Due to a variety of factors, it is difficult to determine how many nurses are working in entre and intrapreneurial roles throughout the world. For instance, entre- and intrapreneurship is defined differently across professions and countries. Thus the concept of nurses as entrepreneurial may not be widely understood or realised in some areas/cultures.
Nurse entrepreneurs may work as independent contractors and it is often difficult to systematically record the number of nurses outside of the public and private systems by role and skill mix. In some regions, demographics may not exist. In addition, some countries may not recognise independent nurses, who own and run their own primary health practices, to be nurses at all (Manion, 1991).
Figures gathered by the International Council of Nurses estimated that 0.5-1% of registered nurses worldwide work in entrepreneurial roles. Actual numbers within individual countries may be lower or higher as estimates of nurses or midwives who are self-employed or own professionally related businesses are as low as approximately 0.1% in New Zealand (Drennan et al., 2007) and 0.18% in the United States (Cheater, 2010) and as high as 18% in the United Kingdom. However, it appears more common for midwives to be self-employed with estimates of 50% self-employed in New Zealand and 64% in the Netherlands. In Australia, numbers are unknown as the most recent Australian Institute of Health Workforce Nursing and Midwifery Labour Force Survey (2009) does not mention self-employed nurses, although numbers are generally thought to be low. Better data collection and information infrastructure is required for targeted health workforce planning and this need is evident worldwide (Institute of Medicine, 2010).
urses' scope of practice has broadened considerably with the development and implementation of advanced and specialist nursing roles, such as that of the nurse practitioner and the advanced practice nurse, implemented through new models of practice. These expanded roles have been implemented in multiple care settings across the continuum of care from community or public health services and primary care, to acute care, and supportive or long-term care.
In this article, we will discuss how emerging and evolving entrepreneurial and intrapreneurial roles in nursing are rising to meet the challenge of health care reforms throughout the globe, across the continuum of health care. A historical overview of entrepreneurship and intrapreneurship is offered. We offer social entrepreneurship as a sustainable model of enterprising nurse-directed health care and describe brief examples of settings for nurse entre/intrapreneurship, and implications for research and practice.