Today's economic difficulties in the health care industry are producing an ever-increasing number of reasons for nurses to seek other areas in which to market their skills or to develop entrepreneurial ventures in which they can invest their experience. Most experts on career change recommend that prospective job-changers in already overcrowded fields search in areas where their skills and experience relate to the work of the company in ways that may be unexpected (Costa, 1994; Neidlinger, Bartleson, Drews & Hukari, 1992). Barring the availability of fields directly related to the individual's experience Costa (1994) also suggests that job seekers investigate fields where pressures for better cost management and fallout from systemic changes (as in the health care industry at large) make the job-seeker's expertise particularly valuable. In the health care fields, the economic problems of hospitals have had negative effects on all types of providers except for those instances (e.g., home care) where entrepreneurs step in to fill gaps created by broader changes in the system. The point has finally been reached where nurses are finding it difficult to locate jobs. Over half of the hospitals surveyed in a recent study intend to hire fewer RNs and greatly increase the number of unlicensed assistive personnel (UAPs) on staff (Manuel & Sorenson, 1995, p. 251). Emergency Medical Services (EMS) is one area that is undergoing the same downturn in business as that experienced by hospitals. But, as Nordberg (1995, "Simply") points out, this has produced a need for EMS managers with greater skill in management techniques (especially quality management), training and experience in caring, the ability to provide direct supervision and assistance if the need arises, a knowledge of medical care, experience in the supervision of unlicensed caregivers, and the ability to deal with other managers of medical facilities.
Since the mid-1980s the i...