas is Editor-in-Chief of American Nurse Today and system vice president and chief nursing officer of Clinical Excellence Services at CHRISTUS Health in Irving, Texas.

Advisory Board Company. Nursing productivity benchmark generator. May 6, 2014. https://www.advisory.com/technology/workforce-compass/members/tools/nursing-productivity-benchmark-generator

American Association of Colleges of Nursing. Nursing faculty shortage. April 24, 2014. www.aacn.nche.edu/mediarelations/ fact-sheets/nursing-faculty-shortage

American College of Healthcare Executives. Survey: Healthcare finance, reform top issues confronting hospitals in 2014. www.ache.org/pubs/research/ceoissues.cfm

Bae SH. Nursing overtime: why, how much, and under what working conditions? Nurs Econ. 2012;30(2): 60-71.

Bae SH. Presence of nurse mandatory overtime regulations and nurse and patient outcomes. Nurs Econ. 2013;31(2):59-68.

Dembe AE, Erickson JB, Delbos RG, Banks SM. The impact of overtime and long work hours on occupational injuries and illnesses: new evidence from the United States. Occup Environ Med. 2005;62(9):588-97.

J.D. Power and Associates. National Hospital Service Performance Study. 2005.

Jones CB. Revisiting nurse turnover costs: adjusting for inflation. J Nurs Adm. 2008;38(1):11-8.

KPMG Healthcare & Pharmaceutical Institute. KPMG’s 2011 U.S. hospital nursing labor costs study. April 2011. www.natho.org/pdfs/KPMG_2011_Nursing_LaborCostStudy.pdf

McCaughey D, McGhan G, Walsh EM, Rathert C, Belue R. The relationship of positive work environments and workplace injury: evidence from the National Nursing Assistant Survey. Health Care Manage Rev . 2014;39(1):75-88.

McHugh MD, Kutney-Lee A, Cimiotti JP, Sloane DM, Aiken LH. Nurses’ widespread job dissatisfaction, burnout, and frustration with health benefits signal problems for patient care. Health Aff (Millwood) . 2011:30(2):202-10.

NSI Nursing Solutions. Study compares travel nurse use to hiring nurses as “your employees.” 2015.  www.nsinursingsolutions.com/Files/assets/library/workforce/Travel%20Nurse%20Use%20&%20Cost%20Study%202015.pdf

Rau J. Methodology: how value-based purchasing payments are calculated. Kaiser Health News. November 13, 2014. khn.org/news/value-based-purchasing-medicare-methodology/

Occupational Safety and Health Administration. Worker safety in your hospital: know the facts. September 2013. www.osha.gov/dsg/hospitals/documents/1.1_Data_highlights_508.pdf

Old DM, Clarke SP. The effect of work hours on adverse events and errors in health care. J Safety Res. 2010;41(2):153-62.

Rogers AE, Hwang WT, Scott LD, Aiken LH, Dinges DF. The working hours of hospital staff nurses and patient safety. Health Aff (Millwood). 2004;23(4):202-12.

Sage Growth Partners Analysis. How overtime may be harming your business and your patients. Healthcare in the know webinar. 2015. //KG: I don’t see a date on this webinar; do you?// apihealthcare.com/Webinar-How-overtime-may-be-harming-your-business-ng

Scott LD, Rogers AE, Hwang WT, Zhang Y. Effects of critical care nurses’ work hours on vigilance and patients’ safety. Am J Crit Care. 2006;15(1):30-7.

Stimpfel AW, Sloane DM, Aiken LH. The longer the shifts for hospital nurses, the higher the levels of burnout and patient dissatisfaction. Health Aff (Millwood). 2012;31(11):2501-9.

U.S. Department of Health and Human Resources. Health Resources and Services Administration. The registered nurse population: findings from the 2008 national sample survey of registered nurses. September 2010; xxviii, 3-27. http://bhpr.hrsa.gov/healthworkforce/rnsurveys/rnsurveyfinal.pdf

U.S. News and World Report. Registered nurse: salary. 2015. money.usnews.com/careers/best-jobs/registered-nurse/salary

Valentine NM, Nash J, Hughes D, Douglas K. Achieving effective staffing through a shared decision-making approach to open-shift management. J Nurs Adm. 2008;38(7-8):331-5.

Westbrooke JI, Duffield C, Li L, Creswick NJ. How much time do nurses have? A longitudinal study quantifying hospital nurses’ patterns of task time distribution and interactions with health professionals. BMC Health Serv Res. 2011;11:319.

Click to read the next article: Moving the needle: What the data tell us about academic progression

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Working for herself: case study of a private duty nurse, 1965-1974

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• 1 School of Nursing and Health Studies, Central Queensland University, Australia.
• PMID: 12710379

Private duty nursing is not well researched in Australian history of nursing literature. While it would appear private duty nursing formed the main avenue of employment for trained nurses during the first part of the twentieth century, this type of nursing seems to have disappeared by the mid 1970s. This paper used a case study obtained from an oral history project to examine possible factors contributing to the phasing out of private duty nursing. It concluded there were two main influential issues: an increase in the use of medical technology and the impact this had on nursing practice; and an increase in the financial value placed on nursing which saw nursing wages increase dramatically from 1970.

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5 Private Nurse Service Success Stories [2024]

Private nurses provide one-on-one medical care to patients who are homebound or in an institution, such as a hospital, nursing home or other such facilities.

A private nursing attendant's responsibilities include taking care of the daily activities of patients like bathe, feed, maintain personal hygiene. Most of the private nurses live with the patient's family in their home, and may also work for long hours.

To become a private duty nurse, you will need to earn a registered nursing degree (RN) or a licensed practical nurse degree (LPN). Registered nurses with 2-3 years of relevant experience can then pursue their career as private duty nurses. Obtaining an advanced certification can also increase more career options.

Private nurses are usually hired by an individual or an agency. However, they work at a patient’s private residence and get paid by the individual. The career scope of private nursing practice is expected to increase by 7% in the coming years, with the increased aging population and the need for home care.

Pricing of a registered private nurse in the US would cost around $25+ an hour, which is approximately $4000 per month.

Here are some real life success stories of starting a private nurse service:

Learn more about starting a private nurse service :

Where to start?

-> How much does it cost to start a private nurse service? -> Pros and cons of a private nurse service

Need inspiration?

-> Examples of established private nurse service -> Marketing ideas for a private nurse service

Other resources

• 42 Trending Private Nurse Service Businesses [2024] 1 of 4
• How Much Does It Cost To Start A Private Nurse Service? (In 2024) 2 of 4
• 47 Pros & Cons Of Starting A Private Nurse Service (2024) 3 of 4
• 48 Marketing Ideas For A Private Nurse Service (2024) 4 of 4

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An innovative approach for graduate nursing student achievement of leadership, quality, and safety competencies ☆

The COVID-19 pandemic abruptly disrupted nursing education, forcing schools of nursing to move from in-person to online classes while clinical sites suspended rotations. These changes jeopardized graduate nursing degree completion for Registered Nurses (RNs) at a time when they were urgently needed to practice. The aim of this initiative was to develop proficiency of Master of Science in Nursing (MSN) leadership competencies in the absence of in-person clinical experiences and ensure timely program completion. To meet this aim, an interactive virtual clinical experience was rapidly designed. A team of expert faculty integrated a blend of perspectives from academia and practice to develop an unfolding case study across the health care continuum based on the real-world trajectory of the pandemic. This innovative interactive virtual clinical resulted in achievement of the aim. The faculty closely monitored progressive development of student proficiency in leadership, quality, and safety competencies as the teams effectively navigated the rigorous demands of the healthcare system within a complex scenario. Students reported satisfaction with the interactive clinical experience and gained increased confidence in leadership, quality, and safety competencies.

The COVID-19 pandemic abruptly disrupted nursing education. Nursing schools were forced to rapidly pivot from campus-based, in-person education to virtual learning platforms. For safety, and to preserve limited protective resources, clinical sites and schools suddenly discontinued traditional in-person clinical experiences. These changes impacted the students and faculty alike and increased the risk of delayed graduation during a time of critical need for nurses within the healthcare system.

Nursing leadership is essential during times of rapid change. A strong association between competent nursing leadership and system quality and safety has been shown in scholarly literature by Adams (2018) and Akbiyik et al. (2020) . The COVID-19 pandemic challenged nursing leadership to provide high quality and safe care delivery within an ever-changing health care system and exhausted workforce. Registered Nurses (RNs) equipped with well-developed competencies in leadership, quality, and safety continue to be urgently needed. The Future of Nursing: Leading Change, Advancing Health ( Institute of Medicine, 2011 ) and The Future of Nursing 2020–2030: Charting a Path to Achieve Health Equity ( National Academy of Sciences, Engineering, and Medicine, 2021 ) emphasized that all nurses should be competent leaders to ensure rapid adaptation to changing situations and community needs.

The American Organization for Nursing Leadership (AONL), the American Academy of Ambulatory Care Nursing (AAACN), and the Association for Leadership Science in Nursing (ALSN) are long-standing professional nursing organizations concentrating on the development of competent nursing leaders. Each organization has clearly outlined leadership, quality and safety competencies required of nurses across care settings ( AAACN, 2017 ; ALSN, 2022 ; AONL, 2015 ). As a strong and respected resource for graduate nursing curricular design, the American Association of Colleges of Nursing (AACN) provides degree competencies important for nursing education ( AACN, 2021 ). According to the AACN, competencies are observable and measurable behaviors demonstrated multiple times across a program of study ( AACN, 2021 ).

The ability to lead teams and drive evidence-based changes facilitates cycles of quality improvement and promotes high quality patient outcomes in healthcare organizations. Masters-prepared RNs who experience a well-developed program of study are educated, competent leaders who can successfully manage health care systems ( Heinen et al., 2019 ). Clinical experiences are an integral component of MSN programs. Guided by the competencies outlined in the AACN's (2011) The Essentials of Master's Education in Nursing and in alignment with the competencies identified by the specific professional nursing organizations for specialty certification ( AAACN, 2017 ; AONL, 2015 ), MSN students were traditionally mentored by nursing leaders within a healthcare setting where abundant clinical opportunities helped cultivate progressive development of required competencies. As the pandemic overtook the healthcare system, many MSN students lost access to onsite clinical experiences during their last semester of the MSN program.

The COVID-19 pandemic disrupted traditional methods of competency development for RNs earning an MSN degree. Graduate student nurses completing their MSN at the College of Graduate Nursing at Western University of Health Sciences, a private, not for profit institution in Pomona, California, were removed from their clinical sites due to concerns over student safety, personal protective equipment shortages, and the need to prevent transmission of a highly infectious novel virus. At the same time, faculty and clinical practice partners recognized the growing need for more MSN prepared nurses during this critical period of the pandemic. The college was challenged to rapidly identify effective strategies to engage students outside of a traditional educational setting to complete development of MSN leadership, quality, and safety competencies. Hence, the purpose of this initiative was to design and implement an interactive virtual clinical experience that promoted proficiency in these competencies in the absence of in-person clinical experiences and ensured on-time program completion.

Education without compromise during the pandemic

The development of nursing leaders who could rapidly adapt to the shifting health care landscape and devise innovative solutions was of utmost importance during this time. The college of nursing has a history of designing and implementing innovative learning alternatives and is dedicated to on-time program completion to support healthcare needs during the pandemic. To facilitate timely completion of graduate nursing degrees for practicing RNs, while promoting continued leadership competency development, evidence-based virtual strategies were explored for small groups of MSN students to demonstrate collaboration, leadership, quality, and safety competencies.

Connecting theory and practice is a difficult yet essential endeavor to ensure graduate students are prepared to apply their knowledge in practice ( Benner et al., 2010 ). Case studies based on real-life situations promote active learning to assist students in their understanding of complex health situations, while facilitating greater understanding of interrelated processes ( Benner et al., 2010 ; Porter-Wenzlaff, 2013 ). Unfolding case studies engage students across time, providing multiple opportunities of knowledge translation into practice and helping students put the pieces together, enhancing competency development ( Benner et al., 2010 ; Herron et al., 2019 ; Porter-Wenzlaff, 2013 ). The unfolding pandemic aligned well for utilizing this method of instruction. The faculty team designed five process improvement and change management scenarios within an innovative unfolding COVID-19 case study as part of an interactive virtual clinical group project.

The interactive virtual clinical was progressively designed to support competency development without compromising learning experiences and outcomes. Using adult learning principles and guided by program outcomes ( College of Graduate Nursing, 2022 ), the virtual clinical was constructed to elicit active participation in a realistic setting while promoting critical thinking and system decision-making skills. The realistic setting provided a framework from which the clinical faculty could provide valuable guidance and direction for the students based upon real-life experiences and practical applications to nursing practice to help bridge the theory to practice gap ( Benner et al., 2010 ; Porter-Wenzlaff, 2013 ).

Interactive virtual clinical development

The dean of the college was incredibly supportive of faculty utilizing creative and innovative evidence-based educational practices to develop expected MSN competencies and to promote on-time program completion during the pandemic. Within a four-week period, the faculty identified expected virtual clinical outcomes that were aligned with the MSN program outcomes and designed a 5-module unfolding case study, with the support of two administrative team members. The case study activities were designed to facilitate development of expected leadership, quality, and safety competencies that would meet the needs of complex healthcare systems. The case scenarios reflected the unfolding of the current real-world COVID-19 pandemic and its impact on the healthcare system from the perspective of nurse leaders. The modules were titled: (1) An Unknown Life-Threatening Crisis (2) Covid-19: Protecting Healthcare Workers and the Community (3) System Changes to Prevent Transmission (4) Creating Alternatives to Care and Surge Preparation, and (5) Re-Opening Health Care. Each scenario spanned two weeks.

The framework to support leadership competency development was based upon the TeamSTEPPS model ( AHRQ, 2019 ) and the Institute for Healthcare Improvement (IHI) Open School Online Course ( IHI, 2022 ). Students explored the concepts of TeamSTEPPS, an evidenced based model and toolkit to improve teamwork and communication among healthcare professionals ( AHRQ, 2019 ), during their Interprofessional Education courses in their first year of study. Additionally, students completed the IHI Basic Certificate in Quality and Safety during their final year ( IHI, 2022 ). With these basic competencies as a foundation, the students would be expected to work in teams to address each scenario from the perspective of a nurse leader and use a Plan-Do-Study-Act (PDSA) template to develop an evidence-based approach to address the situation. Each team was assigned to a hypothetical unit and expected to design an approach to the situation from the perspective of a nurse leader within that specific setting.

Each unfolding case study was presented through a Situation, Background, Assessment, Recommendation (SBAR) ( Appendix A ) as a standardized evidence-based communication technique ( AHRQ, 2019 ). Expectations for the student teams, including the assigned deliverables ( Appendix B , Appendix C ), were clearly defined for each module. Each module required the team to consider the work that needed to be done, consider roles and responsibilities of team members as nurse leaders within the context of the assigned unit/service line, develop a communication plan, and engage in a PDSA cycle to address the system problems presented in each module. Leadership roles within the team were rotated on a regular basis. Rotation of leadership roles and the repeated use of SBAR and PDSA within the five unfolding scenarios kept student groups engaged in cycles of change that led to proficiency in leadership, quality, and safety competencies ( Benner et al., 2010 ; Porter-Wenzlaff, 2013 ).

The MSN-clinical courses within this college are not graded. Students receive unit credit upon successful completion of required clinical hours, expected clinical activities, and competency development for their specific programs. Faculty monitor student clinical progress across time through regular review of student electronic clinical logs and clinical preceptor evaluations. Student logs capture identified clinical activities, student time, and student reflections. Preceptors complete electronic student evaluations at regular intervals throughout the clinical experience. Students receive one unit of credit for every 45 h completed. Clinical unit requirements ranged from 5 to 9 units based on the program.

Implementation

The thirty-two MSN students who participated were familiar with hybrid education (in-person and online) and the college's learning management system (LMS). The didactic portion of the MSN-programs were already delivered in a hybrid format. With assistance from two administrative support team members, each scenario was developed as a module. The virtual clinical modules were then uploaded on the college LMS, which provided the web-based infrastructure for the project.

Each clinical faculty was responsible for one two-week module. Each module began with a dramatic faculty recorded video clip providing an urgent charge for the two-week period. The SBAR, guidelines, instructions, resources, and timelines for deliverables were included in the recorded presentation. Written guidelines were also provided to the students. The interactive virtual clinical was introduced and implemented at the beginning of the final semester allowing students to acquire 80–90 clinical hours, approximately two clinical units.

Students were divided into teams of three to five members. Each team was assigned to a hypothetical nursing unit or service line within a health care system. The assigned settings included: Emergency Department, Intensive Care Unit, Step Down/Definitive Observation Unit, Employee Health Unit, Urgent Care, Clinic and Ambulatory Centers. Student teams scheduled synchronous virtual group meetings totaling 4 h each week using pre-assigned video teleconferencing links. The context and activities of the unfolding case study mirrored real-life events occurring within the COVID-19 pandemic ( Appendix A , Appendix B ). Each phase of the unfolding case study created a unique group experience for the students to synthesize their own real-world experiences, combine available evidence, and integrate the experiences of other students within the group to make critical leadership decisions.

Student group meetings

With every scenario, all student teams were directed to operationalize a response to the COVID-19 pandemic from the perspective of their assigned unit or nursing service line within their selected specialty ( Appendix A , Appendix C ). Working together, the students in each group discussed the challenges presented in the module. The group, under the guidance of the team lead, determined the actions to fulfill the challenges presented, decided who would complete each identified task, and developed a communication plan. The group focused on meeting the operational needs while maintaining the safety of the patients and staff within their respective hypothetical settings. Additional individual student work to support development of team deliverables accounted for the remaining clinical hours. This included but was not limited to literature reviews, exploration of clinical guidelines and regulatory requirements, and best practices in other settings. Synchronous virtual meetings were recorded and uploaded to the LMS for faculty to review teamwork and team dynamics.

Student roles and expectations

Specific roles within each team included recorder, member, and leader. Students' roles were rotated with each new scenario, allowing each student to enhance their team competencies. The recorder was expected to take meeting minutes and send the document within 24 h to the group to get approval prior to submitting it to the LMS grade center for faculty review. Each member of the student group was expected to actively participate in the group discussions and decisions, and to collaborate in the development of a plan using a PDSA template. All group and individual recommendations, plans, and decisions were evidence-based and included references.

Each student rotated through the role of team leader to guide the group through one scenario session throughout the span of the project. The team leader was expected to develop the meeting agenda, engage all team members, facilitate meetings to prioritize decisions and actions, hold group members accountable, and participate in a team leader meeting with the clinical faculty every 1–2 weeks. Team leaders met with clinical faculty for mentoring and formative feedback.

Role of clinical faculty

Due to the loss of clinical sites and clinical site preceptors, the clinical faculty role expanded to include the responsibility of being the clinical preceptor who monitored the groups' progress during the student leader meetings. The clinical faculty met regularly with the team leaders and served as mentors, guiding the team leader as they navigated their role and responsibilities. During the meeting between the team leaders and the clinical faculty, the students discussed the current group status, shared project successes, and addressed any challenges.

The clinical faculty assessed individual and group learning outcomes, observed competency development, promoted clinical reflection, facilitated debriefing, and provided feedback to the students. The faculty guided the MSN student team leaders to utilize evidence-based practices in group clinical decisions and helped them navigate group dynamics, including teamwork, collaboration, conflict management, delegation, and accountability. The team leaders were then expected to communicate feedback, latest information, and ideas gathered from the meeting with the clinical faculty to their team members for consideration as the plan and decisions were further refined. The faculty facilitated reflection on practice during rapidly changing circumstances to promote continued growth in clinical leadership competencies, while guiding application of theoretical knowledge in the simulated practice environment which could then be translated in the hypothetical health care setting.

Documentation

Group recordings and documents were submitted through the LMS for faculty review. Each team submitted a communication plan, meeting agenda, meeting minutes with recording link, the completed PDSA with references, and any other documents related to their assigned unit or service line at the end of each two-week scenario session. Faculty provided formative feedback to promote continued development of competencies.

An electronic clinical documentation program was used to track individual student activities. Each student documented their virtual clinical activities, competencies in progress or achieved, key learnings, goals, clinical experience reflections, and time logs throughout the duration of the virtual clinical group project. Clinical experience reflections were required to facilitate student assimilation of knowledge and experience into their professional growth as practicing nurses.

Evaluation of students

This post-licensure graduate course was a part of a four-semester series and was not tied to a specific didactic course. The MSN clinical course was a credit/no credit course, no letter grades were given. The clinical course was designed to allow students to integrate and apply knowledge and experiences to develop and enhance expected MSN clinical competencies. Students completed clinical hours and logged experiences while receiving mentoring and direction from a clinical instructor and a preceptor or mentor. MSN students specializing in leadership or ambulatory care nursing earned credit and clinical units when they successfully completed the course requirements.

Successful completion of this virtual clinical required demonstration of competencies in leadership, quality, and safety. The learning outcomes and competency development of each student were evaluated every one to two weeks through faculty review of group communication plans, roles and responsibilities chart, final PDSA with references and supporting documents, as well as individual clinical logs. Observation of the students during the recorded interactive sessions allowed faculty to evaluate the effectiveness of team leadership and team dynamics.

Faculty evaluated students using the college's standardized clinical evaluation tool which included a student self-assessment. The standardized clinical evaluation tool covered eight categories that aligned with program outcomes: 1) Integration of knowledge, 2) organizational and system leadership, 3) quality improvement and safety, 4) translating and integrating scholarship into practice, 5) informatics and healthcare technologies, 6) health policy and advocacy, 7) interprofessional collaboration, and 8) clinical prevention and population health. Each student was also given the opportunity to evaluate their peers using the same tool. Students engaged in self and peer evaluation.

As the students began this virtual clinical, some expressed angst over their ability to lead a team within this experience. As the student groups continued to work together during the semester, the faculty noted progressive growth of individual and team leadership skills. Individually and collectively, the students collaboratively integrated knowledge and experiences into competency development. Students expressed their satisfaction with the experience and highlighted how the project increased confidence in their ability as a nurse leader. The students were able to apply their real-world experiences to the interactive virtual clinical group project and overcome conflicting practices to reach a consensus decision.

Students successfully demonstrated their ability to critically think through a complex scenario and apply best practices in alignment with the available evidence to meet the ever-changing demands within the healthcare system. Each PDSA and additional submitted documents highlighted the groups' decisions and ability to develop evidence-based interventions and implementation plans throughout the complex unfolding case study. The PDSA submissions documented thorough planning at multiple system levels across the continuum of care to sustain an environment capable of high quality and safe patient care delivery.

Through the active participation of each student as a team member and team leader, there was progressive development of the required competencies to meet program outcomes. The student documentation demonstrated their ability to prioritize, communicate, and overcome obstacles in the face during a crisis. Through this interactive virtual clinical, the students gained a perspective of the nurse leader role in the hypothetical clinical setting. The team leaders reported the intense responsibility of the situation and being challenged with rapid cycle decision-making to positively impact the healthcare setting. Despite initiating the project with uncertainty, the students discussed their professional growth, highlighting their ability to lead a team and hold colleagues accountable. As the students explored opportunities to meet the challenges of the pandemic in this virtual clinical setting, their perspectives shifted from clinical nurse to nurse leader, broadening the student's worldview. All participating students successfully completed the clinical requirements to graduate on time.

As the pandemic overtook the healthcare system, many MSN students at the College of Graduate nursing lost access to onsite clinical experiences during their last semester of the MSN program. Innovative and creative solutions were needed to alleviate the disruption of in-person clinical rotations and prepare RNs to engage in the healthcare system as nurse leaders as they emerged from an MSN specialty program. Well-written unfolding case studies can facilitate development of desired nurse competencies ( Herron et al., 2019 ). The development of an interactive virtual group project using unfolding case study mitigated the risk of delayed graduation while promoting competency development in future nurse leaders.

Case studies and simulation that closely align with the real-world help bridge the theory to practice gap ( Benner et al., 2010 ). The design of the group project mirrored current health system challenges within the pandemic crisis, providing students with opportunities to advance their skills and engage in leadership, teamwork, collaboration, and evidence-based quality improvement activities. The MSN students were able to quickly adapt to the virtual simulated clinical experience since they were already familiar with online learning. In addition, the groups given the autonomy to establish their own schedule to meet the requirements of the interactive virtual clinical. The real-world based scenarios created the conditions for graduate level students to meet the desired outcomes: leadership, quality, and safety competency development.

The success of this virtual transformation demonstrated the value of a virtual clinical experience to promote leadership growth and development while enhancing student satisfaction. Multiple scenarios within the virtual interactive project enabled planned reinforcement to promote proficiency and facilitate group collaboration and engagement beyond classroom discussions ( Benner et al., 2010 ; Porter-Wenzlaff, 2013 ). The rotation between team member and leader role also enabled the students to experience more than one perspective as they gained appreciation for the role and responsibilities of the nurse leader in the current health care system. Several students shared that they now have a greater respect for the responsibilities and complex decisions their current unit managers were making during the rapidly changing environment of the pandemic.

Strengths and limitations

The interactive virtual clinical experience was developed by an expert faculty team who provided a blend of perspectives from academia and practice. Additionally, strong administrative support contributed to the success of an interactive project in a virtual setting. This project was developed collaboratively and quickly, with design and implementation within a 4-week period due to the pandemic and the urgent need for timely completion of the program. The faculty were confident in their collective knowledge and abilities to move forward together with the development and implementation.

The design of this interactive virtual clinical project was feasible during a time when students could no longer attend in-person clinicals. The virtual nature of this project kept students safe by minimizing physical contact with others and helping to conserve valuable resources, including personal protective equipment of which there was an extreme shortage. This type of project offered flexible scheduling for group members to meet and accomplish each assignment. The success of this project as a virtual alternative can in part be attributed to the students' previous exposure to virtual learning since the program encompassed a hybrid approach. Additionally, the students were able to bring their workplace experiences to contribute to the group discussion and assignments as many were currently practicing RNs.

This virtual clinical project also had some limitations. Due to the immediacy of the unfolding need, it was not designed to be a research project. As the student groups were assigned, the group assignment did not consider student work schedule. Feedback from the students indicated that the mix of day shift and night shift students within a group created a challenge when trying to schedule weekly meetings at mutually acceptable times. Students also felt group size should be around 5–6 students due to workload. Another limitation was that some students were newly licensed and did not have robust practice experiences from which to draw upon for contribution to the group discussions and plans. Additionally, a few students had no experience as an RN in the clinical setting.

Conclusions

There are future opportunities for use of similar virtual unfolding case scenarios to develop MSN competencies. Virtual competency development activities such as unfolding group case studies can provide ongoing experiences with a focus on specific competency development without compromising the quality of education. This interactive virtual clinical project can provide a robust template for future virtual clinical opportunities to continue developing future nurse leaders who are equipped to lead in complex and changing environments. In addition, there are opportunities to study long term effects of interactive virtual education for developing leadership, quality, and safety competencies. In the absence of in-person clinicals, the clinical faculty designed an interactive virtual clinical experience that promoted proficiency in MSN student leadership competencies and supported on-time program completion.

Declaration of competing interest

☆ This project did not receive any specific grant from funding agencies, in the public, commercial, or not-for-profit sectors.

Appendix A. An Unknown Life-Threatening Crisis

Sbar for weeks 1 and 2, appendix b. unfolding case study scenarios and expected outcomes, appendix c. team assignments.

Focus based on assigned setting (emergency department, intensive care unit, etc.). Role of team leader rotated every two weeks. The team leader created an agenda, facilitated meetings, and held team members accountable. The team scribe/recorder took minutes and posted them on LMS with recorded meeting link.

List of team assignments submitted to LMS by end of each 2-week period.

• 1. Roles and responsibilities of each team member and relevant stakeholders.
• 2. Communication plan within the team as well as within the health care system.
• 3. Virtual meeting minutes with recorded meeting link.
• 4. PDSA and any applicable documents (i.e.-decision algorithm), including reference list.
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• Why Are Entrepreneurs Important...

Why Are Entrepreneurs Important in a Private Enterprise System? An Honest Take

• May 15, 2024

Entrepreneurs hold a pivotal role within a private enterprise system, driving not just economic growth but also fostering innovation and societal progress. 

Their importance cannot be understated, as they contribute significantly not only to the economy but also to the very fabric of society. This article delves into the various ways entrepreneurs are crucial for a thriving private enterprise system.

Why Are Entrepreneurs Important in a Private Enterprise System?

Entrepreneurship is the act of creating a business while building and scaling it to generate a profit. However, it is more than just starting a business; it is about spotting opportunities, taking risks beyond security, and having an unwavering belief in your vision. 

It is entrepreneurship that spurs economic growth, introduces innovation, and helps resolve societal challenges. Essentially, entrepreneurship embodies the adventurous spirit of human aspiration, driving the private enterprise system forward.

Entrepreneurs are the backbone of innovation and economic growth. They bring forth new ideas and transform them into tangible goods and services, which results in job creation, increased productivity, and economic expansion. 

In essence, entrepreneurs are the engine that powers the private enterprise system, propelling it towards prosperity and development.

Key Roles of Entrepreneurs in a Private Enterprise System

Stimulating economic growth.

Entrepreneurs are instrumental in creating new jobs. When they establish new businesses, they require manpower, leading to job creation which, in turn, reduces unemployment levels. 

Moreover, as these new ventures grow, more jobs are created, thus further decreasing unemployment rates.

Beyond job creation, entrepreneurs boost economic activity through innovation and developing new business models. This continuous cycle of innovation and business creation is vital for sustained economic growth within a private enterprise system.

Innovation and Market Disruption

One cannot talk about entrepreneurs without highlighting their role in innovation and market disruption. They are the ones who introduce new products, services, and technologies that challenge the status quo, often rendering existing solutions obsolete. 

The stories of Uber and Airbnb are prime examples of how entrepreneurial ventures can disrupt markets, offering new, efficient solutions that better meet consumer needs.

Enhancing Society’s Wellbeing

Social entrepreneurship is another facet where entrepreneurs make significant contributions, addressing societal issues through innovative solutions that improve people’s lives. 

These enterprises aim to make a profit while also improving social, environmental, and cultural conditions. Through this, entrepreneurs enhance the wellbeing of society at large.

Contributing to National Income

Entrepreneurial ventures play a critical role in expanding a country’s tax base. As these businesses grow, they contribute more in terms of taxes, aiding in the development of the country. 

Furthermore, entrepreneurs help in increasing export potentials, earning valuable foreign exchange due to their innovative products and services.

Fostering Healthy Competition

Competition is essential for innovation and efficiency. Entrepreneurs foster competition by challenging existing businesses with new solutions and ideas. 

This competitive pressure forces existing businesses to innovate, improve product quality, and efficiency, benefiting consumers and the economy.

Challenges Faced by Entrepreneurs and How They Overcome Them

Entrepreneurs often face numerous hurdles, including gaining access to capital, navigating market access, and dealing with regulations. 

Despite these challenges, many entrepreneurs find success through persistence, innovation, and adapting their strategies. They overcome obstacles by being flexible, seeking mentorship, and continuously learning from their experiences.

The Global Perspective on Entrepreneurship

In a globalized economy, entrepreneurs play a crucial role not just domestically but internationally. They drive economic diversification, particularly in developing countries, facing and overcoming barriers with innovative solutions. 

This global perspective underlines the importance of entrepreneurs in fostering a diversified, resilient global economy.

The Future of Entrepreneurship in the Private Enterprise System

The future landscape of entrepreneurship is likely to be shaped by technology and digital transformation. As the digital economy continues to expand, entrepreneurs will play a key role in introducing new digital solutions and platforms. 

Emerging trends suggest an increase in digital entrepreneurship, highlighting the evolving nature of innovation and business creation.

Case Studies of Successful Entrepreneurs

Certainly! The world of entrepreneurship is rife with diverse success stories, each illustrating unique paths and strategies. Here are a few case studies showcasing such variety:

1. Sara Blakely – Spanx

Background:.

Sara Blakely started her journey with a simple idea driven by a personal need. While working in sales, she was looking for pantyhose that didn’t have seamed toes and would sit flat under her clothes.

• Blakely took $5,000 of her personal savings to research and develop a prototype.
• She relentlessly pursued hosiery mills to manufacture her product, facing numerous rejections before finally securing a partner.
• Blakely patented her invention and managed marketing and distribution mostly by herself.

Spanx now has expanded into a global brand worth over a billion dollars, making Sara Blakely one of the most successful self-made woman entrepreneurs.

2. Tony Hsieh – Zappos

Tony Hsieh was a Harvard graduate who sold his first company, LinkExchange, to Microsoft for $265 million. He later became the CEO of Zappos, an online shoe and clothing retailer.

• Hsieh focused on company culture as a core part of Zappos’ success. He believed in delivering exceptional customer service and creating a positive work environment.
• He introduced a policy of free shipping both ways to reduce customer purchase hesitation.
• Hsieh instituted a self-management organizational structure named Holacracy to boost innovation.

Zappos became synonymous with outstanding customer service and was sold to Amazon in 2009 for $1.2 billion.

3. Jan Koum – WhatsApp

Jan Koum emigrated from Ukraine to the United States at the age of 16. Before creating WhatsApp, he worked at Yahoo for nine years.

• Koum and his co-founder Brian Acton focused on creating a user-friendly messaging app that didn’t rely on ads.
• They concentrated on creating a cross-platform app ensuring real-time messaging was simple and quick.
• Despite limited marketing resources, the app’s quality led to organic growth, supported mostly by word of mouth.

WhatsApp rapidly gained users worldwide and was acquired by Facebook in 2014 for approximately $19 billion.

Frequently Asked Questions

Why is entrepreneurship considered a key to economic development.

Entrepreneurship is crucial for economic development as it creates new jobs, drives innovation, and contributes to national income, leading to economic growth and development.

How does entrepreneurship affect the job market?

Entrepreneurship positively affects the job market by creating new jobs. As entrepreneurs start and grow their businesses, they need to hire more people, thereby reducing unemployment levels.

What are some common characteristics of successful entrepreneurs?

Successful entrepreneurs often share traits such as creativity, persistence, adaptability, a willingness to take risks, and the ability to identify and seize opportunities.

Can entrepreneurship be taught, or is it an innate skill?

While some aspects of entrepreneurship, such as creativity and risk-taking, may be innate, many entrepreneurial skills can be learned and honed through education, experience, and mentorship.

How do government policies impact entrepreneurship in a private enterprise system?

Government policies can have a significant impact on entrepreneurship by either fostering or hindering entrepreneurial activity. Policies that reduce bureaucratic hurdles, provide easy access to finance, and support innovation can encourage entrepreneurship, while restrictive policies can stifle it.

Entrepreneurs serve as the lifeblood of a private enterprise system, injecting vitality, innovation, and growth. By understanding their key roles and the challenges they face, we can create a nurturing environment that celebrates and supports entrepreneurial endeavors, paving the way for a prosperous economic future.

Entrepreneurs are indispensable in a private enterprise system. They spur economic growth, lead innovation, tackle societal issues, and much more. 

Encouraging an entrepreneurial culture is crucial for sustainable economic development. As society continues to evolve, the role of entrepreneurs in driving progress and prosperity remains unquestionably significant.

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Laser Clinics was a global success story, but like so many before, a franchising scandal could bring it undone

Analysis Laser Clinics was a global success story, but like so many before, a franchising scandal could bring it undone

"Con artists", "amateurs", "Avoid! Avoid! Avoid!" are some of the more polite reviews that lit up social media when a global retail franchise network started closing stores with little thought for its customers who had pre-paid for services.

Laser Clinics, which offers laser hair removal, injectables and other non-surgical cosmetic treatments, first opened in Australia in 2008 and now has more than 200 clinics globally. It's battling a PR crisis as some of its UK stores close, attracting the wrath of customers on social media, in newspapers and on TV.

It comes as some franchisees threaten legal action, claiming they are being driven out of business by the owner of the franchise, private equity giant KKR, famously referred to as "barbarians at the gate".

The Laser Clinics website includes a map with more than 100 stores in Australia, 20 in New Zealand, 50 in the UK and seven in Canada. Its Asian clinics have disappeared from the website after the franchise expanded there just a few years ago.

The bad publicity is spreading like wildfire, with one customer posting on trustpilot.com: "One after the other the clinics are closing down … This is the downfall of [the] major Australian company Laser Clinics … The customers are left with no notice of the closures, the management should refund all customers' hard-earned money. Media has unveiled the reality about their methods of operations, so public is not duped."

On May 8, the BBC's popular consumer program , Watchdog on The One Show, shone a national spotlight on the situation when it interviewed a series of customers who had bought treatments in advance only to find the clinic had shut down. They said they were either told they couldn't get a refund or advised to go to the nearest clinic that was still operating, which was an hour away by transport.

It isn't the first time Laser Clinics has found itself at the centre of controversy.

In 2021, the company  made headlines in Australia when 52 of its franchised clinics sent the firm   a legal letter alleging they were being gouged on costs for equipment and supplies and by an aggressive discounting of treatments.

That stoush ended when KKR did a deal with most of the 52 aggrieved clinics to buy them out.

Since then, things have gone downhill for many franchisees, both here and overseas. COVID hit, more competitors entered the industry and, in Australia, a series of regulatory reforms including advertising restrictions made it harder to attract and retain customers.

A case study in what happens when franchising goes wrong

Laser Clinics first opened in Australia in 2008 as a franchise network set up by former ­actuary Babak Moini and legal IT expert Alistair Champion. It was sold in 2017 to KKR, which expanded its footprint globally, including opening in the UK in 2019.

Unlike the original founders, who franchisees described as passionate about the business and having treated   the franchise as a partnership, franchisees say the very nature of private equity is to buy assets with a view to squeezing as much out of them then flipping them in three to seven years. They say decisions are made based on numbers and with a short-term horizon.

Franchising represents almost 10 per cent of Australia's GDP, employs more than half a million workers and, according to the Franchise Council of Australia, includes 1,200 franchisors and 94,000 franchise outlets, many of them hard-working Australians who have used their retirement savings to buy a ready-made business with a brand and systems in place.

When franchising works, it works well — but when it doesn't, it can be devastating for franchisees and workers.

In the past few years, the industry has been dogged with scandal after scandal, including convenience store giant 7-Eleven , which was recently sold, Retail Food Group, whose brands include Donut King, Brumby's, Gloria Jean's, Pizza Capers, Crust Gourmet Pizzas and Michel's Patisserie , and came under scrutiny when it was found to have squeezed its franchisees mercilessly with a string of fees, royalties, rebates and refurbishment costs. Others include listed pizza giant Domino's, which was exposed in 2017 over some unscrupulous business practices .

To put it into perspective, in the past 30 years there have been 18 inquiries into franchising. The last one, in 2019, found that the regulatory system had "manifestly failed to deter systemic poor conduct and exploitative behaviour and has entrenched the power imbalance".

It likened what was happening in the franchising sector to the bad behaviour uncovered in the banking royal commission.

Franchisees 'cannot wait to leave'

This behaviour has spread to the UK, with a number of disgruntled Laser Clinics franchisees speaking to me on the condition of anonymity.

One, who still runs a clinic in the UK, said Singapore had gone and Canada was also struggling. She said it was difficult to find a buyer for franchisees trying to exit the Laser Clinics network.

"No-one will invest in this company … It's a complete shit show," the franchisee said.

"Articles in the national newspapers, franchisees going legal. It's just crazy. I simply cannot wait to leave."

Another said a marketing strategy of constantly discounting the treatments was a tipping point for many. Pricing is controlled by the head office and franchisees in the UK and London claim that customers have been conditioned to wait for the sales.

In the UK, some stores are being bought back from KKR for one pound. This offer has been made to walk away from the clinic while still possibly incurring further costs of tens of thousands of pounds but being relieved of the main debt and released from any personal guarantees other than for laser machines bought on finance if the clinic is to close permanently. So far four franchisees are said to have accepted the offer.

Some of the stories are harrowing, including couples investing their life savings only to discover their dream of running a small business with global partners was more like being an employee trapped by their money.

"Despite working 15 to 17 hours a day, seven days a week, I received no support from Laser Clinics system and head office staff," said one of the many current and former franchisees I spoke to.

The franchisee, who asked for anonymity due to fears of retribution, said Laser Clinics had destroyed them in ways they never thought possible.

"This lack of guidance and assistance took a toll on my mental and physical health, resulting in severe depression and heart palpitations and even drove me to contemplate suicide," they said.

Another said the experience of becoming a Laser Clinics franchisee had been devastating.

"In such a short time my marriage, family and friendships have collapsed and I'm not living with my children anymore. I am now unable to even pay [for] the most basic [things] like food, and all my bills and debts are uncontrollably continuing to soar," they said.

Some franchisees sent a legal letter in February this year outlining their concerns. The letter claimed that head office misrepresented the financial outlook of the clinic they bought into and that operating costs were understated, such as inaccurate assurances as to the number of staff required to run each clinic adequately. It said fixing prices at which the clinics could sell treatments had an adverse impact on business.

"As such, they have been saddled with franchise operations that are far less profitable than anticipated and, in some cases, loss-making and likely to remain so," the legal letter said.

Laser Clinics was sent a list of questions. It ignored some of them and instead provided a statement that said it continued to invest strongly in its leadership, offering and people "as we deliver on our ambition of being the global leader in skin treatments".

It said its goal was to support the long-term success of all its franchisees. "They are front and centre of our strategic plan and their success is pivotal to our growth and to our joint venture model."

In the UK, it said it was working to re-open and invest in several clinics. For those that had been permanently closed, it said, where possible, any pre-paid treatments had been transferred to the closest available clinic. "If a suitable alternative is not available, Laser Clinics is working with the client to consider their options in line with our legal obligations.

"For our clients and team members in our larger clinic network in the UK, this change has no impact and it is business as usual."

But the poor treatment of some UK franchisees and the brand damage caused by mishandling some customers has sent a chill wind through the global network which it will need to address. If it continues to brush it off as "business as usual" it may find itself holding an asset with limited appeal.

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