Private Duty Nursing Question?

P_RN, ADN, RN · Aug 9, 2003

I had no idea there were still private duty nurses around. The ones that came to our floor were usually in their 70's and mostly functioned as a sitter as they didn't give meds or treatments.

They were expensive too, back in the 90's their agency got $45/hr and they got about 2/3 of that.

Monica RN,BSN · Aug 9, 2003

Dear Cheerful,

I have a few friends who have placed ads and have clients in private duty. They set their own rates, as it is not paid by Medicare or medicaid in their cases. It is a direct fee for service,

billed according to how long they were there, flat hourly rate and no taxes taken out. I guess they claim it themselves somehow at tax time, or maybe they just don't claim it, I dunno.....

They charge anywhere from 20.00 to 25.00 an hour depending if they are just "babysitting with minor med management, or if the case is more in depth.

The question that seems to come up is that of liability. In many states, nurses cant be "independent contractors" as it falls under the same type of this as if a nurse gives a neighbor wrong advice, and the neighbor sues because the "nurse should have known better" Some nursing malpractice policies exclude private duty unless you are working under a licensed agency. Seems the agency would be sued first, and puts the nurses malpractice company at a less risk of having to pay out in a law suit.

I an not up to date on all the nurse practice laws as it pertains to Private duty outside of a facility or agency, like described here, but I know it varies in diff states if it is allowed or not.

The private duty agencies in our area charge 35.00 an hour for a nurse and pay the nurse about 20.00 to 25.00 an hour, much like the fees my friend charge. Comes out about the same I guess, exept whenthey do it direct they do not have tax taken out...

I hope this helps a little bit.

Agnus · Aug 9, 2003

I would argue that nurses are permitted to be independent contractors. They legally exist in all states. As long as you do not violate you scope of practice you are fine. I would also argue that Liability Insurance is available to independently practicing nurses.

See the Forum on this board, "Nurse Entrapreneur"

Private duty has been around as long as nursing has.

Independent contractors are responsible for thier own witholdings. They are self employed and there-fore essentially the same as a business owner. Don't even try not reporting to IRS.

Because you are responsible for ALL of your own withholdings and "benefits" you should charge accordingly. In otherwords if you are making $25 working for an employer plus vacation, sick time, benefits etc. Then you need to charge at least enough to cover all these things.

Whether you pay into Social Security or not remember to allow enough to do so as you would be getting this "benefit" working for someone else. Also keep in mind that the employer matches what is deducted from you pay. I. E. if you are employed the employer pays half your SSI.

In some states they also pay the full amt of unemployment (some states MAY have the employee pay all or part. I am not sure)

There are also things like workers comp. ins. that the employer must pay . I mention these things as they are all the cost of employing someone. So you should charge accordingly as you are just as entitled to these benefits or the $$ equavalent.

So if you are charging $25 without the benefits that normally come with a job and having to do all your own withholdings the customer is getting a REAL bargan IF $25 is what you would make working for someone else. AND they likely do not Know that it is a bargan. So charge accordingly.

Monica RN,BSN · Aug 9, 2003

Thanks for the update... :)

jemb · Aug 9, 2003

A friend of mine who became quadriplegic from an accident a few years ago has 24 hour private duty RN care. He has been lucky enough to find very good RNs who have stayed with him for a long time. He has a lot of needs, and no one to help him if he did not hire nurses.

I haven't done private duty myself since the early 80's, but was making $22-24/ hr then (no benefits, but taxes were withheld). I booked through an agency, but I always contacted the patient's physician myself by phone to determine medical/actual nursing needs vs. patient's or family member's say-so. Sometimes the patients and their family members were unclear as to which meds were current or discontinued, where a fracture actually was or even if there was one, etc...

It's not something I would want to do again, but it was a handy addition to my income when I was paying off bills that had accumulated while I was still in school.

I did not have the experience then (or desire) to get involved with home vents and such, but I do remember that there was a need for such nurses.

renerian, BSN, RN · Aug 9, 2003

Lots of need for private duty agency vent nurses. renerian

Edward,IL · Aug 9, 2003

>I do private duty homecare as a self-employed nurse and part-time through a home health agency.

>It is legal in 50 states for a nurse to receive renumeration for their services (you do not have to be an employee of an institution or agency if you do not want to).

>Go to the web site of The National Association of Independent Nurses (NAIN). They can help you with getting started.

>Also check out James Huffman RN, author of Dare to Be Free. This is a very good book for any nurse wanting to become self-employed.

>Yes, there is a tremendously large need for nurses to do private duty at home. It is a great way to have a positive nursing experience and make a real difference in a patient's care. It's also great as a second job to regular employment (you won't be completely exhausted at the end of your shift).

JMHO, Edward, IL