The Journal of the New York State Nurses Association, Vol. 46, Number 2

Page 28

Nurse Entrepreneurs: The Real Independent Practice of Nursing Carol Lynn Esposito, EdD, JD, MS, RN-BC, NPD Lucille Contreras Sollazzo, BSN, RN-BC, NPD

n A bstract

General trends in population health are having an impact on healthcare and the role of the registered professional nurse (RN) as a unionized nurse entrepreneur within a social justice system. The aging population and mental health disease in the United States is placing increased demand on healthcare. Between 2010 and 2030, the aged will increase by 75% to 69 million in the United States. One in five Americans will be a senior citizen. In 2050, an estimated 88.5 million in the United States will be aged 65 and older, and by 2060, there will be about 98 million older persons. Statistics indicate that 80% of older adults have at least one chronic condition, while 68% have at least two chronic conditions. An estimated 18.1% (43.6 million) of U.S. adults aged 18 years or older suffer from mental illness, and 4.2% (9.8 million) suffer from a seriously debilitating mental illness. These statistics are driving a paradigm shift in the role of RNs as primary care services suppliers and RN entrepreneurs. Increasing numbers of RNs will be needed to care for the growing number of U.S. adults with chronic conditions and geriatric syndromes. These trends will shape and mold the nurse entrepreneur of the future.

Introduction A shift is being made from the biomedical model of illness toward population health management by focusing on assessment, prevention, wellness, and chronic disease management. As a result, the demand for primary care services in New York State is projected to rise over the next five years, due largely to population growth and aging, and to a smaller extent, to expanded health insurance and New York’s history as a gateway for immigration into the United States. Primary care serves four important functions: It enhances access to care for each new medical need; it provides long-term, person-focused (as opposed to disease-focused) care; it facilitates comprehensive care for the majority of a person’s health-related needs; and it integrates coordination of care when it must be sought elsewhere.

Currently, the leading causes of illness, disability, and death in New York are largely preventable. Primary care encounters with healthcare providers are important occasions for addressing preventable illnesses, health promotion, disease prevention, and treatment (Epi, 2011). Nurses, in the role of primary care providers and entrepreneurs are uniquely positioned to promote and provide quality primary care within a social justice system by supporting the development of targeted products and services of a direct care, educational, research, administrative, or consultative nature (Vannucci & Weinstein, 2017). Nurses now have the opportunity to move their skill set beyond the bedside, explore entrepreneurship opportunities, and become drivers and leaders in population health management and equal access to healthcare services for all populations. Nurses now have a unique opportunity to focus on alternative, nursedriven detection and prevention models of care that can provide patients (individuals and families) and other clients, such as industries, schools,

Carol Lynn Esposito, EdD, JD, MS, RN-BC, NPD, is currently employed by the New York State Nurses Association as the Director of Nursing Education and Practice. She also held positions at NYSNA as the Director of Labor Education, and as Associate Director in NYSNA's Labor Program. An attorney with over 25 years experience in the field of medical and nursing malpractice, and 30 years as a nursing educator, Dr. Esposito has been adjunct faculty at Adelphi University School of Nursing; Hofstra University; University of Continuing Education; Dowling College; and Excelsior College School of Nursing. She has authored many articles and text materials on subjects of interest to nurses. Lucille Contreras Sollazzo, BSN, RN-BC, NPD, is currently employed by the New York State Nurses Association as the Associate Director of Nursing Education and Practice. She also has held positions at NYSNA as the Associate Director in NYSNA's Labor Program and as a Nursing Representative in the Labor Program. A nurse for over 30 years, she has worked in many specialty areas and has just completed a Master’s Degree in Nursing Education. 26

Journal of the New York State Nurses Association, Volume 46, Number 2


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