Legal issues and other topics in private duty nursing

Specialties Private Duty

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I live in a small rural community and am the only R.N here. I am often asked about doing private duty jobs, but I have always been reluctant of doing so because I feel like I am not covered legally and lack knowledge about all the laws and issues that can come up in private duty work. Can anyone direct me to find more information for the state of Nevada or private duty nursing in general?

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Do not know of any resource for your question, but I believe you will go a long way in protecting yourself by keeping your up to date. I would not worry over issues that might come up. Cross bridges when you get to them. Do you have a go to person, perhaps from a previous job or school? When you have someone to ask, it makes it easier.

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Specializes in Healthcare risk management and liability.

Some potential resources for more information:

1. Contact the state nursing association. Many state associations publish material on the state laws/regulations on nursing practice.

2. Contact the state BON. Many Boards publish materials on the state laws/regulations on nursing practice.

3. If you carry from NSO or ProLiability, contact them and ask for a risk management opinion

4. Contact your state healthcare risk management association (your nearest hospital risk manager should have the contact info) and ask some of the members about it.

5. Google 'private duty nursing laws Nevada' and see what comes up.

The potential problem, as I see it, is that PDN is a pretty small market niche, compared to nursing in general, and I don't think there may be a lot of specialty-specific resources or expertise available. The other issue is how you get paid for it, especially if you want to bill insurance. That brings up a whole host of following the compliance, billing and documentation requirements in order to get paid.

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Specializes in NICU, ICU, PICU, Academia.

I was in a similar, rural community several years ago- and what I found was this. 99% of the time, people were not really looking for a nurse- they were looking for home health aide type person. I was asked to 'sit' (12-14 hours/ day) with someone's dotty elderly aunt, toilet someone's dad every two hours (so they could leave him alone and unable to get out of his recliner while they worked) and such.

The requests for actual RN-level care were these: Daily Lovenox injections (wife had crippling arthritis and could not manage the syringe), switch out peritoneal dialysis bags (same lady, just could not wrangle the bags or lift them) and evaluate a central line for patency (IV pump was beeping because patient was lying on the tubing). Those I did without charge or thought of recompense because, well, because these people were my neighbors and needed help.

The others I declined and educated them on why they did not necessarily need a nurse, and how to access home health / sitter resources.

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Thank you. I have helped with injections and other minor things and I would never accept pay for helping a neighbor or friend. I have been approached for more CNA duties such as sitting with an elderly client or setting up medication, or closer monitoring after a surgery and a few other jobs that compensation would be appropriate. What do you charge per hour? I make $28/hr on my med/surg job so what should I charge.

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For monitoring type situations, for an RN: $24 or $25 an hour would be appropriate. But if there are skilled interventions, such as injections, enteral feedings, start/stop/monitor IV meds, etc., $26 or $27 an hour or even your hospital rate of $28 an hour, would be better. If you want to decrease your rates due to your rural environment (limited income base) just subtract $5 an hour from those rates. Emphasize that CNA type duties, such as a bath visit, would result in a range of $10 - $12/hour wages for the CNA, and it really is better for them to hire a CNA or HHA, or even an LPN, to do those lower level tasks. I would rethink doing anything for a neighbor that is within the normal duties of a nurse for nothing. Check with your malpractice carrier for any legal ramifications.

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Specializes in Pediatric Private Duty; Camp Nursing.
or even an LPN, to do those lower level tasks.

No, an LPN would not take $10-12/hr for lower level tasks. We are nurses too and command better wages. We are not glorified CNAs.

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No, an LPN would not take $10-12/hr for lower level tasks. We are nurses too and command better wages. We are not glorified CNAs.

There is very little difference in offering an LPN $14 an hour to do 'nursing' care and offering a HHA or CNA $12 (or $14)/hr to do the same care, which is what many agencies in my area do. And I did not state in my post that the LPN would be paid $10 an hour, although that may be inferred by the not all-inclusive sentence.

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