Nurses make things work even with systems that were not designed with their workflow in mind. Rather than developing workarounds (potentially unsafe practices), nurses need to speak up when products are difficult to use, interrupt their workflow, or cause distractions in the workplace. Now is the time for nurses to innovate wherever they work or learn.
How can we as nurse faculty teach students how to innovate products and processes to improve nursing care and the health of the people we serve? What entrepreneurial characteristics should we instill in students to enable them to bring about change? Let's start with a definition of nursing entrepreneurship, which means "having a sense of opportunity, being autonomous, independent, flexible, determined, innovative, proactive, self-confident, disciplined, communicative, responsible, taking calculated risks, acting in a holistic way, to conquer new care settings, to add value to the profession before society, to boost the country's economic growth, to carry out financial and conflict management, to have legislative awareness and to turn to the future" (da Silva Copelli et al., 2019).
To be entrepreneurs, leaders, and change agents, nurses must have a sense of opportunity - in other words, to believe change is possible. The status quo is the enemy of innovation, often leading nurses to believe that organizational structures and policies prevent them from making change. However, our earliest leaders in nursing fought the status quo. Let's first consider the ideas of two early nursing leaders: Clara Barton, the founder of the American Red Cross, and Florence Nightingale, the founder of modern nursing. Barton disdained the status quo, believing that better ways were always possible (Barton, 1907). Nightingale said, "Unless we are making progress in our nursing every year, every month, every week, take my word for it we are going back" (Nash, 1914). More than a century ago, both leaders urged nurses to move nursing care forward - meaning nurses must innovate!
Nurses are uniquely positioned to understand the needs of the people we serve. The website Innovation 101 from Johnson & Johnson (https://nursing.jnj.com/innovation-101) identifies nurse innovators across decades who made significant contributions to health care. In the 1940s, Adda May Allen, a nurse at Columbia Hospital, created disposable baby bottle liners to eliminate the vacuum from bottles that prevented effective feeding. In the 1950s, Sister Jean Ward, head of the neonatal unit at Rochford General Hospital, noticed that sunshine reduced jaundice in newborns. Her observations led to modern phototherapy to treat jaundice. In the late 1960s, Anita Dorr, a veteran nurse from World War II, created a workflow innovation now called the crash cart. This innovation came out of the need to have emergency supplies and equipment at hand when working in emergency rooms.
Innovation in nursing is called for in the American Association of Colleges of Nursing 2021 Essentials and in the Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity (National Academy of Medicine, 2021). The nursing curricula are already filled, but the future of nursing depends on having nurses who can put their creative ideas to work solving practical problems in all settings where care is delivered.
Innovative thinking begins in undergraduate education with carefully planned experiences for nursing cohorts and students from other fields, including engineering, business, and psychology. Giuliano et al. (2022) describe a 15-credit hour certificate program in innovation and entrepreneurship across four years of undergraduate education. With seminars, courses, experiential experiences, peer/faculty support, and connections to companies, nurses and other undergraduates learn to work in teams to understand health care problems and create innovative solutions. Other approaches to empower nurses and stimulate creative thinking include setting up innovation challenges, providing immersive workshops on innovation, and creating maker spaces where software and supplies to create prototypes are free for students and faculty to use. Resources dedicated to innovation are available on the American Nurses Association Innovation Website (https://www.nursingworld.org/practice-policy/innovation/), which contains podcasts, webinars, books, journal articles, and blogs.
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