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Entrepreneurship
BRIEFS Entrepreneurship: Advancing Education and Practice Program Objectives LYNN,SCRUBY, RN, MS,* A N D Nursing education programs require the use of clinical settings for the attainment of student learning objectives. These settings are usually negotiated annually between the educational programs and the host health care agencies. The view of negotiation that is held by both parties either advances or limits the attainment of learning and practice program objectives. When negotiation is viewed within the entrepreneurial context, the nurse entrepreneur within the clinical resources field is able to recognize what is unique in the setting, the learner, and the subject so that both the educational setting and health care agency can benefit. The authors discuss their experience with negotiating for clinical learning resources for university nursing students. Six entrepreneurial strategies for successful negotiation are described. The strategies include aspects of systems change, transformational leadership, the marketing of knowledge, and new program development. (Index words: Entrepreneur strategies; Marketing strategies; Nursing, education.) J Prof Nurs 3:307-310, 1987.
'ursing education programs require the use of clinical settings for the attainment of student learning objectives. These settings are usually negotiated annually between the educational institutions and the host health care agencies. The view of negotiation that is held by both parties either advances or limits the attainment of
N
*Assistant Professor and Community Resources Coordinator, University of Manitoba, School of Nursing, Winnipeg, Manitoba, Canada. tNursing Consultant, Practice at the Manitoba Association of Registered Nurses, Winnipeg, Manitoba; Adjunct Professor, University of Manitoba, School or Nursing, Winnipeg, Manitoba, Canada. This article is based on the authors experiences as Community Resources Coordinators at the University of Manitoba, School of Nursing, Winnipeg, Manitoba, Canada. Address correspondence and reprint requests to Ms. Scruby: Assistant Professorand Community ResourcesCoordinator, School of Nursing, University of Manitoba, Room 246, Bison Building, Winnipeg, Manitoba, Canada R3T 2N2. 8755-7223/87 $0.00 + .25 J O U R N A L OF PROFESSIONAL NURSING
PATRICIA
FARRELL,
RN, MSct
education and practice objectives. This article focuses on the mutual benefits that can be achieved by organizations that recognize the value of negotiation within the entrepreneurial context. The entrepreneur is different from the person who only negotiates, coordinates, or manages. ~ Entrepreneurship may incorporate all of these functions but must also include marketing and leadership in order to promote the desired activity. 2 Entrepreneurship when applied to the relevant educational dimensions of subject, student, and setting provides a strategy for the attainment of program objectives for both the educational institution and the health care practice setting)
Why Entrepreneurship?
The vast majority of literature dealing with the concept of entrepreneurship is found in the field of business and only recently do we see the concept beginning to surface in the nursing literature. While the meaning of entrepreneurship has had negative connotations, it momentarily serves to expand the previously limiting treatment of acquiring clinical learning resources. The authors believe that the concept of the nurse entrepreneur as a successful and enterprising negotiator will gain acceptance and recognition by the nursing community. Since the entrepreneurial approach assists in identifying benefits resulting from the cooperative sharing of resources, the outcome for both educational and practice settings will be a graduate capable of competing in the market place of health care delivery. Corporate business settings are often used for student learning in relation to the health of the employee. The concept ofentrepreneurship is not new to the business community. From the corporate point of view, the cost-effectiveness of producing the end product is a priority. Anything that will benefit this end objective will be readily entertained as a feasible and workable approach. The entrepreneurial notion of marketing the value of the nursing student implies a restructuring of the health professionals' approach with a language and style that is understandable to the business community. Since the student practices in many different settings, it is necessary for the negotiator
• SEPTEMBER-'OCTOBER
1987
307
308
J O U R N A L OF PROFESSIONAL N U R S I N G
•
SEPTEMBER--OCTOBER 1 9 8 7
to relate effectively to all members of the health professions and the corporate business community. A persistent problem identified in the literature is the gap between nursing education and the practice of nursing. Various solutions have been proposed. Among these are joint appointments of faculty and practitioner; senior nursing student elective experiences; the use of non-traditional practice settings; and attention to the socialization of the student into the professional role through student membership on professional committees. The authors propose the entrepreneurial approach as a solution. Negotiators on both sides, education and practice, can view the acquisition of clinical learning space not as a purely technical problem, but rather a knowledge, idea-building process for progressive change. Therefore, ideas can be the power tools to achieve understanding and bridge the gap between nursing education and practice. The entrepreneur is creatively innovative and will view the problem from various perspectives giving rise to mutual agreement based on alternate innovative solutions. Kanter suggests that we need to view innovation within the context of new ideas and strategies for problem solving. 4
Essential to the entrepreneurial approach is knowledge networking. Knowledge networking evolves from networks we establish: "networks offer what bureaucracies can never deliver--the horizontal link. ''5 There are trends pushing for a new management style based on the network. W i t h i n the context of knowledge networking, the objective of the nurse entrepreneur is to creatively apply relevant practice setting information to the mutual advantage of the negotiating participants. According to Naisbitt, our organizations will be restructured into small units, more entrepreneurial units, more participatory units that will come to support knowledge networking. There are many good ideas within organizations that have market value. The organization that facilitates people to actualize those ideas will have tapped a rich resource. Entrepreneurship is a special way of approaching subject or knowledge problems. W e need to move from the thinking of technical innovation to innovative, cognitive, problemsolving approaches. "Nurses can learn valuable lessons from business on how to succeed in a competitive environment. To succeed in these challenging and changing times nurses must become innovators who welcome change as a creative opportunity."4
Educational Dimensions
THE STUDENT DIMENSION
The use of the Chater framework facilitates an exploration of the concept of entrepreneurship within the three interacting dimensions of subject, student, and setting. 3 Chater envisions the three dimensions as three overlapping circles. The entrepreneur functions best within the overlapping areas of the three dimensions. From this vantage point, a clearer perception of the mutual benefits to education and practice can be achieved.
How is the student conceptualized within the entrepreneurial framework? The entrepreneur is one who organizes, promotes, or manages the student. The promotion of the student also involves marketing. How is the university nursing student different from all other students, across disciplines, competing for learning experiences? If the traditional negotiating framework prevails, the assumption is one of equality . . . each student from each school has the right to equitable learning space. If the framework of entrepreneurship prevails, the learner must be promoted as special and the agency that accepts that learner is a benefiting agency. The entrepreneur will be able to "sell" the recognition of true benefits. This may vary from special projects conducted by the student, to eventual employment and leadership within the setting. An example would be students providing an employee health education program on site that is seen by the employer to benefit both corporate objectives and employee health. The entrepreneur not only sells the "benefits" but also strengthens the perception of the role the agency must play to achieve quality nursing care. The agency that "has something to offer" is the one that learners will perceive as necessary to their learning. Helping the agency to this commitment is part of entrepreneurship. The nurse entrepreneur must also attend to the special needs of the adult learner. For example, the diploma graduate who has returned to university to obtain a baccalaureate nursing degree after several years nursing experience has different learning requirements than the high school student entering the same university program. This learner needs to build on or creatively utilize past work experience while learning new leadership skills. Active involvement by the student in the entrepreneurial approach would facilitate this process. If the framework for satisfying this variety of learner objectives is limited to "negotiating" space for learners, what may result is a fixed agreement for
THE SUBJECT DIMENSION
The subject dimension refers to the knowledge component in the discipline of nursing. How can nursing create a market for its knowledge or subject? The theory, research, and practice knowledge generated in academic settings can be used by agencies for their benefit. University schools of nursing are mandated by the very nature of the university system to generate knowledge. The nurse entrepreneur can bring an interpretation of knowledge to the health agencies that is creative, fresh, and alive adding to the body of knowledge with which we are familiar. Entrepreneurs are able to create opportunities for the dissemination, understanding, and the beneficial application of knowledge. Similar to entrepreneurs who create new businesses, nurses can be entrepreneurs who create innovative ways of applying knowledge. As reflected in the research of Naisbitt, a trend in society is the mass production of knowledge and "this knowledge" is the driving force of our economy. 5 More specifically, in academic settings there is a limited movement of knowledge for public u s e - the knowledge while available is primarily used by academics. The entrepreneur is free to create markets for existing knowledge. The outcome is new opportunities for student learning supportive of the creative thinking of both academician and practitioner.
SCRUBY AND FARRELL
309
ENTREPRENEURSHIP
a specified number of spaces in pediatrics or a specified number of spaces in community health. Learning objectives are sacrificed to available space. The spirit of entrepreneurship may, indeed, sacrifice a few learning objectives at times, but also has a ready eye for new and untried space opportunities. The entrepreneur will "negotiate" the basic space but will promote the learner as unique and able to move into previously untried settings. The entrepreneur is cognizant of health care trends and will not readily entertain a settlement of traditional hospital medical-surgical experience if the learning objectives can be met in new community or ambulatory outpatient settings or programs. In summary, the entrepreneur conceptualizes a negotiating position by presenting the student as a benefit to the agency and interpreting the value to the agency as a participator in the education of the professional nurse.
THE SETTING DIMENSION The problem of acquiring appropriate settings for the student can be best dealt with by the nurse entrepreneur. This is because the entrepreneurial approach will increase awareness of benefits to the setting provider. Historically, the Greeks did not hold the enterprising individual in high regard especially since it was viewed that one person's profit was another person's loss. As Martin points out, profit remains suspect in the minds of many people today. 6 In the establishment of cooperative systems the nurse entrepreneur is interested in gaining what is essential for her organization to meet its goals. Clinical practice experience is essential for the education of the baccalaureate nurse. On examination of the education and health care delivery systems, specifically their restraints and limitations, the authors found the organizational structure of systems communication and personal views on the use of human and other resources could be forces to impede or facilitate the negotiation process. The common perspective they encountered was that clinical learning space ought to be divided equitably among all schools requesting access, giving something to all requesting parties. The future however, requires that agencies will need to have their priorities in place. As demand for clinical practice settings increases, the negotiator who can assist in the enhancement of the agencies' goals will be the successful negotiator. This is recognized by the entrepreneurial negotiator as a viable opportunity. The successful negotiation for suitable clinical learning space requires that the nurse entrepreneur has current, accurate knowledge about the real priorities of the health care system and the business community. This knowledge about each setting should include relevant information about priorities related to time, budget, and public relations. One example is the new, or previously untried use of a corporation as a setting for student projects on health promotion. The nurse entrepreneur over a business lunch with corporate executives can learn what the special priorities of the corporation are. Are there special time frames or budget deadlines facing the executive that might be eased by the timely introduction of a new idea that has relevance for the corporate image? Is there specific knowledge that the corporation needs which the student project might address?
The corporate executive is enabled to enhance the corporation as caring about the health of its employees. Furthermore, new knowledge may be left with the corporation in the form ofself-heahh assessment packages and structures for health promotion support groups. Another example of innovative setting use, but within the existing system, requires that the nurse entrepreneur strive to sit on relevant boards of directors or participate as a member of special government task forces to examine aspects of the health care system. In this way the nurse entrepreneur can gain inside information in a timely way. Such information might include planning for expansion of a particular in-hospital setting. Matching the right learner to that setting might result in facilitating the process of change of introducing existing staff to a new idea in a nonthreatening but influential manner. The staff could be sensitized to some aspect of the planned change in advance of a greater agency effort. Negotiating in the entrepreneurial style places a high value on total understanding of leadership. Leadership is generally the strategic factor in cooperation and includes a management style based on networking and participation. The competitive aspect of acquiring clinical resources for student practice needs to be recognized. The entrepreneur will take up the challenge, tune up negotiating skills, compete in the market place for outcomes advantageous to the learning of the student, and be able to point out the ultimate benefit to the agencies themselves. The entrepreneur will show a willingness to take risks, to try the untried, in other words to represent the problem in an innovative way while demonstrating benefits to the agency. The outcome of successful negotiation is the recognition and valuing of the product, in this case the student, that will indeed meet the needs of society in the market place of health care.
Marketing Strategies The clinical resources entrepreneur, negotiating with the key persons within an organizational structure, can view this process as an opportunity to effect change on existing systems with mutual benefit to the program objective of both agency and university schools. In order to extend leadership to this situation, the first strategy of the entrepreneur must be to identify key persons in the negotiation process. In the authors' experience, the least successful method was agency-initiated meetings where all schools together bargained for the space available in a competitive auctiontype environment. The result was noncooperation. The most effective method was to identify the key persons who represent the agency and work together with them in a direct agency to university school, one-to-one relationship. A positive outcome of this strategy was the releasing of additional clinical learning space and creative use of existing clinical learning opportunities. Frequently, it is not the people but the system that is at fault and requires change! The entrepreneur must have the sensitivity to rebalance the system to incorporate the necessary change. The successful *entrepreneur will initiate alternative options for the agency to
310
JOURNAL OF PROFESSIONAL NURSING
change the negotiating arrangement in order to achieve agreement. A second strategy involves empowering host agency personnel, who may be functioning within fixed stiuctures or systems, to use the concept of entrepreneurship. The idea of restrictive dependence is turned to advantage in indicating to agency personnel the opportunity for independence within their structures, while advancing the overall goal of higher level health care. Establishing congruence between education and practice program objectives and priorities on a face-to-face basis can provide an opportunity for empowering to succeed. A third strategy requires the entrepreneur to communicate the nature of knowledge within the academic environment thereby freeing the use of knowledge by the host agency for practice and continuing education. The entrepreneur can thus assist in the dissemination of research knowledge generated by faculty and students, resulting in the translation of research into social action. A fourth strategy is the development and participation in projects of mutual benefit. This might take the form of proposal writing, systems design, policy change, and exploration of settings not previously used for student learning. A fifth strategy in the entrepreneurial approach is to create a market for new programs and respond to the need of the agencies for better prepared nurses. The entrepreneur can use a marketing approach to new program development. Knowledge of both the academic and practice settings can be used to stimulate agency desi:'e for a better prepared nurse and educators' provision of attractive programs. This approach is clearly evident in some of the program development and revisions in baccalaureate education for registered nurses. A sixth strategy within each setting is the identification of the resources needed for a successful entrepreneurial effort. These include secretarial support and allotment of sufficient time for proposal development, preparation of marketing strategies, and networking. This strategy can
• SEPTEMBER-OCTOBER1987
then be extended to the concept of shared resources between the university and the host agencies.
Conclusion Leadership in the entrepreneurial sense requires an understanding and use of empowering and power sharing. ~ This idea is also supported by Burns in his description of transformational leadership, s This leadership style occurs when one or more persons engage with others such that leaders and followers raise one another to higher levels of motivation and understanding. The outcome for both the host agency and clinical resources entrepreneur is a feeling of strength and achievement in sharing in the educational preparation of the professional nurse. As clinical resource entrepreneurs, the authors' use of the concept entrepreneurship facilitated the generation of new ideas from old approaches, thus expanding the horizons of the negotiators to reach new realms of understanding and agreement not previously considered possible for advancing the attainment of education and practice programs objectives.
References I. ArcherSE: Publichealth service. Nurs Outlook 31:304-309, 1983 2. FisherR, Ury W: Getting'To Yes: NegotiatingAgreementWithout Giving in. Boston, HoughtonMifflin, 1981 3. ChaterS: A conceptualframeworkfor curriculumdevelopment.Nurs Outlook 23:428-433, 1975 4. KanterR: Innovation--theonly hope for times ahead? Nurs Econom 3:178-182, 1985 5. NaisbittJ: Megatrends:Ten New DirectionsTransformingOur Lives. New York, Warner, 1982 6. Martin8: Exploringthe conceptof enterprise. Nuts Econom2:406408, 1984 7. LarsenJ: Leadership, nursesand the 1980"s.J Adv Nuts 8:429-435, 1983 8. BurnsJ: Leadership. New York, Harper & Row, 1978
'ursing education programs require the use of clinical settings for the attainment of student learning objectives. These settings are usually negotiated annually between the educational institutions and the host health care agencies. The view of negotiation that is held by both parties either advances or limits the attainment of
N
*Assistant Professor and Community Resources Coordinator, University of Manitoba, School of Nursing, Winnipeg, Manitoba, Canada. tNursing Consultant, Practice at the Manitoba Association of Registered Nurses, Winnipeg, Manitoba; Adjunct Professor, University of Manitoba, School or Nursing, Winnipeg, Manitoba, Canada. This article is based on the authors experiences as Community Resources Coordinators at the University of Manitoba, School of Nursing, Winnipeg, Manitoba, Canada. Address correspondence and reprint requests to Ms. Scruby: Assistant Professorand Community ResourcesCoordinator, School of Nursing, University of Manitoba, Room 246, Bison Building, Winnipeg, Manitoba, Canada R3T 2N2. 8755-7223/87 $0.00 + .25 J O U R N A L OF PROFESSIONAL NURSING
PATRICIA
FARRELL,
RN, MSct
education and practice objectives. This article focuses on the mutual benefits that can be achieved by organizations that recognize the value of negotiation within the entrepreneurial context. The entrepreneur is different from the person who only negotiates, coordinates, or manages. ~ Entrepreneurship may incorporate all of these functions but must also include marketing and leadership in order to promote the desired activity. 2 Entrepreneurship when applied to the relevant educational dimensions of subject, student, and setting provides a strategy for the attainment of program objectives for both the educational institution and the health care practice setting)
Why Entrepreneurship?
The vast majority of literature dealing with the concept of entrepreneurship is found in the field of business and only recently do we see the concept beginning to surface in the nursing literature. While the meaning of entrepreneurship has had negative connotations, it momentarily serves to expand the previously limiting treatment of acquiring clinical learning resources. The authors believe that the concept of the nurse entrepreneur as a successful and enterprising negotiator will gain acceptance and recognition by the nursing community. Since the entrepreneurial approach assists in identifying benefits resulting from the cooperative sharing of resources, the outcome for both educational and practice settings will be a graduate capable of competing in the market place of health care delivery. Corporate business settings are often used for student learning in relation to the health of the employee. The concept ofentrepreneurship is not new to the business community. From the corporate point of view, the cost-effectiveness of producing the end product is a priority. Anything that will benefit this end objective will be readily entertained as a feasible and workable approach. The entrepreneurial notion of marketing the value of the nursing student implies a restructuring of the health professionals' approach with a language and style that is understandable to the business community. Since the student practices in many different settings, it is necessary for the negotiator
• SEPTEMBER-'OCTOBER
1987
307
308
J O U R N A L OF PROFESSIONAL N U R S I N G
•
SEPTEMBER--OCTOBER 1 9 8 7
to relate effectively to all members of the health professions and the corporate business community. A persistent problem identified in the literature is the gap between nursing education and the practice of nursing. Various solutions have been proposed. Among these are joint appointments of faculty and practitioner; senior nursing student elective experiences; the use of non-traditional practice settings; and attention to the socialization of the student into the professional role through student membership on professional committees. The authors propose the entrepreneurial approach as a solution. Negotiators on both sides, education and practice, can view the acquisition of clinical learning space not as a purely technical problem, but rather a knowledge, idea-building process for progressive change. Therefore, ideas can be the power tools to achieve understanding and bridge the gap between nursing education and practice. The entrepreneur is creatively innovative and will view the problem from various perspectives giving rise to mutual agreement based on alternate innovative solutions. Kanter suggests that we need to view innovation within the context of new ideas and strategies for problem solving. 4
Essential to the entrepreneurial approach is knowledge networking. Knowledge networking evolves from networks we establish: "networks offer what bureaucracies can never deliver--the horizontal link. ''5 There are trends pushing for a new management style based on the network. W i t h i n the context of knowledge networking, the objective of the nurse entrepreneur is to creatively apply relevant practice setting information to the mutual advantage of the negotiating participants. According to Naisbitt, our organizations will be restructured into small units, more entrepreneurial units, more participatory units that will come to support knowledge networking. There are many good ideas within organizations that have market value. The organization that facilitates people to actualize those ideas will have tapped a rich resource. Entrepreneurship is a special way of approaching subject or knowledge problems. W e need to move from the thinking of technical innovation to innovative, cognitive, problemsolving approaches. "Nurses can learn valuable lessons from business on how to succeed in a competitive environment. To succeed in these challenging and changing times nurses must become innovators who welcome change as a creative opportunity."4
Educational Dimensions
THE STUDENT DIMENSION
The use of the Chater framework facilitates an exploration of the concept of entrepreneurship within the three interacting dimensions of subject, student, and setting. 3 Chater envisions the three dimensions as three overlapping circles. The entrepreneur functions best within the overlapping areas of the three dimensions. From this vantage point, a clearer perception of the mutual benefits to education and practice can be achieved.
How is the student conceptualized within the entrepreneurial framework? The entrepreneur is one who organizes, promotes, or manages the student. The promotion of the student also involves marketing. How is the university nursing student different from all other students, across disciplines, competing for learning experiences? If the traditional negotiating framework prevails, the assumption is one of equality . . . each student from each school has the right to equitable learning space. If the framework of entrepreneurship prevails, the learner must be promoted as special and the agency that accepts that learner is a benefiting agency. The entrepreneur will be able to "sell" the recognition of true benefits. This may vary from special projects conducted by the student, to eventual employment and leadership within the setting. An example would be students providing an employee health education program on site that is seen by the employer to benefit both corporate objectives and employee health. The entrepreneur not only sells the "benefits" but also strengthens the perception of the role the agency must play to achieve quality nursing care. The agency that "has something to offer" is the one that learners will perceive as necessary to their learning. Helping the agency to this commitment is part of entrepreneurship. The nurse entrepreneur must also attend to the special needs of the adult learner. For example, the diploma graduate who has returned to university to obtain a baccalaureate nursing degree after several years nursing experience has different learning requirements than the high school student entering the same university program. This learner needs to build on or creatively utilize past work experience while learning new leadership skills. Active involvement by the student in the entrepreneurial approach would facilitate this process. If the framework for satisfying this variety of learner objectives is limited to "negotiating" space for learners, what may result is a fixed agreement for
THE SUBJECT DIMENSION
The subject dimension refers to the knowledge component in the discipline of nursing. How can nursing create a market for its knowledge or subject? The theory, research, and practice knowledge generated in academic settings can be used by agencies for their benefit. University schools of nursing are mandated by the very nature of the university system to generate knowledge. The nurse entrepreneur can bring an interpretation of knowledge to the health agencies that is creative, fresh, and alive adding to the body of knowledge with which we are familiar. Entrepreneurs are able to create opportunities for the dissemination, understanding, and the beneficial application of knowledge. Similar to entrepreneurs who create new businesses, nurses can be entrepreneurs who create innovative ways of applying knowledge. As reflected in the research of Naisbitt, a trend in society is the mass production of knowledge and "this knowledge" is the driving force of our economy. 5 More specifically, in academic settings there is a limited movement of knowledge for public u s e - the knowledge while available is primarily used by academics. The entrepreneur is free to create markets for existing knowledge. The outcome is new opportunities for student learning supportive of the creative thinking of both academician and practitioner.
SCRUBY AND FARRELL
309
ENTREPRENEURSHIP
a specified number of spaces in pediatrics or a specified number of spaces in community health. Learning objectives are sacrificed to available space. The spirit of entrepreneurship may, indeed, sacrifice a few learning objectives at times, but also has a ready eye for new and untried space opportunities. The entrepreneur will "negotiate" the basic space but will promote the learner as unique and able to move into previously untried settings. The entrepreneur is cognizant of health care trends and will not readily entertain a settlement of traditional hospital medical-surgical experience if the learning objectives can be met in new community or ambulatory outpatient settings or programs. In summary, the entrepreneur conceptualizes a negotiating position by presenting the student as a benefit to the agency and interpreting the value to the agency as a participator in the education of the professional nurse.
THE SETTING DIMENSION The problem of acquiring appropriate settings for the student can be best dealt with by the nurse entrepreneur. This is because the entrepreneurial approach will increase awareness of benefits to the setting provider. Historically, the Greeks did not hold the enterprising individual in high regard especially since it was viewed that one person's profit was another person's loss. As Martin points out, profit remains suspect in the minds of many people today. 6 In the establishment of cooperative systems the nurse entrepreneur is interested in gaining what is essential for her organization to meet its goals. Clinical practice experience is essential for the education of the baccalaureate nurse. On examination of the education and health care delivery systems, specifically their restraints and limitations, the authors found the organizational structure of systems communication and personal views on the use of human and other resources could be forces to impede or facilitate the negotiation process. The common perspective they encountered was that clinical learning space ought to be divided equitably among all schools requesting access, giving something to all requesting parties. The future however, requires that agencies will need to have their priorities in place. As demand for clinical practice settings increases, the negotiator who can assist in the enhancement of the agencies' goals will be the successful negotiator. This is recognized by the entrepreneurial negotiator as a viable opportunity. The successful negotiation for suitable clinical learning space requires that the nurse entrepreneur has current, accurate knowledge about the real priorities of the health care system and the business community. This knowledge about each setting should include relevant information about priorities related to time, budget, and public relations. One example is the new, or previously untried use of a corporation as a setting for student projects on health promotion. The nurse entrepreneur over a business lunch with corporate executives can learn what the special priorities of the corporation are. Are there special time frames or budget deadlines facing the executive that might be eased by the timely introduction of a new idea that has relevance for the corporate image? Is there specific knowledge that the corporation needs which the student project might address?
The corporate executive is enabled to enhance the corporation as caring about the health of its employees. Furthermore, new knowledge may be left with the corporation in the form ofself-heahh assessment packages and structures for health promotion support groups. Another example of innovative setting use, but within the existing system, requires that the nurse entrepreneur strive to sit on relevant boards of directors or participate as a member of special government task forces to examine aspects of the health care system. In this way the nurse entrepreneur can gain inside information in a timely way. Such information might include planning for expansion of a particular in-hospital setting. Matching the right learner to that setting might result in facilitating the process of change of introducing existing staff to a new idea in a nonthreatening but influential manner. The staff could be sensitized to some aspect of the planned change in advance of a greater agency effort. Negotiating in the entrepreneurial style places a high value on total understanding of leadership. Leadership is generally the strategic factor in cooperation and includes a management style based on networking and participation. The competitive aspect of acquiring clinical resources for student practice needs to be recognized. The entrepreneur will take up the challenge, tune up negotiating skills, compete in the market place for outcomes advantageous to the learning of the student, and be able to point out the ultimate benefit to the agencies themselves. The entrepreneur will show a willingness to take risks, to try the untried, in other words to represent the problem in an innovative way while demonstrating benefits to the agency. The outcome of successful negotiation is the recognition and valuing of the product, in this case the student, that will indeed meet the needs of society in the market place of health care.
Marketing Strategies The clinical resources entrepreneur, negotiating with the key persons within an organizational structure, can view this process as an opportunity to effect change on existing systems with mutual benefit to the program objective of both agency and university schools. In order to extend leadership to this situation, the first strategy of the entrepreneur must be to identify key persons in the negotiation process. In the authors' experience, the least successful method was agency-initiated meetings where all schools together bargained for the space available in a competitive auctiontype environment. The result was noncooperation. The most effective method was to identify the key persons who represent the agency and work together with them in a direct agency to university school, one-to-one relationship. A positive outcome of this strategy was the releasing of additional clinical learning space and creative use of existing clinical learning opportunities. Frequently, it is not the people but the system that is at fault and requires change! The entrepreneur must have the sensitivity to rebalance the system to incorporate the necessary change. The successful *entrepreneur will initiate alternative options for the agency to
310
JOURNAL OF PROFESSIONAL NURSING
change the negotiating arrangement in order to achieve agreement. A second strategy involves empowering host agency personnel, who may be functioning within fixed stiuctures or systems, to use the concept of entrepreneurship. The idea of restrictive dependence is turned to advantage in indicating to agency personnel the opportunity for independence within their structures, while advancing the overall goal of higher level health care. Establishing congruence between education and practice program objectives and priorities on a face-to-face basis can provide an opportunity for empowering to succeed. A third strategy requires the entrepreneur to communicate the nature of knowledge within the academic environment thereby freeing the use of knowledge by the host agency for practice and continuing education. The entrepreneur can thus assist in the dissemination of research knowledge generated by faculty and students, resulting in the translation of research into social action. A fourth strategy is the development and participation in projects of mutual benefit. This might take the form of proposal writing, systems design, policy change, and exploration of settings not previously used for student learning. A fifth strategy in the entrepreneurial approach is to create a market for new programs and respond to the need of the agencies for better prepared nurses. The entrepreneur can use a marketing approach to new program development. Knowledge of both the academic and practice settings can be used to stimulate agency desi:'e for a better prepared nurse and educators' provision of attractive programs. This approach is clearly evident in some of the program development and revisions in baccalaureate education for registered nurses. A sixth strategy within each setting is the identification of the resources needed for a successful entrepreneurial effort. These include secretarial support and allotment of sufficient time for proposal development, preparation of marketing strategies, and networking. This strategy can
• SEPTEMBER-OCTOBER1987
then be extended to the concept of shared resources between the university and the host agencies.
Conclusion Leadership in the entrepreneurial sense requires an understanding and use of empowering and power sharing. ~ This idea is also supported by Burns in his description of transformational leadership, s This leadership style occurs when one or more persons engage with others such that leaders and followers raise one another to higher levels of motivation and understanding. The outcome for both the host agency and clinical resources entrepreneur is a feeling of strength and achievement in sharing in the educational preparation of the professional nurse. As clinical resource entrepreneurs, the authors' use of the concept entrepreneurship facilitated the generation of new ideas from old approaches, thus expanding the horizons of the negotiators to reach new realms of understanding and agreement not previously considered possible for advancing the attainment of education and practice programs objectives.
References I. ArcherSE: Publichealth service. Nurs Outlook 31:304-309, 1983 2. FisherR, Ury W: Getting'To Yes: NegotiatingAgreementWithout Giving in. Boston, HoughtonMifflin, 1981 3. ChaterS: A conceptualframeworkfor curriculumdevelopment.Nurs Outlook 23:428-433, 1975 4. KanterR: Innovation--theonly hope for times ahead? Nurs Econom 3:178-182, 1985 5. NaisbittJ: Megatrends:Ten New DirectionsTransformingOur Lives. New York, Warner, 1982 6. Martin8: Exploringthe conceptof enterprise. Nuts Econom2:406408, 1984 7. LarsenJ: Leadership, nursesand the 1980"s.J Adv Nuts 8:429-435, 1983 8. BurnsJ: Leadership. New York, Harper & Row, 1978