CHAPTER ONE
INTRODUCTION
Background Of Study
Entrepreneurship in the health care sector is not a new phenomenon. Already before World War II, many nurses worked as entrepreneurs. After the war, nurses began to work in public services in many countries due to social and economic changes. Approximately 1% of all nurses work as entrepreneurs (ICN, 2004). A nurse is defined as an entrepreneur if he or she offers different nursing services in private-sector markets: care, education, research, and administrative work (Wilson, Averis and Walsh, 2004).
The costs of health care have continued to increase, alarming those within and outside the industry. It is quite common to hear about escalating costs and insurance premiums, in addition to budgetary cutbacks as major concerns facing the healthcare industry. Many have suggested that entrepreneurship will play an important role in the transformation of this industry (Allen, 2008). One of the recognized segments of entrepreneurship is the nurse entrepreneur, where an autonomous independent nurse works directly with clients in a private practice setting (Smith, 2006). It is widely believed that nurse entrepreneurs offer a cost-effective alternative for specific types of health services. Additionally, the low overhead of a nurse entrepreneur allows these services to be offered in areas underserved by hospitals (Cook, 2005). Current literature, White and Begun (2008) does not elucidate the knowledge and attitude and what factors inhibit the readiness of nurses to become entrepreneurs, hence, this study.
Nurses have been launching businesses for many years starting with private duty nursing at the turn of the 20th century which was later replaced by institutional nursing after WWII (ICN, 2004). Private-duty nursing was the main form of work for nurses during the first 50 years of the profession and in many ways was the precursor to nurse entrepreneurship as it is today (Shirey, 2015). The empowerment, entrepreneurial skill, and control over professional practice that was exhibited by the early 20th century private-duty nurse can still provide an example for today’s nurses (Whelen, 2012). Nurses in the 21st century are more educated, valued, and respected than ever before which positions them well to advance the profession through entrepreneurial endeavors (Shirey, 2015).
There has been a return to nurse entrepreneurship in the past few decades due to a variety of social and economic factors that have promoted innovative approaches to health care delivery (ICN, 2004). Based on those same factors, nurses are relied on to fill more leadership positions in health care to assist with the needs of a changing health care system (IOM, 2011). Nurse practitioners (NPs) have been proven to provide an equal level of care when compared to physicians and are in a position to be able to provide high quality and affordable health care (Horrocks,, Anderson and Salisbury, 2002). These characteristics of affordability and high quality make NPs well suited for business ownership. Nurse practitioners interested in opening their own practices need to possess business and leadership skills to be successful. These skills are beyond the scope of graduate nursing education and the entrepreneurial NP must search out relevant resources and guidance, independently.
Social, political, and economic factors such as an economic crisis, the dissatisfaction of nurses with their work, and changes in the health needs of the population and consumers have caused more nurses to become entrepreneurs during the last decades (Boore and Porter, 2001). The development, scope of practice, and regulation of nurse entrepreneurs will also depend on economic infrastructure and policies implemented at the national, regional, and local levels (Department of Health, 2010).
The notion of entrepreneurship is not relevant for clinical nurses only; it is relevant for any nurses who are in managerial positions and need to understand changes in the organizational process.
During times of economic uncertainty, knowledge about entrepreneurship and entrepreneurial skills can be exploited when health care staff needs to figure out how to do more with fewer resources (Boore and Porter, 2010). Some studies indicate that a lack of competence in entrepreneurship is a major barrier for nurses who want to become entrepreneurs (Drennan, Davis, Goodman, 2007). Nurse entrepreneurs claim that when their education is based on the traditional forms of nursing, it does not provide them with enough knowledge about entrepreneurship or establishing and running a company (Elango, Hunter and Winchell 2007).Therefore, a critical discussion about the role of education in enhancing entrepreneurship among nurses is needed.
Statement of Problem
The ever increasing population is faced with numerous health challenges. These challenges, demands healthcare services which the few healthcare providers cannot meet up with. This therefore, calls on nurses to set up healthcare services. Establishment of health care services is an aspect of nursing entrepreneurship. There is a strong need to understand the nurses knowledge of entrepreneurship their attitude to confront the barriers confronting the entrepreneurship hence this study.
Justification of Study
This study will help in the reduction of the involuntary unemployment in Nigeria, firstly among Nurses and secondly to other employees that will be employed in the establishment. The burden of unemployment in Nigeria has broaden its tenets to nurses especially those in the south south of the country due to the early turnout of saturated nurses into the labour market. It has been observed that some nurses take employment in private hospitals where they are overworked and only to receive ‘peanut salary’’ at the end of the month another category that are self employed who call themselves nurse entrepreneur do not focus their business on nursing (for professional development) rather they turn themselves into mini pharmacist and petty traders.
Objective of the Study
This study seek to attain the following objectives:
1 Assess nurses knowledge of entrepreneurship.
2 Ascertain their attitude regarding entrepreneurship in nursing.
3 Identify perceived barriers regarding entrepreneur in nursing.
- To raise insight into solving the involuntary unemployment among Nurses.
- To instigate nurses into being an employer and job creator
Significance of the study
The study will reveal level of knowledge attitude and practice of nursing entrepreneurship among selected registered nurses in the area. This study will therefore be needful in the following areas:
- The Nurses: This may sensitise the various nursing organizations of the need to mount aggressive aweaness programmes on the potential of nurse and how to harness the resources in her environment.
- The Policy markers: Policy issues on how to sourmount barriers and curb nurse unemployment in the area may be based on the findings. Results may also generate comparative study in other areas.
- The public: The study will also add to existing sparse literature surrounding entrepreneurship in nursing, especially in Nigeria.
Research Question
1 What is the nurse knowledge to entrepreneurship?
2 What is the nurse attitude regarding entrepreneurship in nursing?
3 What is the perceived barriers regarding entrepreneur in nursing?
4 What can be done to increase knowledge and reduce the barrier?
Scope of the study
The study is delimited to all nurses in Irrua specialist teaching hospital, Edo State.
Operational definition of terms
Nurse
A nurse is defined as an entrepreneur if he or she offers different nursing services in private-sector markets: care, education, research, and administrative work (Wilson, Averis and Walsh, 2004).
Nursing
Nursing means caring professional practices by a person registered with the Nursing Council, who supports, cares for and treats users to achieve or maintain health and where this is not possible, cares for a user so that he or she lives in comfort and with dignity until death (South Africa, 2005).
Entrepreneurship
Entrepreneurship is described as an extremely creative process that connects creativity, dreams, and imagination by entwining them with realistic application of economic principles that conclude in the transformation of an idea into a tangible product with social and /or financial benefits.
Attitude
Attitude is a psychological construct, a mental and emotional entity that characterizes a person. They are complex and an acquired state through experiences.
Knowledge
Knowledge is a familiarity, awareness, or understanding of someone or something, such as facts, information, descriptions, or skills, which is acquired through experience or education by perceiving, discovering, or learning
Barriers
A boundary or limit. An obstacle or impediment. Something that separates or holds apart. A physical or biological factor that limits the migration, interbreeding, or free movement of individuals or populations
