How do you find your patients/clients?

I work for an agency. we have 5 nursing cases that the nurses rotate around in no orderly fashion. it is nice because you do get that break from being with one client all the time. it is hard at first with trying to remember everyone's schedules and procedures, but after a while, it gets easy.

i gladly took the pay offered by the agency because it was way above what i would have expected or even gotten at a hospital.

hope that helps!

My private duty case was an extension of a case that I worked for through the agency. The family paid nurses out of pocket to do shifts because the agencies could never get enough nurses to cover the required hours. The primary RN on the case had been doing this for years. When I asked her about conflict of interest issues, she told me that her stock answer for the agency is "You can't tell me what I can, or can't do, on my time off." Worked for her.

I work for an agency currently but I am also an independent nurse and I bill Medicaid directly for one of my clients. I get my independent cases through word of mouth, although lately I have been on cases through an agency I just left that went entirely independent thanks, in large part, to me. I will be eligible to work those cases in the next couple of weeks (obligatory contractual waiting period will be expired) although I will likely just serve as a backup since my plate is plenty full. I've seen cases advertised on Craigslist and I know some independents network with hospital social workers so they get referrals before the patient is even discharged. Also, check your area, you may have a registry you can sign up with that will match you with cases. They may charge a monthly enrollment or membership fee but that's usually all they take off the top and the rest goes to you. You will still be an independent, which offers great flexibility in your scheduling and greater choices of cases. Joining a registry is usually more beneficial and lucrative than going directly through an agency, although not as lucrative as finding a case by yourself.

Private duty pays more in my experience. For NYS, where I am, I can make $22.41 for a low tech Medicaid paid case. A high tech is $25.93. Pediatric medically fragile cases have a 30% enhancement. It is $29.13 and $33.71 respectively. Those rates are per billed hour. The agency I work for full time is a home health agency, but I am a private duty nurse through them so I am entitled to my enhancement. Therefore, for illustrative purposes only, if my hourly rate is $18.90 per hour, and my client's case is billed at $33.71, I would get my hourly rate plus the $7.78 enhancement per hour. That would come out to $26.68 per hour before taxes. The agency is still getting about $8 an hour off the top of every hour you work. HTH.

Independent nurses are responsible for their own taxes, mileage, and record keeping type systems (binders, notebooks, etc). If you go through an agency these things MAY be covered, and taxes will be taken out for you, but in the end it's better to be independent because you can deduct those expenses on your taxes.

What kind of records exactly do you have to keep track of? And do you need to get some kind of liability insurance in case something happens to your patient while in your care?

My private duty pay was higher because no percentage was being paid to the agency. Another case I worked on for the agency, went private duty. The client offered the agency nurses a few dollars more than their agency pay to work for him privately. He saved on the agency fees, and the nurses came out ahead with a pay raise to do the same case.

It's always wise to have your own liability insurance no matter where you are working . You keep track of all business expenses; mileage, supplies (if you provide any yourself, such as special gloves), equipment (computer, internet, etc. if used for business expenses), any other related business expenses such as business lunches or advertising costs. I also advise keeping copies of incident reports, shift reports (or an exclusion journal), hours worked/income, quarterly tax documents, any other document that you need to CYB and/or file accurate tax returns.