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!
