The entrepreneurial nurse-midwife: A profile of successful business practice

The changing health care market increases competition for professionals who provide patient services so it is imperative that nurse-midwives in entrepreneurial ventures recognize strategies most likely to result in financial profitability and create models of efficient service delivery that can both survive and prosper in the new market economy. Roy\u27s Adaptation Model of Nursing Administration (RAMA) provided the structural framework to develop a profile of 99 nurse-midwifery practices and to determine if variables representing small business location, size, and financial indices; characteristics of role performance associated with management functions; personality traits of nurse-midwife owners; and environmental influences experienced in the current economic climate were related to business success as measured by a financial index of relative profitability. Only 20 practices of the 67 providing numerical data on revenues and expenses reported successful business performance relative to the industry standard. Practice owners with successful business performance reported a smaller financial investment made at time of startup, a smaller number of new clients relative to the overall client caseload base, and less professional experience prior to their first entrepreneurial venture. Limited significant findings demonstrated that for the sample studied, evidence of successful performance was not related to organizational adaptation, and credibility of the RAMA could not be supported