Patricia S. Moore

You don't have to leave your hospital system to be an entrepreneur.

CLIN ICAL NURSE SPEC IALI STTM A misconception among clinical nurse specialists (CNSs) is that entrepreneurial activities can only be accomplished in the private sector and not within hospital systems. However, there are two kinds of CNS entrepreneurs: an entrepreneur, who works outside of an organization and an intrapreneur, who takes hands-on responsibility for creating innovation as an employee of an organization.1 Pinochet developed the concept of intracorporate entrepreneurs in 1976, and the concept has continued to grow since that time primarily by companies and not hospital systems. CNSs with an entrepreneurial spirit may not wish to leave hospitals to become entrepreneurs. In fact, hospital systems that embrace entrepreneurship will find themselves on the cutting edge of patient care with system growth and economic advantage. However, few CNSs consider framing their work as an intrapreneurial endeavor. As a part of expected CNS work, patient care problems may be solved through the introduction of new products, redesign of processes, or addition of new services.2,3 For CNSs to be intrapreneurial, in addition to being traditional clinical problem solvers, the CNSs will use intrapreneurial thinking rather than corporate thinking to solve patient care problems. Using traditional or corporate thinking means that CNSs look for how others have solved similar problems, recommending purchase of existing products, or introducing new services similar to what other hospital systems have previously developed. In other words, traditional CNSs will look to strengthen and improve hospital systems using existing solutions. What makes the CNSs’ work intrapreneurial rather than part of expected performance? Innovation is a hallmark of CNS intrapreneurs. CNS intrapreneurs are actionoriented dreamers. They may spend considerable time building and testing their mental images about new care processes or products. Others may believe they are daydreaming. However, it is the creation and testing of mental images that is the prelude to actualizing their dreams to improve practice and contribute to the economic advantages of their hospital systems. One difference between CNSs as inventors and CNSs as intrapreneurs is that inventors create new products and processes in their minds or even on paper, but intrapreneurs bring their ideas into systems to solve patient care problems. CNS intrapreneurs focus not only on the patient care benefits of change but also on the economic value of the innovations. When CNSs think about ways to deliver better patient care, they not only want to improve care for the patient but also want hospital systems to benefit. All CNSs are concerned about cost-avoidance and costreduction, but CNS intrapreneurs are also looking for revenue generation from their innovations. CNS intrapreneurs are concerned about enabling their hospital to grow and profit—how to turn their ideas into profitable reality. Because of these attributes, CNS intrapreneurs are not only willing to assume some of the risks of innovation but also to seek to participate in the benefits realized by hospital systems. These attributes are what differentiate traditional CNS work from CNS intrapreneurship.

The diabetes educator as an entrepreneur: Starting your business

If you determine that you have many of the attributes of an entrepreneur (including being a risk taker), if you have a passion for your products and services, and if you are willing to risk an uncertain income, then you are ready to be an entrepreneur. The steps outlined in this article provide a basic overview of how to set up a business. If you decide to become an entrepreneur, there are numerous books and Web sites to guide you through the steps of establishing and managing a business. Although the challenges of becoming an entrepreneur may seem intimidating, becoming an entrepreneur can be very rewarding.