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!

What state are you in?

Thanks for the input. That is actually really helpful. I only recently got that news from my attorney and am awaiting a response where I've proposed other staff I can hire without exposing unnecessary liability. In the meantime, I wanted to get an idea of what the market looks like and what people on the other end reading the job descriptions on these job boards would be thinking. It would make no sense to invest in putting up a listing no one cares for, might as well brainstorm now and have a better thought out recruiting strategy.

Granted, I have only read a few of the the posts, but I'm not understanding why you can't hire a Medical Assistant. That pay is above reasonable for an MA. I think the tones of some posts stem from the lack of understanding of the depth of knowledge nurses have, and the intense education we have received. From many doctors to the public as a whole, people simply don't understand our depth of knowledge and skill. That is why from the very 1st post, I internally scoffed.

Specializes in LTC.
What state are you in?

Wisconsin.

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.

Private duty companies around here in Chicagoland are, and I'm thinking of 3 specific companies, 22/hr, 25/hr and 27/hr starting pay. No exaggerations here. And they are BEGGING for nurses. Especially the 22/hr company I currently work for. They try to get people in through referral bonuses. I'm not about to subject fellow nursing colleagues to 22/hr. I've only done it myself this last year to take a break from bedside and I needed a job ASAP. My last day is in 2 days. Then I'm bringing my broke butt back to bedside at 35/hr. 6 years experience. No exaggeration needed.

I DID work for a year in an asthma, allergy and immunology office at only $14/hr for 10 hours a week a few years ago when I was desperate and searching for employment. The doctor and his family of doctors and my family go way back. They are notorious for their horrendous pay. And my mom knows his overhead very well. She did the billing and payroll, including 2k a month to his daughter who didn't even work there. (20 years ago) Stingy af to his employees, yet paid his daughter FOR NOTHING.

I don't know where you are getting exaggerations from. Pay differs greatly on location, specialty, where the money comes from (like OP coming from a start up company where he cannot afford to pay more) etc.

Hey CuriousMD!

I'm the TMS Coordinator / Office Manager for a TMS provider in central CA.

We generally hire graduates of local colleges with degrees ranging from biology to psychology and related fields as technicians. The training for TMS Technician certification is thorough but not too rigorous and our techs do a fantastic job. As nurses generally expect higher compensation maybe look into fresh undergrad - grads looking for their first steps into healthcare: they'd probably also be stoked about the pay as opposed to disappointed. I'm a prospective nurse as well and I am hoping to make far more in nursing than I make now at a TMS clinic but I also totally understand the pay you're offering and can confirm that it's pretty standard if not on the higher side.

TLDR; you don't need nurses just smart detail-oriented employees as technicians and it may be a better fit.

Hope that helps! Message me if you have any questions!

Blessings -

Specializes in critical care.

I just looked at a typical billing rate for TMS and I am absolutely appalled that with your prediction of 45 treatments per week leaves you with a pay expectation of $20/hour. Stop telling us what your overhead is. Stop trying to compare your anticipated income to what psychiatrists typically make. Either pay a nurse the hourly wages that a nurse should make, offer benefits, and give a competitive vacation package. Would you ever go into practice with a physician and offer them half what they should make? If you WANT a nurse, PAY for a nurse. You CAN afford it.

(I mean, seriously, the last commenter here is running a TMS program. In my observation, programs offering only one type of treatment (and hiring "coordinators", no less) exist because they're profitable.)

Also, for the love of god, don't hire a new grad nurse. This would be career suicide for a desperate new grad who would accept any offer thrown at them just to start working, especially if they continue to work for you for a long time.

God, I'm going to have this thread rattling in my brain for awhile now. Just when we've been working so hard toward better respect between different types of healthcare licenses, stuff like this still happens.

First off, congrats on starting your own practice! My opinion is that 20$ is a bit low... I would do my very best if I was you to try to bump that up to at least 25$. Even without benefits, you will find some takers. Maybe someone who is not the primary breadwinner, someone who has worked the hospital life and will gladly take a pay cut to not have to deal with all that, there are lots of options here. I would also leave the option open for extra, bonuses etc as the practice grows. Per diem may also be a good idea. Best of luck and I think that the new technology you are using is so promising!!

I would suggest restructuring your schedule so that the actual procedures are all on the same day/limited days of the week, so that you can find an RN who would be interested in Part Time/per diem work that they can hold down with another job elsewhere. For example instead of procedures at beginning of shift every day, they take place all day on X day(s) of the week. Pay them better wages for their hours in line with what an RN should make, and have appropriate medical personnel on hand during those hours. Then you can pay a clerical person a more appropriate (read=lower) wage to do the rest of the non-nursing clerical role you describe the rest of the time.

Where is this job? Would you consider hiring a nurse who has a reprimand on their license? A lot of nurses can't find work because of the reprimand and they would be willing to work for $20/hr.

Private duty companies around here in Chicagoland are, and I'm thinking of 3 specific companies, 22/hr, 25/hr and 27/hr starting pay. No exaggerations here. And they are BEGGING for nurses. Especially the 22/hr company I currently work for. They try to get people in through referral bonuses. I'm not about to subject fellow nursing colleagues to 22/hr. I've only done it myself this last year to take a break from bedside and I needed a job ASAP. My last day is in 2 days. Then I'm bringing my broke butt back to bedside at 35/hr. 6 years experience. No exaggeration needed.

I DID work for a year in an asthma, allergy and immunology office at only $14/hr for 10 hours a week a few years ago when I was desperate and searching for employment. The doctor and his family of doctors and my family go way back. They are notorious for their horrendous pay. And my mom knows his overhead very well. She did the billing and payroll, including 2k a month to his daughter who didn't even work there. (20 years ago) Stingy af to his employees, yet paid his daughter FOR NOTHING.

I don't know where you are getting exaggerations from. Pay differs greatly on location, specialty, where the money comes from (like OP coming from a start up company where he cannot afford to pay more) etc.

I meant that there are many fields of nursing that pay $20/hr to Rn's,private duty being one of them.

I have not had a raise in PDN for 8 years now,and my pay was actually reduced(Im in Nj now)

But i still stand by my point.....there are many nurses making $20/hr. I knew very few nurses making $35 an hour and over unless per diem,ER,etc.

Specializes in UR/PA, Hematology/Oncology, Med Surg, Psych.
Hey CuriousMD!

I'm the TMS Coordinator / Office Manager for a TMS provider in central CA.

We generally hire graduates of local colleges with degrees ranging from biology to psychology and related fields as technicians. The training for TMS Technician certification is thorough but not too rigorous and our techs do a fantastic job. As nurses generally expect higher compensation maybe look into fresh undergrad - grads looking for their first steps into healthcare: they'd probably also be stoked about the pay as opposed to disappointed. I'm a prospective nurse as well and I am hoping to make far more in nursing than I make now at a TMS clinic but I also totally understand the pay you're offering and can confirm that it's pretty standard if not on the higher side.

TLDR; you don't need nurses just smart detail-oriented employees as technicians and it may be a better fit.

Hope that helps! Message me if you have any questions!

Blessings -

A physician will not be in the office at all times. Does that occur at your clinic? Something doesn't sound legal about a Tech, a Medical Assistant, or a non-medical person performing these procedures while alone in the office.

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