"I think it's a really really bad idea. #1 being paid out of pocket is illegal, I'm assuming you won't be reporting it as income to the IRS? #2 you have no one to back you up on anything, you could easily be sued and lose whatever license it is that you have. You can go through an agency to get private duty work, you'll have backing and will pay your fair share of taxes."
Being paid out of pocket is not illegal. I occ. do private duty and report my earnings and get 10-99 from some clients. You are considered self employed, and can deduct your mileage and other expenses. Nurses have been their own employers
for years--look under Entrepreneurs in Nursing on allnurses. We are considered Independent Contractors and cut out the middleman. As long as you understand the nurse practice act and work within your license boundries, there should be no problems. And being sued is not that easy, esp. when dealing with an elderly client in a state with a malpractice cap. And when did agencies start backing their nurses? They back up who pays them, not the person they have to shell $$$ out to.
As an RN, I have taken clients who only needed a CNA/HHA and recommended to the family and pt. that is all they need for the level of care provided. And the familys have refused, saying they would feel more comfortable if they were cared for by an RN. Most of the time it was an easy visit or shift, and I got paid to read, talk with the pt. and watch TV with the client and catch them up on current affairs, as well as heard some great history stories!
I think by out of pocket she meant she would only take private pay pts., not bill insurance/Medicaid/Medicare.
I write a note everyday that I see a client in a bound book. I chart wt, meals/snacks, level of activity, meds taken, phone calls to family and MD, any interventions or suggestions/teaching to the pt/family, hygiene, time of arrival/departure and occ will have a family member sign it.