When Catie Harris, PhD, MBA, RN, saw residents graduate from her hospital neurosurgery department with more opportunities, prestige and pay, she thought maybe education was the answer to nursing advancement.
She pursued multiple master’s degrees in nursing and business, a doctorate of nursing and dozens of certificates. Despite what she describes as “serial degree collecting,” her pay decreased as she gained skills and knowledge.
“I took a 20 percent pay cut from an RN to an NP. Going from an NP to a doctorate, I took a 30 percent pay cut,” says Harris.
The hospital healthcare system is leading to nursing burnout
Harris’s reality was indicative of a systemic problem where nurses are overworked, underpaid and undervalued. “Nurses need to be the ones at the table. They’re the largest workforce in the hospital and the least represented,” says Harris.
The following data was published in Nurse.com’s 2022 Nurse Salary Research Report:
- 29 percent of nurses across all license types considered leaving in 2021, compared with 11 percent in 2020.
- Among those nurses, higher pay was the most influential motivation to stay, followed by better support for work-life balance and a more reasonable workload.
Several years before COVID, Harris realized that there are systemic problems in nursing. The pandemic amplified them.
Annie DePasquale, MD, a family physician and owner of Collaborating Docs, which matches nurse practitioners in business with collaborating physicians, hears daily stories of burnt-out nurses. “The American healthcare system is set up so that it’s almost impossible to do everything you want for patients, document it and follow up properly when you have a visit every 15 minutes. What the U.S. healthcare system expects us to do is unattainable.”
Harris ran a neurosurgery department toward the end of her time working in a hospital system. She confronted an attending physician known for angry outbursts and was disciplined for her action. “I thought I was indispensable to that unit. I worked 80 hours a week and got paid for 40.”
Despite her hard work and leadership, Harris was suspended for three days. This moment of reckoning became a springboard for the next chapter of her nursing career. Today, Harris owns NursePreneurs, helping thousands of nurses monetize their knowledge and skills and inspiring them to change how healthcare is delivered.
Nurses with burnout are launching businesses outside of hospital systems
When Harris first left the hospital system to pursue a new career in nursing, she met nurses working in careers she never would have imagined. Embassies worldwide, Nascar and cruise lines all hire nurses and nurse practitioners, and clinicians in many disciplines are opening private practices, working in medispas and developing products.
Today, most nurses are aware of jobs outside of hospitals, as more people are dissatisfied. But what hasn’t changed is the mindset Harris faced at the time. “I just was working so much that I never stopped to think about it.”
3 tips for nurses looking to start new businesses
As owner of Nursepreneurs, Harris coaches nurses to launch businesses one-on-one, in an online community and group courses. Following is her advice for starting a new nursing business.
Start with changing your mindset
Mindset is one of the biggest hurdles for nurses transitioning from the hospital system to other careers in nursing.
Harris advises “thinking like an entrepreneur.” She warns nurses that starting a business means stepping into a leadership position. This differs from a leadership position in a hospital where exceptional nurses are selected for leadership roles. “That’s more of a puppet position because there is no real power. Their job is to hear everybody’s complaints,” says Harris.
Harris explains the biggest transition from a hospital system to business is taking charge. “When you transition into the real world, you’re standing up and saying, I see a problem, I have a solution, and this is what we’re going to do.”
Harris recommends starting small and taking it one step at a time. “Start by serving your family and friends. Just put one foot in front of the other.”
Identify a nursing business to pursue
Opportunities for nurses are numerous, but certain niches are common. Harris recommends aligning the business model with the lifestyle you want. “That begins with defining what you think would make you happy. I don’t think nurses ever sat down and thought about it,” says Harris.
Following are the top three nursing businesses Harris sees:
IV hydration: Nurses are used to placing an IV so it’s easy to imagine opening an IV hydration clinic. It’s also increasingly popular among patients, making starting less intimidating.
Medispa: This requires learning to do treatments like injections, injectables and fillers, but nurses are well-poised to learn this quickly.
Concierge nursing: Telehealth or brick-and-mortar clinics in concierge nursing are versatile and have low start-up costs. These business models do best when focusing on a specific niche like post-op recovery, special needs care or medication management for seniors.
Cash-based concierge businesses are great models for avoiding burnout, says DePasquale. Avoiding the paperwork and haggling with insurance reimbursement saves nurses time they can spend with patients.
Identify the problem you want to solve and your target audience
Many nurses starting a business jump over the problem and try just to offer solutions. They struggle to create a business model and market it. Even IV hydration is a vast business with a lot of possibilities. For example, Harris says if you offer corporate wellness IV drips, you shouldn’t walk into an HR department with a business called “Hangover Drips.”
“Having a problem to start with and an audience you’re going after is everything. It’s the hardest part, and everybody wants to skip over it and get straight to what services they’re offering,” says Harris.
Sometimes a solution to a problem is why a nurse wants to start a business. Nurses get to know specific patient populations well, making them the first to identify problems and potential solutions. “They’ve worked with certain patient populations for so long that they know their clients inside and out. They know what they need and are missing,” says Harris.
Harris has helped two nurses solve problems they identified.
- Supporting breast cancer survivors: Once patients enter remission for breast cancer, they no longer receive much support. But one nurse who serves this population found remission is precisely when women need more help. She launched a business to empower breast cancer survivors with community support, diet and fitness advice and the medical knowledge they needed to increase their chances of staying in remission.
- Wound care pillow: Patients who spend much time in bed must turn every two hours to avoid pressure wounds. However, hard pillows can cause pressure wounds. A wound care nurse developed a turning wedge, Bedsore Rescue, with no pressure points. It prevents pressure injuries and allows existing ones to heal. She markets directly to consumers.
Most importantly, Harris recommends staying patient and persistent. Starting a new nurse or nurse practitioner business is not a get-rich-quick scheme. But for those nurses who are looking for a new career because of nursing burnout or to make some money on the side, the opportunities are endless.
Lastly, when transitioning from a hospital system, ensure that you are covered in your new endeavors. It is imperative to your career, license and reputation to have a professional liability insurance policy that protects you from job to job, and in between.