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Hiring an RN into private practice

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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!

Edited by curiousMD

NurseCard, ADN

Specializes in Med/Surge, Psych, LTC, Home Health. Has 13 years experience.

Sounds very interesting and intriguing. I wonder if you would even

necessarily need RN's. Maybe LPN's. I wish I knew how to answer this!

So have you tried using the employment websites to recruit?

Thanks! That's reassuring! I'm still in the very early stages. Just filed paperwork to set up the entity. My attorney said standard of care is to have an RN. But that's the first I heard of that. Most TMS providers don't do that. I figured if seizure was the biggest concern may make more sense to get an EMT. I will try all the major job sites like indeed, ziprecruiter, etc. I just wasn't sure if the pay especially since I can't afford benefits would be a barrier to people being interested. But it is a pretty sweet gig, relaxing tempo and low pressure.

VivaLasViejas, ASN, RN

Specializes in LTC, assisted living, med-surg, psych. Has 20 years experience.

Sorry to tell you this, but you're not going to get an RN for $20 an hour. An LPN, maybe, but not an RN, and especially without benefits. You may want to scale down your ambitions where it comes to finding a nurse for your practice. Good luck to you.

JustBeachyNurse, RN

Specializes in Complex pediatrics turned LTC/subacute geriatrics. Has 10 years experience.

An EMT won't be able to do this. Salary no benefits too low for most nurses. Maybe a medical assistant.

NurseCard, ADN

Specializes in Med/Surge, Psych, LTC, Home Health. Has 13 years experience.

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. :(

Sorry to tell you this, but you're not going to get an RN for $20 an hour. An LPN, maybe, but not an RN, and especially without benefits. You may want to scale down your ambitions where it comes to finding a nurse for your practice. Good luck to you.

With minimum wage increasing to $15/hr in many areas, you will have a hard time finding licensed nurses.

meanmaryjean, DNP, RN

Specializes in NICU, ICU, PICU, Academia. Has 40 years experience.

Wow. A whole.$20/hour! And no benefits?

Give up some of your take and pay the RN professional.wages.

Closed Account 12345

Has 12 years experience.

When I was a new graduate nurse with no experience, in the early 2000s, I made $25/hour with great benefits. I earned raises at 6 months and 1 year. There were also secretaries to return phone calls and make appointments, and medical billing/coders to handle the financial end of things.

Instead of saying the nurse has the potential to earn $11,000 more depending on patient encounters, why not include that amount in the base salary? Then find a way to come up with an additional $12,000 so you can offer your nurse healthcare, continuing education, and 2 weeks of paid vacation (since you're planning on taking that yourself) even if it reduces your own profits.

In general, clinics pay less than hospital settings, but $51,000 + benefits is still low. You're not just hiring a warm body; you're hiring a licensed professional and trusting your patients in his/her hands.

Target pays $15/hour, benefits, and a store discount.

meanmaryjean, DNP, RN

Specializes in NICU, ICU, PICU, Academia. Has 40 years experience.

Thanks! That's reassuring! I'm still in the very early stages. Just filed paperwork to set up the entity. My attorney said standard of care is to have an RN. But that's the first I heard of that. Most TMS providers don't do that. I figured if seizure was the biggest concern may make more sense to get an EMT. I will try all the major job sites like indeed, ziprecruiter, etc. I just wasn't sure if the pay especially since I can't afford benefits would be a barrier to people being interested. But it is a pretty sweet gig, relaxing tempo and low pressure.

If YOU will have benefits then so should your employees. No matter what the 'tempo' you imagine for them. Ugh

Everline

Specializes in public health, women's health, reproductive health.

I am a public health nurse so that salary does not alarm or surprise me, lol. However, I receive excellent benefits to include, among many other things, college tuition paid, generous personal and sick leave and a pension in retirement. I work a "regular" work week, never work weekends or holidays and it's rare that I ever stay late. Even with all that, a low salary is a hard sell for any professional. I think you have the possibility of finding someone, but retaining them will be difficult. You might want to adjust your plan, as others have suggested. Good luck to you as you start your own practice.

klone, MSN, RN

Specializes in Women's Health/OB Leadership. Has 14 years experience.

What a gross example of nurses not getting the respect they deserve as a well-educated professional.

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.

TriciaJ, RN

Specializes in Psych, Corrections, Med-Surg, Ambulatory. Has 39 years experience.

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.

wondern, ASN

Has 20 years experience.

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?

wondern, ASN

Has 20 years experience.

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.

wondern, ASN

Has 20 years experience.

Yeah, like I said waaaaay better!