Advanced practice nurse entrepreneurs in a multidisciplinary surgical-assisting partnership

AORN Journal, Sept, 2005 by Linda DeCarlo

BUSINESS ACUMEN. Self-employment challenges nurses to combine nursing knowledge with business acumen. (8) Business partnerships and practice management skills are necessary for APNs to move away from traditional employment models. (12) Business knowledge, however, is not emphasized in nursing or medical school curricula. Practitioners must research relevant literature, consult experts, attend seminars, and continue their education in the field of business to understand the complexities of managing a profitable practice. To be successful, entrepreneurs need to understand and adapt to legislative, financial, and political realities of the current health care environment. (8)

THE CONCEPT OF PARTNERSHIP

Advanced practice nurses who are willing to work together and have the drive to succeed, have an opportunity to make life easier for surgeons, physicians' office staff members, and hospital staff members by forming a partnership. A partnership is a relationship between two or more people committed to a common purpose who willingly cooperate with each other, add strength to the association, and share the risks and rewards. An oral or written contract may be present in the arrangement. The term partnership in business can be defined as "a contractual relationship between two or more people in a joint enterprise who agree to share, not necessarily equally, in profits and losses of the organization." (13,(p251)) In its definition of a partnership, the Dictionary for Business and Finance adds the terms voluntary to the contractual relationship and competent to the people involved in the contract. (14)

A partnership is a horizontal form of organization, (15) meaning that ideally, all of the members have equal power and equal responsibility, it is critical to define relationships because "partnership demands equity." (12,(p82)) A multidisciplinary surgical-assisting partnership provides an equal opportunity for success for all its members. Individual financial outcomes may vary, however, depending on factors such as clinical skills and personal characteristics.

MULTIDISCIPLINARY SURGICAL-ASSISTING PARTNERSHIPS

A multidisciplinary surgical-assisting partnership model composed of self-employed APNs using a shared office coordinator, depicted in Figure 1, shows RNFAs, NPs, CNSs and MDs as components of a wheel. The coordinator is depicted as the hub in the center of the wheel. A disc representing collaboration, competition, collegiality, and conflict surrounds the hub. The synergy of all the components holds the wheel together.

[FIGURE 1 OMITTED]

COLLABORATION. According to one source, principles of unity are statements of mutually shared beliefs and agreements that bring individuals together as a group. (16) Principles can be created to maintain stability, despite differences in style, personality, beliefs, and backgrounds. The definition of a shared purpose must be agreed upon and realistic. The agreement of all members of the group to volunteer to provide community call coverage is an example of a shared purpose. Members of the group are willing to help each other when surgery schedules change, with an ultimate goal of providing surgeons with an assistant so patient safety will not be compromised.