employee or consultant?

[rck213]

I was recently approached by a local homecare agency to help them institute policy and procedure for homecare of the pediatric population which was previously provided by the county health dept. Their nurses have no pediatric experience.

This agency is now affiliated with a healthcare network. The network hospital was a former employer of mine. I worked on their pediatric unit for over 20 years and helped develop policy and procedure for that unit.

The Nurse Manager of Maternal Child Health at the hospital referred the homecare agency director to me as a resource Pediatric Nurse for them. I am currently(for the past two years) at a family practice office, I can no longer perform bedside nursing due to personal health issues.

Originally I was going to be an employee of the healhcare agency,on an as needed basis,to help orient nurses to pediatric care, help write policy and procedure for the ped patients and help adapt their documentation to reflect age specific care. Suddenly the agency is telling me I will be employed as a "consultant" per a contract at a rate yet to be determined.

I am now being told that I must get a business license from the county, I must submit my own taxes and social security BUT I must be available to the agency by phone during hours of operation for any questions the nurses in the field might have and I might have to actually go into the home with the nurse if it is a case she is not comfortable with.

I am not a business person. I have worked per diem in many different areas of nursing but was always compensated as an employee. This seems like they want it both ways. :angryfire

I have no idea how to be a "consultant" Does NY state have specific rules and regulations?

If anyone can point me to any information that could be of help I would greatly appreciate it.

[Altra, BSN, RN]

http://www.irs.gov/businesses/small/article/0,,id=115045,00.html

You might start w/IRS info on being self-employed.

I agree, while this sounds like a great opportunity, it's not to be undertaken lightly. You'll need to be sure of what your costs will be before you negotiate the contract, and think about whether or not you think you'll do this type of work again in the future.

I do not yet have experience in health care management, but I'm a little leery about your liability if you are the sole source of pediatric-specific training for these nurses. Particularly if you accompany another nurse on a home visit, and guide his/her care, it seems to me that you have then assumed supervisory responsibility for this nurse's assessments and actions but yet you are not part of the same organizational structure. You may be comfortable with this - it's just something to think about.

I'm just thinking off the top of my head -- if I as a nurse am uncertain about how to proceed w/a specific aspect of patient care, I need to refer to my organization's policies. And if the policy doesn't seem clear to me, then I need to discuss the specifics of the patient's care w/my superiors on up the line.

Good luck to you! :)

[rck213]

You echoed my thoughts exactly. It is all about liability at this point, I would be on my own. I do not think the compensation and length of employment would be enough to offset the costs I would incur to set up my "business" and maintain my own malpractice insurance. Plus being expected to be on call every day without compensation just doesn't seem right.

I wanted to be a per diem employee, covered by the homecare agency, no benefits, flexible schedule as needs dictate. For some reason they didn't want that.

Just doesn't feel right to me.