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JOURNAL OF RESEARCH IN NATIONAL DEVELOPMENT VOLUME 6 NO 2, DECEMBER, 2008

PROJECT AND ENTREPRENEURSHIP IN NURSING

Dr G. F.  Okorafor
Department of Project Management Technology
Federal University of Technology, Owerri, Nigeria

Abstract

The paper is on the relevance of project and entrepreneurship on the life of a nursing professional. It highlighted the general economic well-being of the average Nigerian worker and how the nursing professional fits into the socio-economic cobweb identified as the Nigerian paradox. The average Nigerian nursing professional being honest and hardworking finds it hard to cut corners in order to make ends meet. In order to economically survive, the professionals for one reason or the other have found their way (exodus) out of the profession to the detriment of the societal interest. It was also seen that the management of the retirement benefits in the past in both sectors of the economy has been everything but honest and transparent. In order to enable the professional enjoy today’s full life as well as life on retirement, the need for entrepreneurship and project executions becomes the only viable option.

Keywords:  Nursing professional; Project, Entrepreneurship Pension Funds.


Introduction
Nigerian as a nation paradoxes of life. This is so for obvious reasons. The nation has abundant human and non-human resources yet nothing seems to work well in the country. The nation’s annual revenue earnings especially from her crude petroleum sales are on the increase yet the country is one of the poorest nations on earth.  The take home pay of an average worker in the country has risen by more than ten folds in the last ten years yet an average worker cannot afford an average of two decent meals a day. The average worker is hard working yet has nothing to show for the hard-work at the end of the day. The nation is a country where decent and honest workers merely struggle to make a living. Nurses happen to fall into the category of Nigerians that can be described as honest and hardworking and who barely make a living out of their sweet. When one finds it hard to have a decent life when in active service, one wonders what becomes of such a person when he/she is off paid service. The problem that therefore confronts members of the nursing profession is how to survive in a paradox country called Nigerian in the short run and have a decent living in the long run. I believe that this is what this paper attempts to address. In order to address the problem the concepts of project and entrepreneurship are brought into focus.

Nursing Profession
As this discussion is organized under the aegis of the nursing profession, it becomes paramount that we understand what the profession is all about. A profession is simply a vocation or occupation which involves special learning and carries certain amount of social prestige. Lexion Publications (1995) is of this view and we fully subscribe to it. A nurse is a person trained to take care of the sick or the infirm under the direction of a medical doctor. This person is usually a woman from the beginning though men have today found their way into the profession. Nursing profession is therefore a vocation composed of men and women with special training to take care of the sick and the infirm. The profession is therefore not an ad-hoc arrangement by commercially oriented people but something one takes up as a life career. The mere fact that the members of

this profession deal mainly with the sick and the infirm indicates that their hearts must be made up of loving, tender and kind substances. True nurses cannot be financial merchants and cannot subject their clients to financial embarrassments. Their major pre-occupation is to keep their clients happy whether rich or poor. Members of the profession therefore make all attempts to keep body and soul together with their legitimate take home pays under the paradox situation exhibited by the Nigerian nation.

There is a general saying that only the sick needs the services of doctors and nurses. There is also a saying that economic poverty breeds sickness. The import of these sayings is that a populous Nigeria with high level of economic poverty in the midst of huge resource base will naturally have a lot of sick people and hence an increasing number of nurses to take care of the sick. The question then is does Nigeria have the required nurses to take care of its growing sick people. This question can be answered by a look at table 1. Between 1994 and 2004, the population per a nursing staff rose form 615 to 2872. This actually peaked at 3048 in the year 2000. Within the same period the number of registered nurses dropped from 157, 338 to 45239. In actual sense the annual growth rate of nurses with the period was –6.30%. A lot of dedication can be made from these and these include:

  1. There have been decreasing number of people wanting to take up nursing vocation while the population has been on the increase.
  2. It does appear that those already in the profession find their way out at the slightest opportunity. The decreasing number of the professional on year to year basis attest to this. It is inconceivable to believe that the number of people in a highly needed service area could drop from 164466 in 1995 to 100397 in 1996 and from 123562 in 1999 to 37803 in 2000.

 

On can conclude that the scenario exists because nurses are made of softer hearts and would not soil their hands by doing illegal things, yet, they live in a Nigerian paradox situation. The best way out to most being therefore to check out of the profession at the earliest opportunity.

Retirement and Life After

The life of a man is akin to a project life cycle. There is the time for development, maturity and finally decay or descent. Every individual who lives a full life has a time when he/she must take a permanent rest from the sequence of activities he/she has been used to all his/her active life. This withdrawal is termed retirement and retirement can either be forced or voluntary. Which ever way the full implication is that the usual sources of livelihood has been closed while life itself still goes on. My friends, the Agulannas (2003) have done a good job in informing the public on the best window to manage this new life. In order to continue a bit comfortably after retirement which must be against the run of age and vitality, new sources of income must be developed. It is however necessary to note that retirement is not restricted to those in paid jobs only. People in private practice can also retire from their normal occupation as a result of age and or sickness a good number of nurses are on there own and hence on private practice. When one is forced to leave his/her normal source(s) of living for whatever reason, he/she becomes a burden unto others except proactive means of alternative sources of living have been put in place. In our country today, most people in paid jobs look up to their pensions and gratuities as the alternative sources of living on retirement. The futility of dependence on these sources have played itself out in our country.

The public sector pension has been non-contributory till of recent and the public sector management of the pension fund has been everything but satisfactory. A good number of retirees including nurses have died in the process of pursuing their pension benefits or turned beggars and dependants

because of the non-availability of the benefits. Receipt of gratuities is a privilege bestowed on a few individuals. Gratuity is a bulk payment made once in order to enable the beneficiary start off a new life. Because of the amounts normally involved, the public sector organs responsible for the processing and payments normally hide under the cloak of unavailability of funds to deny the would be beneficiaries their entitlements. At the end of the day, pension and gratuity become more of paper exercise than reality to the would-be beneficiaries. Under this sceneries, those who fail to make alternative arrangements for the retirement normally end up being customers to nurses but non-fee paying ones for that matter. Nurses in this category become patients or rather friends of the ones still in active service. Hence, over burdening the working nurses without adequate compensation.

On seeing the futility of relying on the old pension scheme as a source of living after one’s working life, the Federal Government of Nigeria has gone ahead and repealed the old pension Act and introduced new ones. The new and the old scheme are indicated in Table 2. The only major change in the new scheme is the concept of participatory contribution. We strongly believe that the ills of the old scheme may not been cured by the new scheme. The problem has never been the percentages paid out as gratuity or pension but the management of the schemes. We are of the opinion that the beneficiaries will still have to pay their way through the various structures put in place for the scheme’s management. The scheme has been handed over to the so-called private sector profit motivated agents whose main drawing force is project maximization and not the welfare of the beneficiaries. A critical study of their operations would reveal to any critical mind, that these insurance companies were only out to milk innocent contributors dry. The same agents have turned around to become managers of public sector pensions. Many God save this country.

In view of the low purchasing power of our currency which makes nonsense of the

jumbo salaries received by the Nigerian working class and the failure of both the public and private sector managed pensions in the past, the success or failure of living after an active career life of a professional like a nurse will depend on such factors as age and health of the concerned; the socio-economic environment obtainable; the family stability and the network of people built up while in active service. These must be proactively planned for if healthy living is anticipated. The planning and plan executions are products of projects and entrepreneurship.  

Project

Many authorities have tried to define a project in the past and have come up with varied definitions depending on the leanings of the authors. A few of these definitions may be useful here. Gray and Larson (2003) defined a project as a complex, non-routine, one time effort limited by time, budget, resources and performance specification to meet customer needs. Frankel (1990) just defined a project as organized activities, which are meant to make things happen; stting that successful projects cause improvement to those concerned. Kerzner (2003) preferred to define a project  by stating what a project is identified with. These include:

  1. Having specific objectives to be met within certain specifications
  2. Having a start and end dates
  3. Having funding limits
  4. and consuming human ‘and non-human resources. Finally, the Project Management Institute of USA  (2004) defined a project as a temporary undertaking with a view to creating unique products, services or results. Form the above definitions, one can easily state that a project is a unique, finite undertaking with clearly defined objectives and in most cases will involves interrelated activities or tasks which outcome will satisfy the stakeholders or clients needs within the constraining parameters of time
  1. cost and quality. We may add at this point that a project provides the base from which future needs can be satisfied. Project are not ends unto themselves but means to ends. The intents of projects are therefore futuristic and pro-active. The meaning therefore is that projects are embarked upon in order to satisfy future needs. Embarked upon in order to satisfy today’s need. Here lies the relevance of projects to the nurse professionals. We have stated the problems nurses face meeting their daily needs in the paradox nation called Nigeria in the normal cause of there professional career. The problem becomes how will nurses improve themselves economically while still in active service and later on retirement. The concepts of project makes meaning here. Project are how ever not embarked upon by all and sundry. Only people with special talents can and do embark on project implementation. These special people are called entrepreneurs.

 

Projects in Nursing

Nurses from a critical component in the health service delivery system, hence no health service delivery can be complete and comprehensive without the inputs of nurses.

Are there some health services that can be delivered on project basis? if yes, it then means that some nursing inputs can be delivered on project basis.

Existing health service programmes in Nigeria like the NPI, ORT, the mosquito eradication consist of clusters of activities called project. Each cluster is time based, needs budget and has specific output specifications. The success of the programmes are therefore dependent on the related projects.

The import of the above is that the success of the programmes depends much on nurses

acquiring the vital knowledge of project management.

 

Entrepreneurs
Honest and decent people in Nigeria hardly make ends meet by relying mainly on legitimate rewards from their gainful employments. In order to take care of the shortfalls in meeting day to day needs and take care of the future, projects must be embarked upon by the gainful employees. Only entrepreneurs do this. Stoner et al (2000) defined an entrepreneur as an originator of new business ventures as well as new organization for the new ventures. Such a person has the ability to make use of factors of production to produce new goods or services. He is therefore able to perceive business opportunities that many do not visibly see or do not care about in order to create wealth with which to enhance the quality of life. Drucker (1986) simply said that an entrepreneur if he/she who searches for opportunities, responds to identified ones and exploits them.

How do entrepreneurs get started? Longenecker et al (1997) identified four ways through which entrepreneurs can get started and these include.

  1. To start a business from the scratch
  2. To buy off existing business
  3. To open a franchised business
  4. To enter into a family business

In order to have successful entrepreneurs, two elements are very critical. These are education and experience. Time is normally needed to acquire these elements. There is a minimum time to gain the necessary education and experience. We believe that all present here knows how long it takes to produce a qualified and registered nursing professional. Equally, we are aware that the acquisition of the paper certification does not necessarily make one a nursing professional. A period of practice is needed. We note however that the acquisition of the two named elements does not signal the emergence of entrepreneurs.

Entrepreneurship involves embarking on project executions and project execution involves risk taking. A good number of Nigerians inherently dislike work and the attendant risks. This view corresponds to the view already expressed by McGregor (1960). In order to produce successful entrepreneurs from the nursing professionals, it is necessary to consider the issue of capital accumulation. This is very necessary because financial resources are needed to meet current family responsibilities which many members of the profession find hard to meet. Gambling with the little financial resources available with high potentials for failure against current family obligations becomes a matter for serious consideration. We are aware of the saying that fortune favours the brave i.e. the higher the risk, the higher the returns. As a result of man’s dislike for risk taking, successful entrepreneurs are normally created by what Longeneker et al (1997) called precipitating events. These events include loss of jobs, job dissatisfaction and or unexpected opportunities. In this country, loss of jobs appears to be the main motivating force behind the emergency of many entrepreneurs.

Few reasons are normally adduces for the emergence of non-forced entrepreneurs and these include:

  1. Profit maximization: in this regard, the entrepreneur expects returns that will not only compensate for time and money invested but also for risks and initiatives taken.
  2. Independence: The entrepreneur is free from others supervision and bureaucratic rules.
  3. Freedom: the entrepreneur is free from routine, boring and unchallenging jobs.

These benefits make an entrepreneur a more fulfilled individual than an employee of other persons or institutions. Bearing the above in mind, nursing professionals do not need to wait for the precipitating events to occur before embracing the entrepreneurial sprit.

Illustrations

In order to appreciate the relevance of projects and entrepreneurship in enhancing the quality of life people, nursing professional inclusive, we illustrate with a hypothetic case of a nursing professional. In doing this we need to note the following facts:

  1. The new pension law stipulated that employees must contribute a minimum of 7.5% of their monthly emolument to the pension fund while the employers would contribute a minimum of 7.5%.
  2. Employees cannot access funds from the pension scheme until they attain the age of 50 year or on retirement which even comes later.
  3. We assume full working life of 35 year which starts at the age of 25 years. Hence, retirement is at the age of 60 years.
  4. We assume that our nurse earns on the average, N100,000.00 monthly emolument for the 35 years working life.
  5. Withdrawal from the pension fund is monthly.
  6. Average earning from the pension fund is 6% pa.
Option A: Pension and Gratuity

If the nurse is not a risk taker and only depends on the anticipated pension and gratuity because contributions to these are mandatory as per the pension Act, the contribution to the pension fund compounded at 6% for the 35 years is equal to N11,143,478.00. When the employer’s counterpart contribution is added, the account balance stands at N22,286,956.00 on retirement from active service at the age of 60 years, our hypothetical professional is entitled to 300% gratuity and 80% monthly pension. These are based on the terminal emolument which in this case in N100.000.00

The gratuity would amount to N30,000.00 and monthly pension of N80,000.00

  1. To the uninitiated, these appear very rosy. But wait a bit. These can only materialize after 60 years as nothing can be accessed from the source before this period.
  2. What is the average life expectancy of Nigerians?
  3. Life must be lived before one is 60 years
  4. Habits are not learnt over night. If one is not used to taking business decisions and the associated risks, he/she cannot learn to do so after 60 years.
  5. What is the history of Nigeria in pension funds managements both at the public and the private sector levels. Dismal is the answer. One then wonders how the attitude can substantially change in foreseeable future. We leave our salves to think over this but we must remember the history of the defunct National Provident Fund (NPF) and the National Housing Fund (NHF). 
Option B: Financial Investment

We assume here that contribution to the National Pension Fund is mandatory to all employees but that this employee wants to be an entrepreneur. To do this, he/she has elected to save another 7.5% of the monthly emolument towards the realization of this dream. This means that the employee saves 15% of the monthly emolument distinct from the employer’s 7.5% contribution to the pension fund.

The monthly savings amount to N7500.00. if this is left in a savings account at 6% per annum compounded, the balance at the end of the first year will amount to approximately N98,500.00 this amount can now be invested in a high yielding equity that currently sells at N15.00 per share. The total shares purchased will be 6566 shares.

 

If we assume that the equity earned 50k per share in the first year and the share price rose to N20.00 per share and script issue of 5 to 1 given to the equity holders, the scenario would appear as follows:
⇨         Total dividend earned…N3,283.00
⇨         Script issue                     …1,313
⇨         Total shares                    …7,879
⇨         Worth of shares              …N157,580.00

From the above, the employee can utilise the realised dividend to take care of family financial requirements while the worth of his / her investments continues to increase. This is scenario for the first year only. The same N7,500.00 would be available monthly for further investments and the investor has the opportunity of shifting the investments to various portfolio according to market situations.

Option C: Investment in Small Businesses

In the option C, our professional decided to be an entrepreneur from day one. In order to achieve this, the seed capital is saved from the first year of service. The seed fund is taken to be the 7.5% monthly emolument saved in the year and this approximates N98,500.00. This amount is invested in a small business in any of the ways already indicated by Longenecker et al (1997) if proper planning is carried out, a minimum return of 25% would be expected at the end of the second year and this will be equal to N24,625.00. The implication is that the original N7500.00 per month saved in the first 12 months would have become about N123, 125.00 by the end of the second year. The savings in the second year will still be in tact. From the above, it would be seen that the employee,

  1. Should have earned an additional N24, 625.00 minimum which could be used for current consumption at the end of year two.
  2. Still has the savings and hence investments in tact and in growing state.
  3. Already has a fall back position in case any of the precipitating factors occur.
  1. May have created employment for other people
  2. Does not have idle time for gossips and evil thinking.
  3. Would have built-up a solid base for the future generation
  4. Would have adequately taken care of the current and future consumptions of the family
  5. Benefits from the pension fund when materialized would on be an added-on and no more principal source of living.

 

Conclusion

The conclusion involves restating the following:

  1. Life for salaried workers in Nigeria has become more of nightmare because of the existing paradoxes in the country.
  2. The public workers who survive and live moderate lives are those who cut corners
  3. Decent and hard working professionals find it hand cutting corners and the nursing professional belong to this group.
  4. The management of retiring benefits and such other programmes like the former NPF and NHF has been anything but transparent and successful.
  5. The retirement benefits even if successfully husbanded cannot be accessed until one retires at 60 or at a minimum age of 50 years, in which case, such benefits will not be available for current consumption. One needs to live to retires.
  6. For any nursing professional to aspire to live a good and decent life today and hopes to have a comfortable retirement, such a professional must get involved from the on-set with project and entrepreneurial developments. This cannot be done without the necessary seed fund. We therefore recommend that all concerned take
  1. immediate steps to start saving a minimum of 15% of the personnel emoluments. 7.5% of this goes to the pension fund account while the balance of 7.5% of this goes to private savings accounts. The best way to handle the private saving is to direct one’s bankers to credit such an account from the proceeds of one’s salary accounts using a standing order instrument, No withdrawal should be made from this savings account under any condition. The ability to withstand the temptation of withdrawing from the savings accounts is the major test of the entrepreneurial spirit and drive.    

 

References
Agulanna E.C. and Agulanna G.G. (2003) Management of Retirement and Ageing:  Owerri; Joe Mankpa Publishers

CBN (1998,2000,2004) Annual Reports and Statement of Accounts, Lagos, CBN

Drucker P.F. (1986) Innovation and Entrepreneurship;  New York; Harper and Row

FGN (2004) Pension Reform Act: Lagos, FGN press

Frankel E.G. (1990) Project Management in Engineering Services and Development; London Butterworth’s

Gray, C.F. and Larson E.W. (2003) Project Management: The Management Process; New
York; McGraw-Hill

Karzner H (2003) Project Management: A Systems Approach to Planning, Scheduling and Controlling: Ohio; John and Sons.

Lexicon Publications (1995) The New Lexicon Webster’s Dictionary of the English Language; Danbury. CT

Longenecker, J.G.; Moore, C.W and Petty, J.W. (1997) Small Business Management: An Entrepreneurial Emphasis; Cincinnati-Ohio; South Western College Publishing.

McGregor, D. (1960): The Human Side of Enterprise; New York, McGraw-Hill

PMI (2004) PMBOK Guide  Newtown Square Pennsylvnia

Stoner, A. F.; Freeman, R.E. and Gilbert, D.R. Jr (2000) Management,  6th ed. Englewood Cliffs, N.J; Prentice-Hall Inc.

Table 1:  Vital Statistics

 

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

Nigerian population (millions)

69.763

99.502

102.318

105.213

108.191

111.947

115.224

118.801

122.444

126.153

129.927

No of registered

157,338

164,446

100,397

104,246

104,197

123,562

37,803

40,619

42,619

45,232

45,239

Nurses % Growth Rate

 

 

4.53

-38.96

3.83

-0.05

18.58

-69.41

6.21

6.13

0.02

Population per nursing staff

 

615

605

1023

1014

1044

906

3048

2959

2789

2872

Average growth rate of nurses per annum

=

-   

-6.30%

 

 

 

 

 

 

 

 

  Source: statistics derived from the 1998, 2000 and 2004 CBN Annual Report and Statement of Accounts.

Table 2: Public Sector Pension And Gratuity %

Years of Service

OLD RATES Gratuity

Pension

NEW RATES Gratuity

Pension

5

-

-

100

-

6

-

-

108

-

7

-

-

116

-

8

-

-

124

-

9

-

-

132

-

10

100

-

100

30

11

110

-

108

32

12

120

-

116

34

13

130

-

124

36

14

140

-

132

38

15

100

30

140

40

16

110

32

148

42

17

120

34

156

44

18

130

36

164

46

19

140

38

172

48

20

150

40

180

50

21

160

42

188

52

22

170

44

196

54

23

180

46

204

56

24

190

48

212

58

25

200

50

220

60

26

210

52

228

62

27

220

54

236

64

28

230

56

244

66

29

240

58

252

68

30

250

60

260

70

31

260

62

268

72

32

270

64

276

74

33

280

66

284

76

34

290

68

292

78

Source: FGN (2004) Pension Reform Act 2004; Federal Government Official Gazette No. 60 Vol. 91.