Private Duty on my own

  1. I'm considering just taking out an ad to do private duty. I hired my housekeeper this way. People could interview me and either hire me or not, I could decide if a patient and family was the type I could manage. Has anyone tried this?
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    About NancyRN

    Joined: Aug '01; Posts: 268; Likes: 13


  3. by   ageless
    Sounds like an excellent way to make extra income, but remember to contact your malpractise insurance carrier to see what your coverage is as an independent practitioner. At one time, I formed a partnership with a plastic surgeon and did in-home private sitting for the first night post-op of ambulatory care surgeries such as facelifts, abdominoplasty, liposuction..etc. Because these elective surgeries are usually not covered by insurance, the patient payed for my services up-front and in cash...$250-400.00. The best thing is that these patients are usually in good health...
  4. by   NancyRN
    ageless, this sounds wonderful! Of course plastic surgery patients wouldn't expect the insurance to pay, and they wouldn't even be having the surgery unless their health was good.

    When you say you contracted with a surgeon, does that mean you actually drew up a contract with a lawyer? Did you just phone the surgeon or was this a friend? I do have private malpractice insurance. Thanks for the advice.:kiss
  5. by   ageless
    I knew the plastic surgeon and worked with him in the OR and was actually his idea. We didn't use an attorney but had a verbal agreement. His office collected my fee and he used my services as an "advertised benefit". It worked out well because of mutual respect. This partnership made both our insurance carriers a little crazy at first, but eventually we worked it out with them and I payed a higher premium. I called him at home if I needed him.
    Brainstorm a plan that you present to the surgeons in your area. Sell yourself to them as a benefit to their patients and an added "comfort service".
    Some plastic surgeries are covered by insurance..reconstruction, Panniculectomy (sometimes), blepharoplasty, etc. Cosmetic surgery is not. Trust me, not all patients are healthy going in to the surgery. I have had to call an ambulance for the seemingly healthy also. Some problems are Anaphylaxis, hypertention, hematoma, and pulmonary emboli. It makes me wonder what would have happened if these patients had been alone. Good luck to you..most of the time I loved it..just don't bring anyone to your home, make it theirs!! *wink. let me know if I can help.
  6. by   TRN
    This sounds interesting. Just a few questions if you don't mind......
    If the patient pays $250-$400 how much are you paid? Does the doctor pay you or did you bill the patient?
    I might approach a plastic surgeon friend of mine with this idea if I could come up with a feasible approach. I would need private malpractice insurance, right? Anything else?
    Thanks for your input. I love b/s nursing, but I am so tired of the politics. I am trying so hard to find a way to practice as an independent nurse. Unfortunately the skills it takes to think with a "business mind" was not encouraged in nursing school. I am always open to new ideas.
  7. by   TiddlDwink
    I did private duty on my own for several months several years ago. Had no trouble getting patients. Had trouble getting rid of them
    Once I committed to staying with the patient (usually 8 to 12 hours at night, and sometimes in the hospital), I was committed. These patients were wealthy and could afford my $35/hr I was charging directly to the patient, who paid directly to me. My problem was that whatever came up, however I felt, whoever was coming from across the country to visit me, I had to go to my patient. There was no one sharing the business with me. No one to call and say, "My mother is here from California. I would like to be off tonight."
    It did not work out for me. What HAS worked out, though, is I do private-pay home health visits. This has been very lucrative since Medicare has decreased its payment options and methods to home care agencies. If a retired doctor's wife is taking Coumadin and needs a protime (especially if she is unable to drive), I will go to her house, do a basic but thorough nursing assessment, and collect the blood. I then take the specimen to the lab (or the M.D.'s office) and send my comprehensive nurse's note to the M.D. I charge $50 per visit within the city, whether the visit takes 20 minutes or an hour. This is billed to the patient. There are days I have 12 or 13 visits, but I am not obligated to give up my life for it. I also have several friends who can pick up a day for me if I need for them to do so. I LOVE my job!:roll
  8. by   NancyRN
    This sounds interesting. No emergencies and you set your own hours! How do you find clients? Where do you get supplies to do a blood draw?
  9. by   TiddlDwink
    I began by talking to several physician offices and leaving brochures and cards in their offices. I also talked to sitter services who sit with the elderly. I went to assisted living facilities and offered (for a small fee) to come once a week and draw everyone's blood who needed it done. Church groups... and soon I had a few calls. Several home health agencies in town had to quit seeing patients because Medicare no longer paid for it. I offered to pick up these on a private pay basis, and got a few that way. It seemed that once I had about 8 or 10, the whole thing snowballed. There was one physician office (3 MDs) who would call and say, "Mrs. Smith is having palpitations. Can you run by there and assess her?" or, "Mrs. Jones says her catheter is leaking. Can you run by there and check it out?" I would "run by" and do a brief head-to-toe, V.S., and either fix the problem or call the physician and give my report. And so forth...
    Then I send an invoice to the patient, and so far (knock on wood) I have been paid in a timely manner. (Sometimes the bill goes to a child or a guardian/power of attorney). But most of these people are fairly well-to-do, and the $50 is worth it to them.
    I get the supplies from the M.D.'s office, or from the lab (we have 3 large independent labs here, and I just go by and get whatever I need. I buy my own gloves and keep a box in the car all the time.
  10. by   NancyRN
    Thanks for the advice, TiddlD. I can see a real demand for what you're doing. It saves the family money too, if it prevents a trip to the ER!
  11. by   TiddlDwink
    True. Or even if it prevents an ambulance bill to the doctor's office to have blood drawn or a urine specimen collected.
  12. by   nightingale

    This sounds just great. I would love to do this.

    Last edit by nightingale on May 5, '02
  13. by   TiddlDwink
    Right now, a friend (who is not a nurse) is running a small sitter service, and has about 4 clients that he provides with sitters around the clock (again, these are fairly well-fff clients). If one of his sitters calls him with problems, he calls me to go out and assess. He wants to expand his service, and has asked if I would be available to provide an "intake assessment" for his new clients. (Paid for by the family/client, of course). So I network outside the actual nursing realm.
  14. by   TRN
    How much does the MD/lab office charge you for supplies? How many years of nursing experience do you have? Did you need a business license to do this or did you just market yourself?