Contract OHN jobs

3rdcareerRN · Nov 18, 2009

Having been an employee at times and a contractor at times, I prefer the contractor route PROVIDED THAT the contract pays enough for me to arrange my own benefits. As a contractor, I did not have to do all the Dilbert-esque things to remain a "good employee". I just did a little more than the contract specified, and everyone was happy.

Two caveats:

- I have always been in "right to work" states, where employees can be fired at will. Being an employee was not a position of security, as it may be in other states.

- Reasonably priced health insurance is harder to find now, which makes being a captive employee more attractive.

"Your mileage may vary." :)

lynnr_98, BSN, MSN, RN · Nov 19, 2009

Thanks for the reply 3rdcareerRN!

If my husband would ever go back to work (he's been laid off from his construction job for over a year) and carry our family's insurance again, I would have the freedom to try contract nursing. Until that happens, I have to make sure I'm an employee with medical benefits. I sure hate feeling stuck and look forward to when I don't have to be the breadwinner/benefits provider anymore!

I'm in California and it seems that the pay rate offered for the contract positions I've seen is less than what I make in my current case management position as an employee with full benefits. I make $35/hr with benefits and the contract positions I've seen pay no more than $34/hr. What's the deal with that? Is it the same in other states? I wonder why the contract positions don't pay more especially since this is such a specialized field.

katkonk, BSN, RN · Dec 22, 2009

Because it is viewed as a very "easy" specialized field, even though they want all these certifications in audiometry, spirometry, DOT urine drug screening, BAT, oh, and to know all the OSHA 300 rules and workers comp. etc. Employers regard it as less than acute care, so therefore less demanding. Re: contracts...depends on the type of contract as far as what it does for the employer. If they have a big corporation like Whole Health Management or Johns Hopkins Univ. heading up multiple sites, then the employer gets the benefit of having the corporate physician available for any issues that come up for one price. Also, most corporations are in the business of business, and don't know squat about hiring, screening, employing, etc. nurses. So, they hire an agency who does that all the time, and the employer just gets supplied with the nurse they want-plain and simple. Re: long term contracts: it is definitely a cost savings to a corporation because they do not have the additional financial burden of contributing to the 401K of the nurse, the health insurance, etc. (And most agencies don't really offer good insurance-so you usually end up getting your own or rolling the dice and hoping nothing happens if you take the agency insurance.) There are also no bonuses paid out to the nurse, etc. The thing I have found about working a long term contract for a major employer, is that I finally end up getting angry. One of the things you do is counsel employees on their benefits-for EAP, for FMLA, for vacation, for restricted work duty, for Flexible spending accounts, long term disability, etc. And as a contractor you are counseling these "elite" corporate employees about all these wonderful benefits, then you stop and say...hey, wait a minute...I am fully involved in this company, know all the managers, etc., work with them every day with the object of saving them $$ on getting reasonable return-to-work times, and absence management, etc....and I don't have ANY of these great benefits. What is wrong with this picture??!! So, I make it a point to never work a long term gig as a contractor. Does this help?

Goodrich · Dec 22, 2009

I started as a contract position through an occupational health clinic. I think it was a trial period and also put the training on the health clinic. After about one year the company offered me a position. I had benefits through the occ med clinic so it didn't matter. That was about 10 years ago.

EwwThat'sNasty · Dec 30, 2009

Six of one, half dozen of the other...

A well paid temp contract position works for some and in some states termination opens (at the moment) ARRA protection such that you are covered under Cobra with the former employer paying 65 or more % of the premium fees. This is true even if you do not have company coverage. For instance, once you are resident in MA you are forced to obtain insurance. Then 4 months later your term ends, and you are unemployed. If you are considered "terminated" from the position MA and the prior employer will cover 9 months of insurance premiums, the former employer paying 65% (to be recouped as a tax rebate) and in the case of MA, MA kicks in 20%. But it is not the same in all states.

Many contract agencies are squishing contract employees and this is what has happened to me. Nice long term (2+ year job) annual cost of living benefits, 401k matching, good medical/dental, good vacation, etc. Now all gone! Many contract agencies are sleeezy but I imagine some are not. Be willing to be skilled enough to say: "thank you but intstead of being impoverished by you reneging on your promises, I'm out'a here."

The problem is that in this economic environment even RN-COHN/S is not enough. Industry is downsizing and that has been going on for decades. Twenty years ago there was one Occ-med nurse for ~200 ee's, now there is about ~600 employees. There are a glut of nurses (except in some areas) and contract agencies are living high off the hog. If you truly wish to obtain what it is that you enumerate the answer is simple: Become an Advanced Nurse Practitioner or PA. Why, because they can often replace an MD and $80k is much, much better to the profit line than $170k for a MD!

Sad, but true!

katkonk, BSN, RN · Jan 17, 2010

The problem is that in this economic environment even RN-COHN/S is not enough. Industry is downsizing and that has been going on for decades. Twenty years ago there was one Occ-med nurse for ~200 ee's, now there is about ~600 employees. There are a glut of nurses (except in some areas) and contract agencies are living high off the hog. If you truly wish to obtain what it is that you enumerate the answer is simple: Become an Advanced Nurse Practitioner or PA. Why, because they can often replace an MD and $80k is much, much better to the profit line than $170k for a MD!

This is very true. I have noticed a HUGE trend over the last 2 years re: using NP's instead of RN's. The business thinks "why not pay just a little more and get the full service NP". This is especially true for corporations that need CDL physicals done, since they can then do them in-house. And if an employee comes in with Strep throat, then they can get an Rx on the spot. Interesting developments are happening in the philosophy of providing onsite care. Hewitt has really interesting study going on using CHS agency, and over the next 1 1/2 years will provide some significant data on the return on investment for providing onsite primary care by mid level providers, as in everything from sniffly noses to OB gyn exams. They are trying to see if this translates to a business savings by minimizing time away from work, and treatment on the spot. The trend is definitely to NP's.

lynnr_98, BSN, MSN, RN · Jan 17, 2010

Thank you all so much for your replies! They've really shed some light on everything.

This is very true. I have noticed a HUGE trend over the last 2 years re: using NP's instead of RN's. The business thinks "why not pay just a little more and get the full service NP". This is especially true for corporations that need CDL physicals done, since they can then do them in-house. And if an employee comes in with Strep throat, then they can get an Rx on the spot. Interesting developments are happening in the philosophy of providing onsite care. Hewitt has really interesting study going on using CHS agency, and over the next 1 1/2 years will provide some significant data on the return on investment for providing onsite primary care by mid level providers, as in everything from sniffly noses to OB gyn exams. They are trying to see if this translates to a business savings by minimizing time away from work, and treatment on the spot. The trend is definitely to NP's.

I've been addicted to searching OHN job ads across the country and have noticed this to be true. I'm seeing more and more ads for NPs! Also, I recently interviewed with Abbott Vascular and was not hired because they wanted someone with more clinical experience as they have onsite care as you described above, katkonk. They have a NP onsite to treat industrial and non-industrial issues. I was recently accepted into the online MSN program in Occupational Health Nursing at University of Iowa. I'm starting to wonder if I should instead try to get into a NP program instead. Or maybe I'll do the MSN first, then do a post-graduate NP certificate afterwards. It seems like the only way to make more money and be more marketable.

What do you guys think about obtaining OSHA certifications or CSP (certified safety professional)? It seems like there's a lot more jobs in Safety or EHS jobs than there are for OHNs. Plus, these jobs seem to pay well and are benefited. What do you think about going this route or should I stick with the MSN and NP route? I think the MSN/NP route would be nice if I ever wanted to work part-time and still make a decent hourly wage. Any thoughts?

EwwThat'sNasty · Jan 18, 2010

I am seeing safety programs being downsized.

In a difficult economic environment especially if job security is an issue, workers' comp cases can increase exponentially, thus in my opinion, in this environment, the nurse has it over the safety people.

However given the opportunity I think that RN; Advanced Nurse Practitioner; COHN-S; along with CSP and/or CIH would be absolutely dynamite. But CSP has a boatload of information to know, and so does CIH. Yet if it suits you, go for it! I've a BS in Safety and have worked as safety specialist extensively, and I am nowhere near knowledgeable to sit for CSP!

I have decided it will be Advanced Practice Nurse or nothing, a simple MSN is definitely (IMHO) not enough in this environment. I do not anticipate a real economic rebound for at least five years. This year alone we are racing towards a triad of horrors: 50-100 billion in bank losses for Consumer Credit Cards, 'a bell curve rise' (bigger than the subprime) on variable rate mortgages, and Monster commercial real estate write-offs.

Beware of student loan debt. There is a limit on deferment time and Sallie Mae is not kind to non-paying debtors.

katkonk, BSN, RN · Jan 18, 2010

I have decided it will be Advanced Practice Nurse or nothing, a simple MSN is definitely (IMHO) not enough in this environment.

I absolutely agree. I wouldn't waste my time on just an MSN degree. They will soon be like the MPH degree-as I read in one HR article-"a dime a dozen". They want clinical expertise, and mostly they want someone who can write Rx's for the employees that are sick so they don't have to leave work for things like bladder infx. NP is definitely the wave of the future. Any CSP cert. is really great, but as she mentioned, it entails a lot. I would concentrate on COHN-S, if you do not already have it, and then NP. And a CCM is great too, because they want someone who knows all about workers comp as well. I have done workers compensation case management for several years in the past, but decided not to pursue the certification because of all the continuing ed you need just for that. And after doing it for years, I didn't feel like it would really add that much to what I already knew. BUT, I do see it on a lot of job postings as a "preferred" item to have on your resume. I, like you, check job postings around the nation almost daily and have for at least 9 years or so. I think it is the best way to really keep a finger on the pulse of the market overall. Good luck on whatever path you choose to go down!!