setting.

STUDENT ACTIVITY SHEET

LESSON PREVIEW/REVIEW (5 minutes)
Instruction: Discuss the eHealth vision by 2020? Explain
briefly.
Community Health Nursing 1 - Lecture BS NURSING /
SECOND YEAR
LESSON TITLE: Health –Related Entrepreneurial
Session # 23
Activities in the Community Setting

Materials:
LEARNING OUTCOMES:
Pen, paper, index card, book, and class List
Upon completion of this lesson, the nursing student can: 1.
Apply entrepreneurial skills in the delivery of nursing care
to individuals and families in community setting;
Reference:
2. Identify opportunities for entrepreneurial nursing practice;
and, Famorca, Z. U., Nies, M. A., & McEwen, M. (2013).
3. Apply strategic interventions to address health-related Nursing Care of the Community. Elsevier
concerns of individuals and families to any health care Gezondheidszorg.

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MAIN LESSON (30 minutes)

Entrepreneur
⎯ Is the ability to take the factors of production or service-land, labor and capital and use them to produce new goods
or services.
⎯ The entrepreneur perceives opportunities that other business executive does not see or do not care about. ⎯
Entrepreneur sees a need and then brings together the manpower, materials, and capital required to meet that need.

Entrepreneurship:
⎯ Involves initiating changes in production.
⎯ The entrepreneurs always search for change, respond to it and exploit it as an opportunity. ⎯ Need to shift
resources from approaches that have produced low value into areas of higher productivity and yield. ⎯ Entrepreneurs
create value.

The key sectors of healthcare industry can be broadly classified into following four sub-segments: ⎯ Health
care services and facilities.
⎯ Medical devices, equipment, and hospital supplies manufacturers.
⎯ Medical insurance, medical services and managed care.
⎯ Pharmaceuticals & Related Segments

Public Health Entrepreneurs are:

⎯ Change agent of population health
⎯ Pioneer of innovations that benefits the wellbeing of humanity
⎯ Offers sustained improvement in the health of populations in the face of need
⎯ Need to shift resources from approaches that have produced low value into areas of higher productivity and yield. ⎯
Social entrepreneur
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Education (Department of Nursing) 1 of 8
Public Health Entrepreneurship is:
⎯ The opportunistic creation and implementation of catalytic innovations intended to offer sustained improvement in the
health of populations in the face of need; without being limited by the resources currently in hand; involving
collaboration with and accountability to the constituency served and the outcomes created.

Entrepreneurship Basic Principles for Success is measured by:

⎯ Be a Solution Provider - “Look for a way to make life easy for others”
⎯ Have a Vision - “Successful entrepreneurs are those that were able to transform their vision into reality” ⎯ Choose
the Right Team - “Good team work builds speed”
⎯ Viable Product/Service - Good products most times sell itself”
⎯ Capital - “Capital isn’t scarce; vision is”
⎯ Accountability - “Accountability breeds responsibility”
⎯ Growth and Marketing - “Without continual growth and progress, such words as improvement, achievement, and
success have no meaning”
⎯ Know Your Customer– “Always treat your customers as special guests”
⎯ Priorities - “Things which matters most must never be at the mercy of things which matter least” ⎯ Never Give Up -
“Never, Never, Never Give Up”

Public Health Inherently Anti-Entrepreneurial:

⎯ No profit motives
⎯ Governmental stuck in the box (Clinical vs PH)
⎯ Slow moving relative to corporate world
⎯ Products are harder to sell (cigarette and alcohol VS milk)
⎯ Lack of accountability (individual level)
⎯ Stifled by funding restraints -best practice paradox.
⎯ Brain drain-under trained work force, both in numbers and specialties
⎯ Hard to target an audience when we have no specific target audience (healthy population) ⎯ We don’t really know
how we’re doing
⎯ Our focus is need and not just needs that will pay.

Public Health Offers Inherent Opportunities for Entrepreneurship:

⎯ Play on people’s fears!!!
⎯ They may not know it, but everybody needs us, and the market is wide open.
⎯ We are selling some fabulous things; decreased expenses, increased happy times
⎯ Small bites = big change
⎯ Passion abounds

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Education (Department of Nursing) 2 of 8
⎯ The market is more receptive. The time to innovate is now!!
⎯ Timing is good for public health and medicine to play nice again
⎯ The nature of public health is responsive.
⎯ There is an inherent need for innovation because we have failed with things in the past. So something has to
change! ⎯ Evaluation tools for outcome (improved health)

The Scope of Public Health Entrepreneurship:

⎯ Life insurance companies
⎯ Large scale companies/factories
⎯ Public health insurance / benefits schemes
⎯ Health product production establishment
⎯ Public health consultancy agencies
⎯ Fitness centers

Several examples of successful public health-related entrepreneurial ventures have emerged in the public health
literature, but more must be done to promote public health enterprise.12–15 Figure 1 outlines several industries and
ventures that are ripe for public health entrepreneurs

The role of entrepreneurship in any economy is critical, as it contributes to the socio-economic development of societies
in various ways, including
1. Identifying Existing Opportunities in the Market - Through production and distribution of goods and services,
entrepreneurial ventures seek to satisfy client needs and improve livelihoods.

2. Creating Employment Opportunities – Entrepreneurship helps bridge the unemployment gap through formal and
informal business ventures that employ millions of people.
3. Contributing to National Income – Through payment of taxes, businesses contribute to government revenue that
consequently facilitates development. Entrepreneurial ventures further contribute to the GDP, an indication of their
importance in raising revenue and financing government projects, as well as contributing to economic growth.
4. Infrastructural Development – Entrepreneurial ventures open up infrastructural development in their localities.
Starting up businesses often leads to the development of transport and communication networks, driven by the need
for infrastructure created by these businesses.
5. Contributing to Community Development – Through participation in Corporate Social Responsibility,
entrepreneurs contribute to and support the development of infrastructure for education, healthcare, business training
& mentorship and other social needs.

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Education (Department of Nursing) 3 of 8
Nurse Entrepreneurs Place to Work:
⎯ Nurse entrepreneurs may work in a variety of settings, including in offices running their own business, as an
independent nurse contractor in hospitals or clinics, in home healthcare visiting patients, or as a nurse educator. ⎯
Nurse entrepreneurs have the freedom to set their own hours and the flexibility to determine their own work
environments based on the company they establish.
The Nurse Entrepreneur does the work by:
⎯ Uses his or her background in professional nursing to start their own business within the healthcare industry. ⎯
Business ventures established by registered nurses run the gamut from medical devices and home health products to
independent nursing services such as patient care, nursing education, home health services and consulting work. ⎯
The day-to-day responsibilities of a nurse entrepreneur depends upon the specific venture, but usually includes
activities related to running a business including accounting, marketing or sales, and developing a customer base.

Roles and Duties of Entrepreneur Nurse:

⎯ Use nursing education and experience to establish their own business venture within the healthcare field. ⎯
Promote the business, including advertising and sales efforts to attract and retain customers ⎯ Hire and manage
employees to assist in running the business as needed
⎯ Tend to the financial side of running a business, including accounting, payroll and tax issues ⎯ Provide healthcare
products or nursing services which may include direct patient care, education or consulting services depending on the
nature of the business

The main Barriers to Business Entrepreneurship in Nursing identified in this study are presented below: ⎯
Legal and regulatory issues - there is a lack of knowledge of legal issues, reimbursement policies and procedures for
the collection of hospitals, health plan operators, states or insurance companies.
⎯ Regulation of the profession - reflecting a traditional nursing structure, in most countries private practice is
unregulated, with a limited scope of nursing practice and, in many cases, still depending on the authority of physicians.
⎯ Job career culture - there is a tendency to pursue careers in public health institutions, especially in countries where
the state is largely responsible for health and privatizations are less present.
⎯ Social values - often, by local culture or religious issues, families can be in charge of caring for people. This model
reduces the chances of hiring nursing professionals for this care.
⎯ Medical-centered model - in this organizational format, the main duty is to obey and follow the orders of physicians
and, under such conditions, it becomes difficult to play care roles that would be, at least theoretically, the responsibility
of nurses.
⎯ Hospital care model - in this standard, access to therapeutic tools for primary, secondary and tertiary prevention is
centralized in the hospital activity, with the private area remaining the focus in primary care and in the prevention of
diseases.
⎯ Reimbursement for health systems - the method adopted in some countries, both public and private, does not
provide for any form of payment, establishes a lower value payment, or even conceives coverage of services by health
plans inadequately.
⎯ Collaborative arrangements with physicians - the collaborative arrangement is understood as the partnership
between a nurse and a physician working in a private practice, being a model required in some countries as a
reimbursement criterion. In this model, besides the difficulty of finding a physician with whom to collaborate, the latter
may charge a fee for the establishment of the collaborative arrangement. In addition, these relationships reinforce the
medico centered mode.
⎯ Economic crises and recessions - economic stability brings predictability and there is a tendency for entrepreneurs to
invest in new business, innovation and technology. However, financial crises and periods of long recession generate
insecurity and reduction in new investments of preparation for the role of manager and lack of operational skills,
resulting in the need for managerial development and training due to his deficiencies in business management.
⎯ Personal and ethical conflicts - personal values prevent the opening of businesses related to caring for people, since
profit generates ethical conflict; make money would be incompatible with the mentality of nursing services, more
related to volunteering than to profit.
⎯ Lack of acceptability and recognition by the public and by the class itself that is l represented by jealousy and the
joke of their colleagues. Behaviors such as these, presented by peers, can unfortunately have adverse psychological
effects on entrepreneurs. The same feeling is noticed when colleagues do not accept, do not help or even hinder the
disclosure of the business.
⎯ Lack of corporatism among nurses -this tendency is not observed to privilege the interests of the professional group
itself, reflecting more individualistic and less supportive attitudes.

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⎯ Lack of public policies - also expressed in the form of incentives for private practice or the opening of new
businesses for which no discounts, exemptions from fees or other practices are granted.
⎯ Lack of technical support - since nurses are accustomed to the hospital environment and teamwork. ⎯ Non-change
culture - Many health managers do not believe in change, they walk conservatism. This is reinforced when there is
great turnover in replacing these administrators.
⎯ Unfair competition - many services, mainly home care services, are provided by undergraduate professionals - often
illegally, since they are not supervised - who practice lower prices and with questionable quality of services. ⎯ Gender
issues - understood in many cultures as a masculine quality, entrepreneurship in an almost massively female
profession has taken some time to be understood as a form of empowering women and bringing benefits to the whole
community.
Examples of Entrepreneurs in Health Care:
✔ Pharmacist
✔ Doctor
✔ Dentist
✔ Athletic Trainer
✔ Therapist

Entrepreneurship involves initiating changes in production and finally entrepreneurs create value. Success is measured
by improved health outcome, change in social environment, and sustainable programming. Debate on Public Health
Entrepreneurship inherently anti entrepreneurial vs. offers opportunities for entrepreneurship. Bring positive change to
achieve improved health. In the end, remember that a bit of healthy competition is always good for the nation, especially
when it results in saving lives.

CHECK FOR UNDERSTANDING (20 minutes)

You will answer and rationalize this by yourself. This will be recorded as your quiz. One (1) point will be given to correct
answer and another one (1) point for the correct ratio. Superimpositions or erasures in you answer/ratio is not allowed.
You are given 20 minutes for this activity:

Multiple Choice

1. A person, firm or other entity which pays for or hires the services of another person.
A. Co-employee
B. Employer
C. Patient
D. Nursing Orderlies
ANSWER: ________
RATIO:_________________________________________________________________________________________
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2. An indicator of success in community organizing about healthcare business is when people are able to: A.
Participate in community activities for the solution of accepting health care product with low cost. B. Implement
activities for the solution of the community problem
C. Plan activities for the solution of the community problem
D. Identify the health problem as a common concern
ANSWER: ________
RATIO:_________________________________________________________________________________________
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3. The various role of entrepreneurship that contribute the socioeconomic development in the society. A. Identifying
existing opportunities in the market
B. Creating employment opportunities
C. Contributing to national income
D. Contributing to Community Development
ANSWER: ________

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4. What are the roles and duties of the entrepreneur nurse?

A. Provide health care products.
B. Nursing educator
C. Promote business according to ordinance of the law
D. None of the above
ANSWER: ________
RATIO:_________________________________________________________________________________________
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5. An individual who provides labor to a company or another person.
A. Employer
B. Owner
C. Employee
D. None of the above
ANSWER: ________
RATIO:_________________________________________________________________________________________
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6. Entrepreneur nurse does the work such as

A. Uses his or her background in professional nursing to start their own business within the healthcare industry B. The
day-to-day responsibilities of a nurse entrepreneur depends upon the specific venture, but usually includes activities
related to running a business including accounting, marketing or sales, and developing a customer base in the
healthcare field.
C. Both A and B
D. None of the above
ANSWER: ________
RATIO:_________________________________________________________________________________________
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7. What is the business side of health care?

A. Gender issues
B. Personal and ethical conflicts
C. The healthcare field also needs people with expertise in areas like policy analysis, finance and accounting,
budgeting, human resources, marketing, and information technology.
D. Athletic trainer
ANSWER: ________
RATIO:_________________________________________________________________________________________
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8. How do you become a health care entrepreneur?

A. Salesgirl
B. Most healthcare entrepreneurs either have a professional degree or have an excellent background in sales C.
Factory worker
D. Student
ANSWER: ________
RATIO:_________________________________________________________________________________________
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9. The scope of public health entrepreneurship is the following except:
A. Public health insurance / benefits schemes
B. Health product production establishment
C. Public health consultancy agencies
D. Lack of technical support
ANSWER: ________
RATIO:_________________________________________________________________________________________
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10. What are the identified entrepreneurship barriers in nursing business?

A. Job career culture
B. Social values
C. Medical-centered model
D. All of the above
ANSWER: ________
RATIO:_________________________________________________________________________________________
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RATIONALIZATION ACTIVITY (THIS WILL BE DONE DURING THE FACE-TO-FACE INTERACTION) The instructor
will now rationalize the answers to the students. You can now ask questions and debate among yourselves. Write the
correct answer and correct/additional ratio in the space provided.

1. ANSWER: ________
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2. ANSWER: ________
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5. ANSWER: ________
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6. ANSWER: ________
RATIO:_______________________________________________________________________________________
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7. ANSWER: ________

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8. ANSWER: ________
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10. ANSWER: ________

RATIO:_______________________________________________________________________________________
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LESSON WRAP-UP (5 minutes)

You will now mark (encircle) the session you have finished today in the tracker below. This is simply a visual to help you
track how much work you have accomplished and how much work there is left to do.

You are done with the session! Let’s track your progress.

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23AL Activity: CAT: 3-2-1

Instructions:
1. As an exit ticket at the end of the class period
2. Record three things you learned from the lesson.
3. Next, two things that you found interesting and that you’d like to learn more about.
4. Then, record one question you still have about the lesson.

Three things you learned:

1. __________________________________________________________________________________ 2.
__________________________________________________________________________________ 3.
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Two things that you’d like to learn more about:

1. __________________________________________________________________________________ 2.
__________________________________________________________________________________
One question you still have:
1.___________________________________________________________________________________

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