Hiring an RN into private practice

Nurses General Nursing

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Hello everyone! I am a psychiatrist and in the process of starting my own practice, it will deliver transcranial magnetic stimulation, an FDA approved treatment for major depression. It's very safe, well tolerated, and only in extremely rare cases can be associated with a seizure during a treatment. Only 25 or so documented cases of the tens (maybe hundreds) of thousands treatments to date. Some were in people actively drinking heavily and others were from the experimental days of TMS when the treatment intensity was too high. So the likelihood of seizure is very low. I'm looking for advice on how to recruit 1-2 RNs to deliver the treatment. It is a very chill job description, just apply the coil and deliver an 18 minute treatment to the patient (no IVs, draws, nothing). It will be first shift, 0800-1600 and the rest of the time is spent answering the clinic phone, following up phone calls, medical records, etc. I won't be able to offer benefits and the hourly wage I can really offer is $20/hr, for working 50 weeks a year, that is 40k. However, there is a bonus that I am thinking of offering for each billed patient encounter, of $3. I'm projecting about 45 patient encounters billed a week, that's an extra 11k or so and as the practice grows, so does that bonus. Anyone have any input on what population may be interested in this type of opportunity and how I can market this? I have no idea how to find well qualified nurses (good sites to post the listing, or maybe good places to find nurses who are interested in a more chill job description but maybe less competitive pay) and especially someone who can be reliable since the treatments are 5 days a week. There is also the bonus that the nurse can have flexibility in their hours too. Thank you for all the input!

40k is the gross salary. After taxes it's more like $33,600 and no benefits. You might be able to get someone who doesn't need insurance and is interested in a second income only but I think those kind of prospective employees are few and far between, especially with full time hours. Also, despite your description of the procedure and responsibilities I think there will be more to this job then what you've portrayed. It isn't just attaching coils. It's assessing and intervening as well. You come across a bit cavalier about the risks associated with the treatment but you must always be aware of and prepared for them and so should your staff. I think some more planning is in order. I wish you the best in your endeavor.

Specializes in Psych, Corrections, Med-Surg, Ambulatory.
I can see maybe a nurse in the later stages of her career looking for

something that is laid back, with less pay being OK. I can see myself

doing something like that, maybe when my kids are both out of the

house. :) but the lack of benefits is a huge barrier. :(

So is the apparent 40 hr work week. Nurses willing to settle for low pay and no benefits do not want to have to be there every day with a measly two weeks of vacation per year. This pot is going to have to be sweetened to attract anyone with an unencumbered license.

What city are you in, curiousMD?

Regardless, you're going to have to do way better than that!

So basically the RN will be there alone, or are you there too?

Waaaaaay better!!!!!

Reality check.

Let's not forget that over in acute care the price point for hiring an at-will RN (effectively/apparently) comes with carte blanche to be thoroughly abusive in different ways, and doubly abusive by everything that goes into covering up the fact that what I just said is true.

What's better? Work with someone you might get to know fairly well and probably be treated like a fellow human being while not making much money, or make a professional wage while being treated like a subhuman piece of garbage?

Both have their obvious and serious philosophical incongruities.

Why get put-out at a physician, but not an MBA or any of the "Cs"? This OP person kinda wants what s/he can't afford, but the "haves" in healthcare corporations don't even pretend to worry about such minor matters. That's mom-and-pop to them - they offer higher wages and then simply make demands that aren't commesurate with compensation after all. And have the complete power to do so.

Not sure that one way of refusing to pay for what you want is better than the other.

Yeah, like I said waaaaay better!

Thanks. That was thoughtful to ask.

Specializes in ED, Pedi Vasc access, Paramedic serving 6 towns.

Hi,

As others have elated to the pay is way to low for an RN, even a new grad! You also need to contact the board of nursing in the state where you intent to do this and make sure this treatment is even within the scope of practice of an RN, and if so what type of training would you have to provide. This may end up being a long process since I am not sure this would be a common procedure for an RN to perform.

Maybe an LPN? Again I just don't think you will find an RN willing to work for 20/hour even if you had benefits, and two weeks of vacation is really nothing to be honest.

Good luck in your endeavors though, and I do hope you are successful!

Annie

Look, in private practice, my overhead is already over 100k. I don't have deep pockets and I work at the VA for my benefits. I'm likely looking for a retired nurse or someone with no children. Basically in a setting where there is less financial pressure. My question was already leaning towards how exactly do I go about finding someone at that stage in their life.

most days I will be there. To answer a question someone said above. Most TMS techs are medical assistants or even have a bachelors in a non medical field. I've seen plenty of MDs even go on vacation while the tech does everything but that I think is just too much liability and unethical. I personally have never heard of needing to hire a nurse to be the tech. But I trust what my attorney advises. I may need to ask her if a medical assistant suffices and I just be in the clinic seeing pts but available in rare event of an emergency. The treatment is very straightforward and I've seen practices more than several years old never have a seizure. And yes, I have seen EMTs work as techs, so there are people who take up the offers. I appreciate the helpful input that has been offered so far. If only there was I way I knew how to find people who have less financial pressure. I remember one nurse told me to look into the bls and acls refresher courses as there are medical staff often there who've been out of work for awhile but want something laid back or even part time.

the point one person made above is spot on. I understand bills need to be paid, I have a family and incredible student loans too. But I managed to make private practice work out by getting my benefits on the side. I serve more severely ill pts at the VA. But even in psychiatry, there is burnout. I could not chronically have screaming borderlines calling me several times a day or have a panel of all chronically suicidal or homicidal people. I'm grateful to be working in a less stressful setting on the side although it means I get paid less than major healthcare systems. Working in an abusive environment and somewhere you are not happy also comes with a hefty price. But, at this point I already have one taker from a retiring nurse I work really well with at the VA. Just trying to find out where I can find more folks like him.

great point some made about getting some part timers.

Specializes in Urgent Care, Oncology.

Honestly, you'd probably have better luck finding several PRN/per diem nurses to do this. I wouldn't mind $20-$23/hour for a side gig with less stress but definitely not a full time position that pays that low. I'm in the South in a large city and I still make $30+/hour with four years experience.

What area of the country are you in, curiousMD? That would most likely be a consideration for some people.

What area of the country are you in, curiousMD? That would most likely be a consideration for some people.

Wisconsin. I know... not great :/.

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