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!

Regarding $20/ hour, there is quite a spectrum of wages related to what part of the country one is in. In my area, $20/ hour starting pay actually reasonable. Maybe consider hiring 2 part-time nurses - full time with no benefits could be a deal breaker for some people.

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Same here. $20/hour would be on the lower end, but certainly not unheard of. I searched TMS tech jobs in my area (Midwestern US), and salaries range fron $12 - $14/hour, with most providers hiring Medical Assistants for the positions. I also saw some ads for LPN's for these positions.

Good luck as you move forward, curiousMD. And thank you for the work you do.

Why haven't you shared where you are? or even what part of the country? Just wondering.

Why haven't you shared where you are? or even what part of the country? Just wondering.

I did.

Wisconsin. I know... not great :/.
Specializes in Varied.

PRN nurses are going to be your best bet at that pay.

Specializes in Ambulatory Care-Family Medicine.

May want to research the nurse practice act for your state. It may be more beneficial for you to hire a LPN if this falls within their scope in your state. Scope of practice varies greatly in different state so have your lawyer really look into it. If you do need a RN you Kay want to look at hiring several part-time or PRN instead of a full time. The no benefits part is really going to hurt your hiring potential if you only want full time. People looking for PRN work typically aren't looking for benefits. This would also help work out vacation time since if you just had one full time person you would have to figure out what to do when she/he was on vacation.

I have a close friend who runs his own Psychiatry office, I do occasional PRN work for him on the side, mostly paperwork and the occasional chaperone for home visit type thing. I make about $7 less/hour than my hospital pay but he is my friend and it is rare so I'm ok with the lower pay from him. It's all about balance.

Specializes in Cardiac Telemetry, ICU.

I'd prefer a literal slap in the face than what you're offering.

Specializes in Med/Surge, Psych, LTC, Home Health.

CuriousMD, I'll just stand up and say, if you were near me I'd work for

you in a heartbeat... just not full time. I actually need a part-time/PRN

gig and something like that would be great.

Just saying. Feel free to move to central KY, I'll work for ya.

CuriousMD, I'll just stand up and say, if you were near me I'd work for

you in a heartbeat... just not full time. I actually need a part-time/PRN

gig and something like that would be great.

Just saying. Feel free to move to central KY, I'll work for ya.

That is so tremendously sweet! If only we lived near each other. Bill (the RN I spoke about) and you sound like you'd make a great team :). To bugya90, balance indeed. Everyone has different needs and are in different stages in life. I could join a lucrative healthcare system and have a panel of all high risk folks, but I can't do that all the time. I could be more lucrative working as a private pill mill, basically a legalized drug dealer and give people all the Adderall and Xanax they want. But that's not why I went into medicine. Sure, my practice built up slower because I'm careful about my controlled substances and practice evidenced base care like CBT for sleep instead of just throwing sedatives at people, but it's about balance and practicing in a manner that works for you. Same reasons some people like a lower key pace. It doesn't pay big dollars but some of the higher paying places have downright malignant and abusive atmospheres. I think I'd lose my soul as a pill mill even though that could easily multiply my income. Evidenced based medicine and lifestyle changes seem to be an increasingly dying art despite their demonstrated efficacy.

Where do you guys live exactly?

Some of you are exaggerating.

There are lots of fields only offering $20/hr with no benefits.

When I did private duty nursing as an Rn with 5 years experience through an agency I was paid $20/hr,and health insurance was crazy expensive,at $200/week. No other benefits were offered either,no vacation,401k,etc. This was in South Carolina.

Specializes in Complex pedi to LTC/SA & now a manager.

Consider subcontracting a PMHAPN(psych advance practice nurse) and a licensed clinician (LPC, LCSW) or two who can be credebtialed to bill insurance. Perhaps in exchange for office space to expand your scope of services to a one stop shop. I know you will screen your patients per standard of care. If you have 2-3 part time RNs perhaps offer to pay to maintain ACLS you are more likely to secure either semi-retired experienced nurse or a hospital nurse who works 12's looking for an extra shift or two. If all under 30hrs no benefits needed (I believe it's still in effect that you must offer minimum basic insurance coverage to employees who work more than X hours/weekly though the employee can decline. Another reason you won't want one FT nurse. Plus you won't have to likely worry about uncovered shifts. If you have 2 nurses that work 2 days and one that works the third)

Once up and ready to open, consider contacting local EMS agencies to visit your practice for a mini-open house to explain what you do and how there is a risk of seizures. This way if you need 911 they will know where to go and what to expect. Most areas require paramedics for seizures because medications like Ativan or Valium may be needed or even prehospital antiseizure infusions. Perhaps even reach out to local urgent care & ED to advise about your new venture. A $100 or so in snacks, drinks and promo flyers explaining your clinic can save a lot of time should the worst cas scenario occur and you need to 911 someone to the local ED. Many EMS & ED staff may not be aware of this treatment and effects

Well... if you're willing to hire maybe an RN "in recovery" you can post this in the recovery forum on here. There are lots of nurses on probation looking for a job that does not involve controlled substances and would love any job, period.

I'm just going to be honest with you, it going to be hard for you to find a nurse to work for that in long term. I recently took a position myself that entailed low pay because I was told that all I would be doing was office work. It turned not to be true and I only lasted one month. At this time , I have decided to stick acute care positions only because there seems to be more liability, less pay and more work involved with non acute care positions in my experience. I think you should look at the scope of practice, and look at your the services required by your clinic. I have been to many private practices in my area and I don't think I have seen a nurse employed there. Most hire a medical assistants and seem to do well with that.

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