Keep this forum alive: Be an entrepreneur

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Hi Folks,

First, this post is long, but I want to make sure I get the message out there. I am really just trying to fire up this forum a bit. I stop by this particular forum every now and again and notice a few questions get posted, with a few responses but then it dwindles a bit as time goes on. I suppose that this is mostly due to the fact that there aren't that many of "us" out there.

To start off, I am not selling anything and just merely providing motivation to all of the current entrepreneurs and to all of the prospective nurses who would like to become independent or go into business for themselves. Also, I am not telling you how you have to do things, but will certainly share how I am working as an independent contractor. Most importantly-YOU can become independent.

I have not always been in nursing and through the different stages of my career path I have owned a couple of businesses along the way. I would say that most nurses that I talk to face to face don't realize that they have the ability to start a business or really just become independent contractors. In my previous careers and of course my interaction with friends/colleagues, I would say that being a contracted employee is not all that foreign. I am sure this is why it was "easy" for me to do it, since I have done it before in other careers. I have worked in the food industry (contracted cooks/chefs), financial sector (contracted CPAs, financial advisors/planners), Sales of any kind (contracted sales staff), marketing/advertising (contracted account people, researchers, creative/graphic designers, even attorneys), and of course computer/IT (numerous folks here contracted for their services, SAP, developers, IT troubleshooters, software engineers).

When I have mentioned this to some of the nurses I have come into contact with, many have stated that they do not want to accept the liability. Well many of these folks mentioned above and in addition to this post in some form have licenses, certification, or some organization that makes the "rules" in how they can practice. Also, I am sure these professionals have something to lose as well. Simple: do the right thing, work within your scope of practice, in the case of being a nurse-Document it, and carry just like many of the other folks do.

We as a profession need to unite and realize our potential. Feed the desire to want something more out of your career, whatever that is to you. I am not saying that nurses need to walk off the lines or move away from the bedside. If you like it and want to continue it, then figure out a way that you can do it on your own terms.

Now to the heart of it:

I worked in one of the most critical ICU's (Hopkins) and pretty much loved every aspect of the patient population, the people I worked with (including the MD's) and I learned a ton. There were experiences that were just jaw dropping and exhilarating and I would say ONE of the best career choices I made and I did it right out of school. I still get excited when I talk about it. Now, I would have to say THE best career choice I have ever made was to go out on my own.

Let me first admit that this was not necessarily something I was thinking about, but was really forced into it. We relocated so that my wife could take a job; Fair enough since we uprooted the family so that I could work at Hopkins. Anyway, daycare was a nightmare (2 kids at the time, we now have 3) and we couldn't get the kids into a daycare setting. Apparently we needed to be on waitlists long before deciding to move. So, my wife was going to an office while I was home with the kids. No problem since financially it wasn't necessary except that I was hoping to work, but certainly wanted a flexible schedule so that I could be with the kids more. I needed a balance and it's not that I wasn't cut out for it, but both my wife and I are the kind of people who have to do some type of work. She consulted from home while I worked in the hospital.

That's when I asked myself why couldn't I consult as well? Find some part time nanny for the kids and have the ability to work in and out of the home. Easier said than done, right? You bet. Something did kind of fall in my lap to start things off. A previous colleague of mine started a business to serve disabled individuals and heard that I was back in town. He needed a nurse to consult, which is pretty much standard in this particular type of business. Most of the organizations have a nurse on staff or use contracted nurses.

It wasn't a lot of hours to start, but a start it was. Now, I will admit that I love to read, research, and Google everything I can on just about anything I am interested in. I already knew how to incorporate (my business is s-corp) and how I wanted to set it up. Most everything I did to set up the corp. was done online and with very little money. Be sure to use local SBA's in your state if you need help. I use QuickBooks to track time, invoice, and do payroll. There are a ton of resources on the web either free or small fees incurred to help with contract templates, organizing the type of business, accounting assistance and of course forums just like this.

Let me also say this and admit that I worked my tail off in that ICU and I enjoyed it. It doesn't really compare to how hard I work now. I work very HARD, but I chose to do this and I truly love what I do. I am representing myself and my business and I take pride in both, so I am going to put everything into the services that I provide. I do however have flexibility to be with my family. I am with my kids everyday for a significant amount of time on some level and this is also why I work hard, so that I can fit it all in.

Aside from the "case management" work that I started doing I also do wellness/health coaching for individuals that either want the support after getting "bad news" from their PCP and need to make a lifestyle change. Some folks want to make a change on their own but really just need someone to assist them in achieving specific goals. I always refer any diagnostic concerns/questions back to the PCP and just work as an extension of the individual's primary medical team.A little advertising and word of mouth is a good way to get this type of service going.

At this time I am unable to take clinical contracts due to the bandwidth that I essentially don't have because of my other contracts and of course the kids. So, I do not have any direct experience with setting up clinical contracts with hospitals at this time, but will certainly pursue this soon. I do know that this is possible and have met the "one person" agency that is currently providing clinical services to hospitals in the area. She has an answering service that charges a small monthly fee to essentially take messages or route calls to the "appropriate department" if a hospital calls.

Let me just end this lengthy post by saying that you will work hard, you are going to have a lot of questions along the way, you will feel as if it is impossible at times and you may tell yourself things like, "I should have done it this way" but you will learn from those mishaps. Just be a good nurse, be smart, embrace your mentors/colleagues who are trying to help, ask questions, stay alert, always seek reliable information from your resources, of course document everything, carry insurance, start small-think BIG.

p.s. Going out on your own is not for everyone, no matter what your career. If you have it in you then experience both sides and see for yourself. Good luck!

How many ways are there for nurses to work independently? I have been brainstorming for a long time and I need some fresh ideas. Anyone have any thoughts? I'd love to see a whole list of avenues we nurses could choose, so I could research each and every one, to find just the right fit for me.

Thanks!

Specializes in home care, catastrophic case mgmt.

There are many ways to be independent in your nursing career. Here are just a few titles that nurses have choosen to pursue: cosmetic nurse specialists, nurse acupuncturists, nurse attorneys, nurse care managers, nurse case managers, independent contract nurses, nurse coaches, nurse consultants, nurse counselor, nurse educators, nurse disease managers, nurse expert witnesses, nurse life care planners, nurse medical bill auditors, nurse medical coders, nurse medical researchers, nurse midwives, nurse paralegals, nurse patient advocates, nurse qualified rehabilitation consultants, nurse rehabilitation consultants, nurse risk managers, nurse speakers, nurse specialists, nurse trainers, nurse wound care specialists, nurse writers, nurses in alternative medicine, community health nurses, forensic nurses, immunization nurses, legal nurse consultants (LNC), psychiatric nurses, sexual assault nurses, sports nutrition nurses, geriatric care managers, nurse health advocates, nurse death investigators, utilization review nurses, and nurse wellness coaches

This list does not exhaust all the possibilities but it should give you a place to start with your research.

Wow! Ask and ye shall receive. Thanks so much. That will keep me busy researching for quite some time. To narrow this field down some, what areas would require the least amount of further formal education? I have a Diploma in Nursing, and have an extensive background over 15 years of practicing in hospitals, rehab and home care, but I have no special certifications or credentials; ie initials following my name.

Who would want me, "just an RN"? Super nurse I am not. But I do have some major strengths, along w/ the inevitable weaknesses we all have.

Anyone out there ever break out of traditional institutional nursing into something more autonomous, w/ a background similar to my own? How did you do it? What did it take to make the transition? How were you received by your new clients?

Thanks again!

:typing

Specializes in CVSICU, case mgmt., Psych, education.

RNentrepreneur really summed it up. I am not sure that I could really add to that. One thing that I will say that I have experienced and continue to do so an IC is that I always seem to find myself with desires to really branch out and grow my business in other areas. Advise that I give myself and to others is to focus on 1-2 services that you can provide and do them well. Then as time goes on and your interests and experience starts to broaden, then it may be good to explore other areas, but keep in mind that if a business is working for you and you enjoy it, by all means stick with it.

I try to develop partnerships with other professionals (ie. PT, OT, SLP, and holistic providers) so that we can all bring our expertise together and provide services that basically focus on the head to toe of the patient. I don't have any special certificates or the alphabet soup after my name, but I do have real world nursing experience and I apply this to my business. I gain a lot of respect for being a nurse in my day to day and clients/patients definitely respect what I have to say. They also appreciate the customer service a nurse can provide. I believe in a "no rush" policy with my patients and clients and if I have to "dig" or tap into other resources to find an answer, then that is what I will do.

Remember, even though there are quite a few nurses out there that are providing services as an IC, this is still not a mainstream idea. It is an ongoing process to not only educate your potential clients, but also other nurses about being an entrepreneur. Also, get to know your specific nurse practice act. In colorado (and this is paraphrased a bit):

Can RNs practice independently?

Yes, when performing independent nursing functions. According to CRS 12-38-103 (10), Practice of Professional Nursing is the performance of both independent nursing functions and delegated medical functions. CRS 12-38-103 (12) requires that delegated medical functions shall be performed under the responsible direction and supervision of a person licensed under the laws of this state to practice medicine, podiatry, or dentistry. In addition, CRS 12-38-128 Independent practice - direct reimbursement, does not prohibit RNs from practicing professional nursing independently for compensation upon a fee for services basis.

www.dora.state.co.us/nursing/statutes/NursePracticeAct.pdf

Plenty of professionals hang their own shingle. Most of them also have to follow their specific governing body of rules as well. An attorney can't give medical advice (unless they have a medical license), M.D. doesn't give legal advice, a CPA isn't going to tell you how to fix your plumbing, and a licensed electrician isn't going to do your taxes for you.

Stay within your scope, and stick with what you know and feel comfortable with. Certifications are always nice and if there is something that you are interested in that would be better that you do obtain some time of certification whether it be legally or just professional growth, then do the research and go for it.

Times are changing and with this current economic time, plenty of organizations will be looking to outsource more to IC's whether medical/nursing, finance, legal, sales, etc. Take the wheel and plot out your course. Don't forget to use Google Maps or GPS if you get lost :chuckle

Specializes in ICU, ER, RESEARCH, REHAB, HOME HEALTH, QUALITY.

not everyone has what it takes to be on their own, I do know after trying different things you MUST have a passion for what ever you do because you will need that to keep going when you get challenged in your business.

yes lets keep this forum going..

Specializes in Clinical Nurse Specialist-ICU, Educator.

Wow-never thought of all those titles. I was most interested in the nurse coaches title. I'm in the middle of getting certified to become a life coach. When I decided to go into this field, I was not aware of a title of nurse coach.

Can anyone tell me more about this? Who does a nursecoach coach? What area of expertise is needed?

Specializes in home care, catastrophic case mgmt.

I don't think there is a clear definition of a nurse coach. I would think this could be a nurse who coaches other nurses. A nurse coach could also be someone who does lifestyle coaching, wellness coaching, nutrition coaching, or a variety of other specialties that a nurse might have.

LeaRae

Specializes in Case Management, Utilization/Quality.

I started my own nursing business 3 years ago after a deligent search for the right "product" to use my license for. The key to any successful business in healthcare is to find something that is lacking or missing or is just to costly for hospitals to do inhouse and then develop a service/product that addresses the need. For me, I developed a service specific to the needs of acute care facilities that directly affects their patient satisfaction and safety outcomes.

Product/service development was the easy part. It is the marketing/sales component of any business that requires the most effort and training. If you believe in what you do or the service you provide, you can "sell" anything to anybody.

Specializes in Telemetry.

I really want to own my own nursing business some day. I want to be a Preventitive Health Nurse. I want to start my own clinic type institution where families can come and learn how to improve their health through diet and exercise, but I want it to be more than just a class. I want to set up like and after school program and have a mock grocery store so I can actively teach children how to look at their food. I want to have a cook night where families come and I have all the ingredients and we cook a meal together learning how the meal at every stage is helping them be healthy. (You would be supprized how many people in their 20s and 30s don't know how to cook!) I want to have an exercise class for diabetics and teach families and people with diabetes how living with diabetes can really make them healtheir people if they take care of themselves. Finally I want to have time to help people understand their diagnosis (really teaching in the hospitals and docotors offices are so limited and unsupportive) I want to teach people what the tests they've had done are for and how it helped the doctor diagnosis their illness. Unfortunatly I want to have a clinic to do all this in and I don't want to charge people very much because the people I want to help don't make much money in the first place.

However, I just started nursing 8 months ago and I really feel like I need to get out of debt before I go leaping off in to some other venture, plus I probably need the hospital experience too! I love this tread and I hope to hear other people's ideas!

Welcome to nursing. It seems as if you already have a good amount of experience in health care, which of course will help you along the way. No matter what you have done prior to nursing, many aspects of your previous career experiences will find some way into your entrepreneurial endeavors as a nurse.

Certainly gather as much experience as you can as a new nurse, but I don't believe it is too soon to start planning your entrepreneur venture. Many nurses (and many other professionals) have started their businesses on a part time basis. Start working on some of the logistics now and seek out mentors that you can bounce ideas off of. Once your head stops hurting from all of the information that you are inundated with as a new nurse and get better adjusted to the lifestyle, then you may want to start putting some of what you have learned into practice as a consultant/IC.

Good luck to you and just keep working towards that goal.

I am SO interested in becoming a health and wellness coach or start a business mainly in disease prevention

First, let me introduce myself to this forum by saying that I have worked not only as a nurse, but also own my own business as a lactation consultant and home birth midwife. Because of the hours involved, I am moving away from that a bit and am now teaching part time in a clinical program and completing a graduate program as a nurse educator.

I would like to continue to work independently. I just posted on another forum about my graduate project, which is to develop some kind of educational program for nurses, students, or the public.

I have been thinking about developing and teaching CEU credit programs, NCLEX programs, or writing more (I have written a few articles, but have found that they pay very little).

I think having some kind of support group for entrepeneur nurses would be a great idea. For those of us that have had our own business, we can share lots of tips on things like taxes, NPI numbers, etc. And we can bounce ideas off one another.

Specializes in CVSICU, case mgmt., Psych, education.

This is what I've been striving for. The more nurse entrepreneurs the better. I'm always happy to share information.

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