Independent Nurses providing medical care? - page 2

This may be a dumb question, but how can a nurse be an independent care provider as so much of what we do depends on physician orders (IVF, meds, certain procedures, etc.)? Do you collaborate with... Read More

  1. by   laserRN
    Hi, I have NSO, but.....when you ask them directly, there are many things they do not cover. Even though working with Lasers is under the Nurse Practice Act in California, they will not cover Nurses doing Laser when you ask them. Also, doing injectibles like Botox and Collagen is certainly something any RN is qualified to do (they are SQ and itradermal injections), they will not cover this either!!!!
    Just FYI.
    Good night....I am pooped.
    LaserRN
    Quote from nightngale1998
    NSO, I believe does have this type of coverage. You would, cover your self individually and then have separate insurance for the corp. through (possibly NSO). You would still be an "employee" but of your business which is really a separate entitiy as a corp.

    If this does not work, chekc with the Better Business Bureau in your area.

    night
  2. by   nightingale
    Yikes!

    Do you have an association that you are aware of (or belong to) that might have an idea? I wish I knew but obviously I do not have a good recomendation. Let us know how your research is going and what you have found out. We all learn so much by these conversations.
    Night
  3. by   laserRN
    I am doing a lot of research on this subject. As more nurses become independent contractors, insurance takes on a whole new meaning. In other words, no more falling back on the 'deep pockets theory'! I will post what I find out as I go along.
    Thanks!
    Quote from nightngale1998
    Yikes!

    Do you have an association that you are aware of (or belong to) that might have an idea? I wish I knew but obviously I do not have a good recomendation. Let us know how your research is going and what you have found out. We all learn so much by these conversations.
    Night
  4. by   suzanne4
    I sent a couple of e-mails back to the US to get some insurance info for all of you. Offhand, I don't remember the name of the company that used to provide my coverage for my medical dermagraphics company.

    I will update this as soon as I get some feedback.
  5. by   mrd330
    Hi where do have liablity insurance through??

    THanks,
    Matt (mrd330@comcast.net)


    Quote from retiredusaf
    I too am an "Independent Nurse". I got tired of all the OR call, politics, and lack of quality of life (because of all the call... 2 weeks a month of beeper AFTER the regular work day.) We also had a new DON. Before she came, it had been approved that 2 of us not on call could leave early when everything was done, still be paid, and HAVE A LIFE! IF we were slow during the day, and 4 of us did not always need to be there till the clock struck 3pm,we could take care of personal things that needed to be done, like a car repair, going to Walmart, seeing a ball game our child was playing in a nearby town, etc. Being able to do these thing ONCE IN AWHILE helped morale so much that we did not mind the 15 days a month we could not even swim, cut the grass, take a shower without wife listening for phone, etc. You need to know that the closest mall is 2 hours away, and Walmart is an hour. Well a new DON put a stop to it all! So as a Dept. we offered to take a $5000 a year pay cut EACH to be able to continue what we'd been doing. Well, the cut in pay was looked at in some ridiculous way as a PAY increase over our hourly rate (less than $20. hr I might add with 20 yrs as a nurse and a BSN!) They did not add in all the Call pay we earned during the year. (1.25 an hour.) Her other concern was ,"What will the other nurses think?" "It won't be fair to them!" That was the stupidest thing we ever heard! That is comparing apples to oranges! Other nurses in this town are OFF when they are not working. They are not called back in. They did not pull call. Well, within 3 months..... 3 out of 4 of us OR nurses quit, and we had over 50 yrs experience between us!!!! Do you think they asked us how they could keep us? NO! Was there an EXIT interview? No.
    That was over 2 yrs ago. Do you think they have REPLACED us with nurses? No, they did replace one of us with an OR tech, but she too is gone. They have hired TRAVELERS and are continuing to do so!! Think of all the money they have spent......all because we asked for some "time" to go home early if we were not on call, and IF the work was done ,yet make enuf money to support our family and call this time "comp" time. .. and take advantage of the daylight hours, knowing the next night we had call and that weekend too. THAT IS WHEN I became independant!!!

    I started a business for tax purposes, incorporated and am president of the company. I can advertise myself as indep. or as an agency depending on what the hospital wants to work with!! Some hospitals will not touch an indep. nurse, they want to go thru an agency. Others are tired of the high price of agencies and want to negotiate a lower price with an indep. contracted nurse, and in either case I bring in over $50 an hour and $8 hr for call. And this is LOW sompared to what agencies charge in other places. I have worked in WY., close to home, am home on weekends and the hospital gives me an apt. free!! ( Since our towns are so far apart, I have to travel. Other indep. nurses can continue to live at home, and contract with a hospital for a designated period of time.) I can depreciate my truck, I pay workman's comp, I have all the liability insur to protect me, I pay my own payroll taxes too, and I can deduct my medical and life insur. as a business expense. I follow all the State rules for a corp. in WY.
    I plan to travel with my motor home in the next 2 years and finish seeing the US. Yes, it is hard not being in my home, but because I am treated so well and paid what I am worth, and pull less call, I really like it. My attitude is: "I am part of the solution, not the problem".
    Indep. nurses are not employees of the hospital... and the IRS has guidelines for indep contractors. Think of yourself as a construction worker with your own business. You make up a contract that you will complete this job by the safety standards, codes, etc. and you will be on the job for X amount of time and for X amount of money. You are trained and do your work for the sake of the project being the best it can be. You state the terms you will work under, and they sign your contract (written by a lawyer).you submit an invoice weekly, monthly, and they pay you. You pay your own taxes and your benefits yourself. You pay your own training, drug screenings, etc. You are not an employee of that firm. That is the philosophy to take as an indep. contractor/ nurse.

    I hope this helps clarify what we do. Please think outside of the box, and help nursing be what it should be. Be happy with your job, either stick together for better benefits and conditions, or branch out like we did. By the way, out of the 3 that left, 2 of us are doing this! My friend works 6 months of the yr, takes the rest of the yr off!
  6. by   nightingale
    If anyone has anything to add on where they have company liability insurance, could you please post it here for all of us to get the info?
  7. by   NRSKarenRN
    the importance of professional liability insurance in managing risk


    abstract and objectives

    abstract
    in 1998, the independent study text "take control: a guide to risk management" was published and co-provided by seabury & smith (formerly maginnis & associates), the chicago insurance company and the illinois nurses association. it was distributed by the american nurses association's constituent member associations. the objectives of this text were to: identify key issues of concern in risk management and describe strategies nurses can use to manage risk.

    seabury and smith corporation has now asked ana to transform this text into "the nursing risk management series" of three different independent study modules (isms) for placement on ana's nursingworld.org web site. the information and knowledge gained should assist nurses in all clinical practice areas to take control and manage the risks within their individual workplace and nursing practice.

    each module contains the abstract, specific objectives, text, reference list through 1998, an updated reference list through june 2001, the nursing post test and its feedback section. the registrant who successfully completes each ism will earn ana's nursing continuing education contact hour certificate.

    these independent study modules are:

    i: "an overview of risk management" (1.4 contact hours);

    ii: "the rewards and risks of the functional aspects of nursing education, information systems and management" (2.8 contact hours) and

    iii. "ethical issues and specific risk hazards faced by nurses in their practice." (1.4 contact hours).

    objectives:
    1. describe the importance of professional liability insurance in managing risk.
    2. explore ways that managed care has changed roles and subsequently impacted risk for nurses.
    3. explain the ethics of managing risks from two perspectives: 1) an organization's wide view and 2) other selected areas of focus
    4. discuss an overview of environmental health & safety risks in the health care industry.
    5. analyze the occupational health risk of latex exposure and the environmental risk of hospital waste both of which affect nurses and the patients for whom they care.
    http://www.nursingworld.org/mods/arc...2/cerm3ful.htm


    developed and funded by ana's professional liability insurance provider, seabury and smith, a marsh & mclennan company and the chicago insurance company. to apply go to: http://www.proliability.com/ana

    for $2-4 million coverage with seabury and smith, as ana member i pay $104.00/year; they've been my peace of mind for over 20 years.
    Last edit by NRSKarenRN on Sep 14, '04
  8. by   laserRN
    hi, just a question? did you post this because it had to do with being an independent practitioner? i went to the website and it only refers to 'employed nurses'. not self-employed nurses. if you have any info to add we would sure appreciate it!
    thank you,
    kathy
    Quote from nrskarenrn
    the importance of professional liability insurance in managing risk


    abstract and objectives

    abstract
    in 1998, the independent study text "take control: a guide to risk management" was published and co-provided by seabury & smith (formerly maginnis & associates), the chicago insurance company and the illinois nurses association. it was distributed by the american nurses association's constituent member associations. the objectives of this text were to: identify key issues of concern in risk management and describe strategies nurses can use to manage risk.

    seabury and smith corporation has now asked ana to transform this text into "the nursing risk management series" of three different independent study modules (isms) for placement on ana's nursingworld.org web site. the information and knowledge gained should assist nurses in all clinical practice areas to take control and manage the risks within their individual workplace and nursing practice.

    each module contains the abstract, specific objectives, text, reference list through 1998, an updated reference list through june 2001, the nursing post test and its feedback section. the registrant who successfully completes each ism will earn ana's nursing continuing education contact hour certificate.

    these independent study modules are:

    i: "an overview of risk management" (1.4 contact hours);

    ii: "the rewards and risks of the functional aspects of nursing education, information systems and management" (2.8 contact hours) and

    iii. "ethical issues and specific risk hazards faced by nurses in their practice." (1.4 contact hours).

    objectives:

    1. describe the importance of professional liability insurance in managing risk.
    2. explore ways that managed care has changed roles and subsequently impacted risk for nurses.
    3. explain the ethics of managing risks from two perspectives: 1) an organization's wide view and 2) other selected areas of focus
    4. discuss an overview of environmental health & safety risks in the health care industry.
    5. analyze the occupational health risk of latex exposure and the environmental risk of hospital waste both of which affect nurses and the patients for whom they care.
    http://www.nursingworld.org/mods/arc...2/cerm3ful.htm


    developed and funded by ana's professional liability insurance provider, seabury and smith, a marsh & mclennan company and the chicago insurance company. to apply go to: http://www.proliability.com/ana

    for $2-4 million coverage with seabury and smith, as ana member i pay $104.00/year; they've been my peace of mind for over 20 years.
  9. by   WyomingRN
    Quote from nightngale1998
    If anyone has anything to add on where they have company liability insurance, could you please post it here for all of us to get the info?
    My company insurance is with NSO. The company policy covers me and any nurses I have to hire throughout the year. This year my cost is approximately $300. Each year it is evaluated to see have many employees I have had. That is the main basis as to what the yearly cost is. It also covers them even though they are part time. I am happy with the policy as so far, I have not seen anything else anywhere to match the coverage or price.

    The policy is in the company name and has the same coverage as my personal policy had- 1million/6 million.

    NSO has a separate division for company/corporate policies. The number I have on my policy folder is 888-288-3534.
  10. by   Nrs. LaLa-Land
    I am an RN interested in Aeshtetics. I have searched various educational programs regarding Medical aesthetics. I am in So. Calif. and would be interested to know about the training program you went through (LaserRN). If you could answer any questions regarding what kind of licensure and certification you have and what you did to achieve them, I would greatly appreciate it!
    I am currently signed up for a medical aesthetics mileu 2-day course in orange county. I am also considering the botox/dermal fillers course as well and probably the laser course too. What kind of laser course would you recommend. Is a one-day class enough training? Pretty expensive but I am prepared to invest in myself.
    Please..any help or suggestions would be wonderful!
    Thanks in advance!!
    Nrs. LaLa-Land
  11. by   laserRN
    Hi,
    I am curious as to which training class you signed up for. I work part time for the Esthetic Skin Institute....as a matter of fact I teach the Laser Class.

    I took the training with the Eclectic Skin Institute which was a partnership that broke up. My Certificates came from them, and they have served me well. I am also certified from about 6 Laser Companies to treat with their equipment.

    One of the partners (Sasha Parker) formed the Esthetic Skin Institute, (www.estheticskininstitute.com) and (having assisted with the parent co) asked me to help her. I am an assisitant instructor, but teach the Laser Class by myself.

    From a rather biased view point :wink2: I think the classes are phenominal. You will get tons of hands on instruction. The information is complete, and as up-to-date as you can possibly get. You are given ways to practice (i.e., independent, business owner, employee, etc.), ways to set up a business....I could go on and on. The classe are a mix of M.D.s, R.N.s, and a few P.A.s.

    I would love to hear back from you. You may have signed up for the A.E.I. classes, which are taught by the other former partner (Barbara Jones). I have not viewed her classes since she became independent, so I cannot speak to the quality of the course.

    Hope that helps!
    Kathy Jakary R.N., B.B.A.

    Quote from Nrs. LaLa-Land
    I am an RN interested in Aeshtetics. I have searched various educational programs regarding Medical aesthetics. I am in So. Calif. and would be interested to know about the training program you went through (LaserRN). If you could answer any questions regarding what kind of licensure and certification you have and what you did to achieve them, I would greatly appreciate it!
    I am currently signed up for a medical aesthetics mileu 2-day course in orange county. I am also considering the botox/dermal fillers course as well and probably the laser course too. What kind of laser course would you recommend. Is a one-day class enough training? Pretty expensive but I am prepared to invest in myself.
    Please..any help or suggestions would be wonderful!
    Thanks in advance!!
    Nrs. LaLa-Land
  12. by   Nrs. LaLa-Land
    Hi...thanks for your reply.
    I have signed up for the 2-Day Milieu class with Esthetic Skin Institute. I am also signing up for the Botox class. THe Dermal Fillers course and the LASER courses are full. I have looked into AEI classes but she is approx $500 more per class than Sasha Parker.
    Since the ESI laser class is full, I was considering taking a course in San Diego. It is a one-day laser course for approx $1200. They are called the Academy of Aesthetics and Laser Medicine. They also offer the Dermal Filler course. I am taking that training through them. Do you know anything about this company?

    I am going into this new area of my profession blindly. I have not had the opportunity to chat with an RN in this field. Needless to say..I was excited to see your post saying how much you love it.
    Do you mind entertaining my questions?
    In your experience, did you find it difficult to find a job in this line of work once your classes were completed? Do you feel like the training was enough to work competently and safely? My fear is that I am going to take these classes and not be able find an employer in my area. I would initially like to work in an office just to get some good experience...and then eventually venture out on my own. Would you recommend working for a plastic surgeon or a dermatologist? Can I expect my pay to be equivelant to my hospital pay?
    Thanks so much for the info....I really appreciate it!!!
  13. by   Mister Chris
    Quote from nightngale1998
    If anyone has anything to add on where they have company liability insurance, could you please post it here for all of us to get the info?
    I have been a Registered Nurse for over 30yrs. The last 4yrs. self employed - "Independent Nurse". I get my personal indemnity insurance through the Queensland Nurses Union Membership. I do not have the details to hand but you could inquire through the nursing unions where you are - hopefully you do have some sort of body that gives you independent suport? I also have other insurance to cover me for sickness etc 'income protection' and 'disability insurance'.
    Yes it is great being independent - and yes you have to be a bit of an entrepreneur to make it successful.

    Good luck

    Mister Chris.

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