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Are you a nurse entrepreneur? It's time to take action


While some people are “born” to be nurses, many develop the qualities needed to succeed in the profession through the discipline of our training and education, says Sarah Chilvers. Leave a comment on on this story to contribute to a national debate on the future of NHS leadership

Nurse entrepreneurs, like myself, are however almost always destined for the role - we just can’t help it. That is not to say we cannot be helped to be better entrepreneurs, or be held back.

Nurse entrepreneurs often tend to threaten their bosses, who resist ideas or action that is outside their expectations or experience. I was told by one of my nursing officers (as they used to be called) that I would have to wait until I had 12 years of experience at basic grade before I could even consider applying for a manager’s job. I wanted to go into management, so guess what? I immediately applied for such a position until I got accepted and, needless to say, 18 months later, I was managing that same nursing officer.

‘Sometimes good ideas, energy and ambition are too much for an organisation to bear. A nurse entrepreneur sometimes has to get out to get on’

In nursing we are presented with different opportunities. One of the joys of the profession is the variety of avenues we can pursue - if that is what we want to do. It is vital for individual nurses wanting to advance their careers to try and take every opportunity that presents itself. It is also possible to create your own opportunities. If you see a way to do this that suits your mission, do it, and don’t wait to be asked.

Others may need to take a risk on you, but that’s fine - just make sure never to disappoint and always deliver. Mistakes are fine, but focus, discipline and delivery are everything. I have had people take huge risks on me, particularly as a “rookie” manager, and I’m very grateful to them for this. But those who have the power to create the environment for nurse entrepreneurs must think carefully about how they wield their influence.

If you spot someone with talent or even just frank enthusiasm, present opportunities to them whenever possible. Be aware, however, that there is something about being an ambitious person that sometimes means they skip important stages of learning as they leap up the career ladder. Try and make sure that does not happen -there are no shortcuts. As well as providing opportunities to the starlet, also ensure they are always provided with the basic disciplines of nursing and management. It is difficult to catch up later.

I missed a critical year of education due to glandular fever before my O levels. I went on to do fine in the exams but, much later on, I found there were certain vital basics (particularly in chemistry) that came back and tripped me up from time to time. In the same way, basic management training is vital for the budding entrepreneur - who will probably be too arrogant to admit it (if they’re like me). If you are this person’s mentor, be very gentle and very forgiving.

Sometimes good ideas, energy and ambition become too much for a department or organisation to bear. I think neither party should feel too bad about this. It is likely that the proposals are not bad or impractical, just not doable at that time. Sometimes a nurse entrepreneur has to “get out” to “get on”.

I would advise any budding nurse entrepreneur to go for your dreams, stay focused, be disciplined and be determined. You will be a survivor and, almost without doubt, a great success. Enjoy it. I have.

Sarah Chilvers is the chief executive of ChilversMcCrea, a business providing primary care services, consultancy and telemedicine solutions

Should the NHS identify potential leaders, or should it be left to individual nurses? Nursing Times and the National Leadership Council wants YOUR views. Post comments below or click here to email us.


Readers' comments (7)

  • I think the NHS should identify potential leaders. However, most ethnic minority staff like myself will miss out as we are majorly stuck in front line services. As as a result like the above entrepreneur, i am considering branching out to self fund my career progression as most ethnic minority staffs still find it hard to break the glass ceiling in the NHS. In particular areas like health care commissioning.

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  • Philip Darbyshire

    Great article Sarah. There is a huge misconception in the "public service" that entrepreneurialism has no place as that's for the 'business world'.

    How many hospitals would love to be the 'Apple' of health care and have a CEO with Steve Jobs creativity and vision?

    There may well be a time to 'get out' and 'get on' as unfortunately, hospitals and universities can become stifling rather than stimulating places.

    This is not 'giving up' on nursing, it is very much a 'giving back' and contributing as significantly as any other nursing role.

    In my 30 year career I have been a clinician, educator, researcher, manager, Professor and now independent consultant. The bottom line remains the same. What I do is help improve the condition and functioning of people and organisations.

    Now, however, I have the privilege of doing this with fantastic organisations: hospitals, health organisations and universities that really want to get things happening and who realise that the old excuses for inertia of 'we have no money' and 'it's a bad time just now' just won't wash any more.

    If you have drive, passion and great ideas, find a mentor(s) and supporter(s) in your organisation who will nourish rather than squash you. They are absolutely out there.

    In the words of one of my mentors, you are in nursing and health care to make waves, not to dip your toe in the water.

    Start rippling!

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  • If you have enthusiasm to help your fellow workers it ! i have been teaching theatre nurses in under resourced countries, mostly africa, for the last 12 years. The information i was able to give them has made a huge difference to their practice and subsequently, to their patient care. They are also much more aware of the need to protect themselves from risk . One of the most worthwhile things I have done........ and believe it or not , everyone says thank you ! Could you ask for more .

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  • What an encouraging article! And if anyone reads it and thinks they cant do it, you CAN!

    I managed to progress from band 5 to band 8a in 5 years, through hard work, study in my own time and some self funding along the way, but it is worth it in the end.

    One big criticism I've had about colleagues along the way is a 'collective lethargy'. Nurses get disheartened really easily and don't try to make things better.

    Did you know, most learning and development budgets go unused or have loads of money left each year that isn't touched and just gets lost? Get your hands on it! Write a letter to your manager to explain why the course would be useful to you AND the department!

    You need to be persistent, know what courses and opportunities are out there. Don't just ask to be put on a course, offer to take say 50% annual leave and only have 50% paid, book a weeks leave and fit some study/courses/shadowing into it. Yes its not a charity going to work, but sometimes there's no other options.

    Also, employers in the NHS aren't really going to find you and push you, you have to push yourself and get out there. Ask to shadow a senior manager for the day. Not only will this give you a unique insight into their role, it will help you network, they will say 'hi' on the corridor and it will stand you out from the rest, open some doors!

    Get involved. Become a link nurse for anything! incontinence, pain, blood transfusion. There's hundreds of link nurses and the Trust would probably be grateful for your offer as it ticks their governance objectives boxes.

    Mentor students, or offer to help coordinating the mentoring of students. It helps you develop your own skills whilst polishing up your CV.

    Join the RCN and become a rep, get active, get involved in policy etc. Another personal development and a CV winner.

    There are almost too many ways to mention to get you there. It may be that if you start to take on some of these roles, it might make you enjoy the job that little bit more. But if you feel stuck in a rut, change jobs. There are loads out there on NHS jobs. Think carefully about what area would help you work towards the senior positions.

    Just believe in yourself and ignore the criticisms from the usually jealous team members!

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  • ps - as for the first responder about 'ethnic minority staff being stuck in frontline areas' I'm not sure what you mean by this, but being an ethnic minority should not stop you from achieving anything! Speak to your managers about the opportunities for you to develop, and if you're still not happy, go further above them. There will be an equality and diversity officer you can contact for specific advice on this area.

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  • I like many other nurses have the idea that the worse you are at your job the higher up the management ladder you climb. I have worked for the nhs in 3 different areas in Scotland now and constantly meet managers who have no qualifications and no idea how to bring service forward. Ward charge nurses who have a year off because of stress return to work as bed managers, strategy managers and return to work co-ordinators??? It is common knowledge that it is not a case of what you know but who. When a manager was using all the powers behind them to endanger nursing staff, we went to the RCN for advice. We were told by the RCN that the manager could not possibly be capable of endangering staff as she was a high flyer within the RCN. Jobs for the boys or girls... ...put a clipboard in their hand as they are too dangerous to go near a patient. this is the problem with the nhs in Scotland

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  • I have found this an incredibly inspiring article. I have progressed through my nursing career to a specialist nurse role for a national service this i feel not well supported by the trust, my line manager or my colleagues. There is a general perception of people being in roles too long and no change in senior roles but if you challenge this in any way you are then examined under the microscope because there must be another reason you have succeeded other than hard work.
    I have had a lot of support from my medical colleagues which have been invaluable. I intend to continue the work I do and progress because the drive at the end of each day is to continue to improve patient care and after reading this article I feel empowered to do so.
    It would be nice to see an end to nursing opinion that you have to do your time to earn certain roles.

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