Nursing

You love being a nurse, but the hospital environment may not suit your career needs anymore. Perhaps you have an idea for a service or product that will enhance patient care. Or you may want to take the knowledge you gained at the bedside to another level. These are among the many reasons nurses decide to strike out on their own and become entrepreneurs.

It takes a lot of guts to run your own business, but if you've got the stamina, are willing to work hard, and are able to obtain the necessary financial backing, the rewards can be extraordinary. Here, we asked several nurse entrepreneurs what it took for them to build successful businesses and what advice they would offer colleagues who are considering becoming their own bosses.

"You've got to really want it"

Vicki D. Lachman, APRN, PhD, MBE, was nearing the end of her studies toward a diploma in nursing from Philadelphia General Hospital, thinking she would become a labor and delivery nurse. Her last rotation, in psychiatry, changed all that. Recalling the experience, Lachman said, "I fell in love." So instead of starting work on the maternity floor, she pursued a master's degree in psychiatric nursing and joined a psychotherapy practice in 1974.

As Lachman established her clientele base, she began offering continuing education programs, such as assertiveness training for women, and was surprised by how much she liked to teach. Meanwhile, she noticed that many of the problems her clients were experiencing stemmed from poor management in the workplace.

Recognizing a consistent need for leadership training, Lachman formed V. L. Associates (www.drvickilachman.com), a consulting, training, and coaching firm for the healthcare industry, in 1979. Since then, she has built a reputation as an expert in organizational development by working with more than 300 medical centers, community hospitals, long-term care facilities, hospices, and healthcare practitioners' offices. She's made more than 3,000 presentations to organizations and conferences, offering her strategies for addressing the problems impeding the effectiveness of healthcare.

In the midst of all this, Lachman managed to find time to earn a PhD in education from Temple University, with a focus on organizational development. Now an associate professor at Drexel University's College of Nursing and Health Professions, she is track coordinator for the MSN in Innovation and Intra/Entrepreneurship in Advanced Nursing Practice (www.drexel.edu/cnhp/nursing/grad_msn_innovation.asp).The program, which began in the fall of 2006, won't have its first graduate until 2008—a nurse who is creating a holistic medical spa outside of Pittsburgh that will offer services like laser treatments and massage. This student did her homework—there's no other facility like it in the area.

Lachman noted that identifying your niche is an important step in going out on your own. "You may have a great business idea, but if there's no market, you're not going anywhere."

Be prepared to devote most of your energy to any new enterprise, she said. "It won't be an eight-hour-a-day job. In the beginning, especially, it'll be six or seven days a week, 12 hours a day. That's why it should be something you're passionate about. You've got to really want it."

Her nursing skills played a large role in her success. "Nursing process is a problem-solving method," Lachman explained. "You know how to assess a patient, now you'll be assessing the market or a community. 'What's my diagnosis? What outcome can I expect?' And then you'll evaluate. It's the same process in a nursing business."

"It takes time to build a business"

Nan Brown, RN, and Lil Bogdan, RN, would concur with Lachman. The two nurses have more than 15 years' combined experience caring for patients with burns and severe skin conditions. While working at Johns Hopkins Hospital in Baltimore, they received extensive training in skin care. At the time, Brown began having skin problems of her own. Her skin was reacting to products in her daily skincare regimen, and she wasn't able to find anything appropriate in the marketplace.

Brown and Bogdan decided to base a research project on the ingredients in personal-care products, and discovered that most of them contain harsh chemicals such as propylene glycol, used in antifreeze. That started them on the road to developing their own nutrient-rich, natural preparations—in Brown's kitchen.

Thus were the seeds sown for their skincare line, L'Athene (www.lathene.com), named for the Greek goddess Athena. Now sold in doctor's offices, hospitals, and spas, L'Athene has become a full-time business.

"Our nursing experience has been the cornerstone of our business," Brown said. "Based on our experience working with challenged skin, we know the value of pure, natural nutrients to promote healing. Our nurse-owned company is about helping people feel better—both inside and out."

The partners had no way of knowing whether their business would succeed. "We did this from passion," admitted Brown. "It came from looking for an answer, not finding it out there, and then creating our own answer to make a positive difference for others. We believed in what we were doing and had the persistence to make it work, which are traits of all nurses."

It took five years for Brown and Bogdan to get their products on the shelves. From 1997 to 1999, they researched, networked, built a team of experts to create the line, and made the products. They took out second mortgages on their homes and turned to friends and family for financial backing.

Then, the entrepreneurs took a year to market the line—they asked nursing colleagues to take the products to co-workers, bosses, patients, family, and friends. From the feedback they received, Brown and Bogdan refined the products and developed packaging. Their first account came in 2002; the line will be expanding into Europe this year.

"It takes time to build a business," advised Bogdan. "There's no such thing as an overnight success."

They began to realize that as nurses, they not only developed clinical skills, but also acquired people skills. Through networking, they found individuals, including chemists and nutritionists, to help them in their venture.

"When you're persistent and have your heart in the right place, doors will open and wonderful things will happen," Bogdan stated. "Nurses have a great deal of power in making things happen."

What sound advice can she offer to nurses considering entrepreneurship? "Find a way to help others that you have a passion for, so you can ride the highs and lows that can arise in business. Also, don't be afraid to ask others for help and guidance. You will be surprised how many people will help you with mentoring advice."

Bogdan added, "Your own fears will be your biggest limitation—don't focus on them, and know that there is always another way to solve a problem. There is no straight road.

"Realize, too, that being a nurse is always a strength—be proud of who you are and what you know. You have already developed many skills for success in business—organization, communication, listening, diplomacy, creative thinking, and a willingness to do most anything. Your heart, your determination, and your enthusiasm will have great power and take you far."

"Have a vision of what you want"

Kathleen Vollman, RN, MSN, CCNS, FCCM, didn't set out to be an inventor; her dream since ninth grade was to become a nurse. It was as a critical care nurse at Harper University Hospital in Detroit that Vollman became frustrated when caring for ARDS patients: She was finding it difficult to turn and position critically ill patients prone, in order to improve their pulmonary oxygenation. Through this struggle, an idea came to her for a device that would make it safe and easy to turn patients prone. As part of her master's thesis, she developed the piece of equipment and studied it with critically ill patients.

It was not with confidence that Vollman approached this venture. Admitting to having a lot of fear, she went ahead with the project anyway. "That single decision massively changed my life for the better."

With help from her extended family to sketch and construct the device, and with money borrowed from her parents to manufacture it, Vollman watched her idea take shape. She read up on copyrights and patents and hired a lawyer. "I learned by the seat of my pants."

Years passed before a deal was inked with Hill-Rom, an international company that manufactures hospital beds, which now produces, markets, and distributes the Vollman Prone Positioner worldwide (www.hillrom.com/usa/Vollman.htm).

All the while, Vollman was working as a clinical nurse specialist (CNS). She was also lecturing and publishing, which earned her a national reputation by the time her invention went to market in the late 1990s.

"I loved being a clinical specialist and a nurse, but I also had this dream and wanted to make sure it got out there," she said. "It was a challenge to juggle the complexity of a full-time job and seeing my dream realized. During that time, I did a lot of personal development, prayer, and soul-searching to make sure I was traveling down the right road."

Her hospital experience as a staff nurse and CNS served as a solid foundation for her next venture. Her strong desire to help other nurses acquire greater skills and knowledge led to the creation of Vollman's speaking and consulting business, Advancing Nursing LLC (www.vollman.com), which officially was established four years ago. She has published and lectured throughout the United States and overseas on pulmonary, critical care, and professional nursing topics.

Because her schedule as a CNS included four 10-hour workdays per week in the medical ICUs at Henry Ford Hospital in Detroit, and one day on the road, she resigned her hospital job in 2003 to concentrate on her latest endeavor. "It was time to move my influence beyond a single institution," she said, adding that it wasn't an easy decision. "That was my mortgage-paying job, my source of healthcare insurance, and a strong social network."

Despite her doubts, her business flourished. "I make considerably more than I ever did working at a hospital, and the life experiences are immeasurable."

You can see that Vollman speaks from her heart when she says that the biggest obstacle to entrepreneurship is a person's own fear. "The key to all of this is, have a vision of what you want, and the passion and persistence to go after it. My vision was to help create environments where nurses feel empowered to own their own practice through the acquisition of knowledge and skill."

"Follow your dream"

Ten years ago, Ann Johnson, RN, and physical therapist Lauren Robertson, MPT, were among 400 employees who lost their jobs when the home nursing service they worked for folded. After their layoffs, Johnson and Robertson shared a sense of defeat, knowing that the healthcare industry was changing and jobs like the ones they had were harder to find.

Johnson had worked for more than 20 years in various hospital departments and didn't wish to return to the acute care setting. Robertson, too, didn't want to step back into the nursing homes and hospitals where she'd worked before. They put their heads together and hatched an idea for a business.

"For many years, I was thrilled to be a bedside nurse," Johnson said. "But then I started thinking about how I could use my nursing skills in some way that would allow me to have more control over my time. With the explosion of the Internet, I saw an opportunity to provide continuing education online."

At the time, home study was an option only available by mail order. The partners figured an online operation would be cheaper and easier to run. They were wrong. "It meant entering the confusing world of computer programmers, consultants, and Web designers," Johnson explained. "We spent hours researching arcane software programs and then learning how to use them, often not very competently."

Neither partner knew how to design a Web site or collect money online. "We bought some Web design software and I tried to design a site while Lauren started writing courses," Johnson recalled. "We took classes in bookkeeping, database design, computer graphics, and accounting, and met with every local consultant we could find. We even hired a graphic designer to help us create the look of the business."

After 16 months of intense effort, Johnson and Robertson launched their Web site in August 1999. Much to their surprise and delight, they started selling courses almost immediately.

They called their fledgling business Wild Iris Medical Education (www.nursingceu.com), for the flowers found in their part of Northern California. It was financed with credit cards, and since income from the business initially was limited, the two went back to work—Johnson as manager of a hospital ED in Ukiah, CA, and Robertson as director of children's services for Mendocino County, CA. They devoted evenings and weekends to editing courses and designing databases. The learning curve was steep—and costly.

"If we had known how hard and expensive business start-ups are, we probably wouldn't have done it," Johnson said. "But we were determined to find a way to make Wild Iris work, and we were always optimistic that it would succeed."

In 2002, Johnson and Robertson decided to give Wild Iris their full attention and quit their day jobs. They knew it meant a significant cut in pay, but realized the time was right to become full-time entrepreneurs.

Their business has grown, but it took seven years before the partners were able to replace the salaries and benefits they used to get working for someone else. Besides nursing CE, Wild Iris now offers courses for physical and occupational therapists, EMTs, and paramedics. The company has recently been incorporated, with Johnson as chief operating officer and president and Robertson as CEO and editor-in-chief. They have three full-time employees, two part-time employees, and three part-time contractors. Everyone works from home.

"We've created an environment that recognizes people have lives outside of work," Johnson said. "My business not only challenges me, but also gives me the great luxury of being able to spend time at home with my family. I'd encourage anyone to follow his or her dream. I can't promise it'll be easy or cheap, but it can happen."

Johnson and Robertson started Wild Iris because they lost good jobs, and they had a desire to create something worthwhile. It turned out that the combination of need, drive, and determination is a powerful force for success in business.

"We're really excited about building a business that allows us to educate health practitioners and create jobs at the same time," Johnson said. "What could be better?"

Get creative

If these nurses have inspired you to dust off those creative ideas that resurface now and then, you are in luck. Beginning next month, RN will feature a regular column by Patricia Ann Bemis, RN, CEN, president of the National Nurses in Business Association (www.nnba.net). She will tell you more about what's involved in becoming an entrepreneur and answer all of your questions as you advance your nursing career.