Thinking about health care differently: nurse practitioners in primary health care as social entrepreneurs
Amber Kirkman 1 , Jill Wilkinson 2 , Shane Scahill 31 New Zealand Registered Nurse, New Zealand
2 Victoria University, Graduate School of Nursing, Midwifery and Health, Wellington, New Zealand
3 Massey University, School of Management, Albany, Auckland, New Zealand
Correspondence to: Amber Kirkman, Cromwell, New Zealand. Email: amberkirkmanrn@gmail.com
Journal of Primary Health Care 10(4) 331-337 https://doi.org/10.1071/HC18053
Published: 19 December 2018
Journal Compilation © Royal New Zealand College of General Practitioners 2018.
This is an open access article licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Abstract
INTRODUCTION: Challenges facing the primary health-care sector mean that policymakers and clinicians need to think and act differently to move forward. The principles of social entrepreneurship have been implemented successfully for improved health outcomes in other developed nations. There is a knowledge gap around whether nurse practitioners (NPs) in New Zealand primary health care (PHC) align with these principles.
AIM: To explore whether and how the innovative activities of primary care NPs can be described as socially entrepreneurial.
METHODS: A descriptive qualitative approach was used with data collected using semi-structured interviews with NPs working in primary care (n = 7). Data were analysed using general inductive thematic analysis techniques.
RESULTS: Nurse practitioners interviewed worked in government-subsidised private general practice businesses. Two main themes emerged: (1) the nursing model of care aligned with social entrepreneurship; and (2) building social capital. NPs described a desire to see health care delivered differently and this aligned with acting as a social entrepreneur. Social capital emerged through the requirement to establish significant collaborative relationships.
DISCUSSION: It was found that NPs’ work can be described as socially entrepreneurial. The holistic, person and community-centred model of NP care has an ultimate mission of improved health outcomes. Social capital is built through collaborative relationships with other health-care providers, individual service users and the community. However, the juxtaposition of the business model in primary care prevents NPs from initiating and leading sustainable change.
KEYWORDS: Nurse practitioner; social entrepreneur; innovation; primary health care; sustainable; health care delivery
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