BackgroundNursing literature seldom examines Catholic sisters as entrepreneurs competing in the hospital marketplace, even though they established hospitals throughout the United States in the late 19thand early 20thcenturies.ObjectivesThis study examines the tension between hospitals as businesses and charities by asking how nursing sisters, who took vows of poverty, could build impressive hospital networks. What links did they forge to make hospital building possible?MethodHistorical methodology is used which draws upon primary sources in archives of three women’s religious congregations. These include nuns’ constitutions and letters, hospital chronicles, journals, minutes of meetings, annual reports, and census records. Secondary sources include nursing, hospital, religious, and economic histories.ResultsCatholic sisters’ entrepreneurial activities were pragmatic adaptions that reflected their commitment to their nursing and hospital establishments. They raised money and formed alliances not to build personal fortunes but to build religious values. Their entrepreneurship and spirituality worked together.DiscussionSister-nurses’ viewed their actions as doing what was necessary to their mission. A finacially stable hospital, with it’s large patient population, enhanced the social and spiritual importance of nun’s work. Yet, the broad-based corporate culture of Catholic hospitals still needs further study.