Working independently

[rachel h, BSN, RN]

I have been reading several threads about nurses working for themselves and being independent contractors. I don't know if this thread may be more appropriate for the Nurse Entrepeneurs (sp) forum, but I was wondering how a nurse can work independently providing direct nursing care, such as with private duty nursing? What kind of things can we do for patients since so much of our job relies on physician orders? Or does that all change outside of the hospital? Thanks...

[renerian, BSN, RN]

In Ohio you can apply to be an independent provider for the Medicaid program and do your own billing and such. You also have to carry your own malpractice insurance.

renerian

[crispix]

Im wondering if an LPN can be a medicare provider,perhaps under the supervision of the patients MD?

I would like to do private duty nursing,mostly for elderly persons,doing nursing care,light housekeeping,transport to doc appts and shopping,etc.Also,for caregiver relief,to give those families who care for loved ones a few hours,or maybe even overnight relief.

I am not sure where to start,have looked a bit on the state board of nursing's site but didnt really know where to look,or to find anything.

Anybody have any advice,experience?

Christine

[jadednurse]

rachel_h: check the threads under nursing entrepreneurs. I just read one that sounded like what you might be looking for...good luck!

[Edward,IL]

There is a lot of opportunity for nurses doing private duty. Nursing care, as defined by most nursing practice acts, follows the nursing process to include nursing assesment, nursing diagnosis, nursing intervention, nursing outcomes. This represents the independent domain of nursing. A nurse can arrange with a client privately to provide personal care, assistance with mobility, assistance with meals and anything else that the nurse is prepared for by virtue of education and licensure. The nurse should outline this in the Nursing Care Plan.

It's important for the professional to know their abilities and limitations, but then there is no problem. (Like if the patient has a fever of 102, an LPN would probably refer patient to his MD. A NP taking care of the patient at home might be able to order cultures and prescribe an antibiotic).

Anything that requires MD orders (medications, medical treatments that require a MD order, lab draws, etc) are included in a Physician's Plan of Treatment. This document is usually done by the nurse and signed by both the nurse and MD.

This is briefly how it works. I suggest you check ou the National Association of Independent Nurses (http://www.independentrn.com)

and become a member, attend a seminar if you can. They can be very helpful with helping you get started. It really isn't that difficult to get going. Good luck.

Edward, IL

[mattsmom81]

i think this is a very exciting area for nurses!! I enjoy reading about independent nursing careers! Good luck to you and hope you find your niche!

[RN J]

I had physiology with a woman who had a home health care business. She employed RNs and CNAs to do private care. She was very reluctant to share any info with me- but she did say she doesn't carry any insurance or liability. She said her staff went into clients homes as they would have a house keeper come in. Is that legal? What kind of paper work or contracts would one need-a personal service agreement? (Minnesota)