Why are you working for an agency?

JNJ · Feb 21, 2003

Astro and Eddy:

Yes you are right, there are many facilities that are not (yet) hiring independent contractors. These tend to be the facilities that do not (yet) have too much of a hiring problem for whatever reason that may be.

However, there are many success stories at independentrn.com where RNs with tenacity have eventually broken thru some of the classic strongholds such as major healthcare provider groups, children's hospitals, etc. The HR dept. may be very much against the paperwork of independent contracts, but if the nurse manager knows of a good RN who is available, he or she will put pressure on HR to break thru this barrier. It's happening as I write, across the country.

Independents are blazing the trail that will lead to better working conditions and appropriate pay for all nurses. Work with us, not against us, please. We are not out to undercut anyone in any part of your working lives. We choose control over more parts of our lives than being an employee usually provides and are willing to do what's necessary to achieve that. That's all. No threat to you.

As previously posted, if you have expertise, experience etc in an in-demand specialty area, it is easier to find work as an independent. However let's remember the postings at the Nurse Entrepreneur part of this web site - there are success stories there from LVNs providing basic care services independently and loving the autonomy.

If you think you can or think you can't - either way you are right! Ford, I believe.

JNJ - independent over 3 continents, 3 states and many years.

eddy · Feb 21, 2003

JNJ - I'm not saying it's impossible. Heck, I even know someone who's done it in the past. If that's the route someone wants to pursue, more power to them.

As a personal choice, I just don't want to deal with the paperwork, the contracts, extra insurance, etc. for what in my research appears to be marginal economic gain. If you add in all the negotiating and marketing time, my assumption is that often you're making less money for the amount of time you work. In these terms work is defined as the entire venture itself, and not just the time spent working in a facility. Before I jumped into nursing I was an accountant, so sorry for the annoyance.

JNJ · Feb 21, 2003

No annoyance, Eddy, I'm just concerned to let my experience be known because it has been so positive. And your comments are valuable to provide balance to what I am saying for those who cannot yet imagine what independence might be like.

I'm numbers savvy enough to understand exactly what you are talking about. It is very easy to underestimate the amount of time that one truly puts into being independent. However, I have done independent, in some form or another, for a long time now, off and on. I do believe I have always factored this in.

When independent, I have nearly always worked less than full time to accommodate any paperwork time. (I'm not focusing on my current 'independent' status as a Medi-Cal provider because I'm now semi-retired and winding down my working life - that's in case anyone out there remembers what I am doing now.)

I also think RNs should factor in the unpaid time we spend, when employed, dealing with work issues. Everything from issues with colleagues, arranging schedules, negotiating pay raises, mandatory CE time, etc. One of my early motivators in the USA was that I was not paid more even though I did not want the benefit package being provided as part of employment.

For me, an almost priceless 'benefit' of being independent is the autonomy. I choose my schedule, I choose my vacation time, I choose my clients (usually), I choose when and how to bill. I used to do the documentation before computers, so you can imagine how easy it is with electronic help. Also, sitting down for half a day a week, doing my paperwork, is easier as I get older, than physically caring for patients.

One thing we have not talked about is the amount of self-discipline involved in being independent. That is considerable and probably a way of life for many RNs anyway. I've never found it a stretch, but some might.

I'd like to see more postings from you with some RN / accounting type insights. Thanks for responding.

eddy · Feb 21, 2003

Very good points JNJ.

It does take a "marketing mind" at least to some degree. One must feel comfortable discussing contracts and negotiating compensation. It also takes a lot of patience and persistence. You may need to call dozens of times just to get through to the person you need to speak with. You are wise to also build up a good database of referrals to back your marketing efforts.

You will need a means of invoicing the facility, though it doesn't mean you need to spend a ton of money. Probably a simple excel spreadsheet type invoice woult suit just fine. Depending on your payment terms, I would venture a guess and say that, in general, you will be looking at about 30 days until you get payment if you go through standard invoicing procedures (going through the accounts payable dept). If you CAN, it would benefit you much more to try and get the facility to add you to their regular payroll cycle, but instead of paying you as an employee (W2) pay as a contractor (1099). Some may do this, some may not... but you should DEFINATELY pursue this route if possible.

If you are not part of the regular payroll cycle, you may also have to be your own collector. Not fun for most of us. Bottom line though you don't work for free, so you'll have to do this if it comes to it.

I don't want to scare anyone away from trying independant contracting, but make sure you are prepared and equipped for such a venture should you choose to take the leap.

If you are just starting out, it may make sense to try subcontracting through an existing agency. It will allow you to build your name AND develop your back end operations better before you go it alone entirely. Just a thought.

Independant contracting isn't for me, but it certainly may be for you. Many people do it, and they find a great deal of satisfaction from it. Just make sure you educate yourself before hand. :)

-eddy