Nurse entrepreneurs - Can any out there give some advice, please?

HealthyNurse · Jan 16, 2013

My understanding is that an independent nurse contractor is able to bill Medicare/Medicaid for services. A self-employed nurse may be an independent nurse contractor or not, depending on what services they are offering and if they want to or are able to bill Medicare for services. So, it really depends on what you envision yourself doing. Could you be a little more specific? If you are a new grad, either RN or NP, it would not be wise to go out on your own (especially doing direct patient care) without getting some experience somewhere. To do so would endanger your new nursing license and open yourself up to huge liability. Nursing school does not come close to preparing you for the real world...

Applehead · Jan 17, 2013

I'm definitely NOT looking to be independent as a new grad. I want to go to NP school, so I plan to work as an RN in a hospital setting until I get my NP, by then I'll have about 4 years experience. I'm not sure if that is an appropriate amount of experience to let myself venture out onto my own. That's why I'm searching for advice. I definitely want to be independent as an NP and want to try not to work for a hospital.

My concern is that I won't have job security. I don't know how being an independent nurse works but I don't want to not be without a job for months. I really want to learn more about this and everything it entails to make sure that this is something I definitely want to get myself into. I guess I moreso like the "idea" of being an independent nurse but I don't actually know the ins and outs of it. I also like the idea of being able to decide my own pay since I believe NPs and nurses in general are severely underpaid. But again, I don't know much about that deal either. I would also like to know if this is something that other nurses would highly recommend or not?

Right now, my big interest is in becoming a PMHNP (mental health NP), however, this may change depending on what the job market looks like and depending on my interests, of course. The goal is NP but I'm not set on a specific specialty yet. Would the area I specialize in impact my career as an independet?

I don't want to be the kind of new nurse who enters the field thinking they know it all, because I won't know it all. So I'm open to any advice, ideas, or recommendations.

nurseprnRN, BSN, RN · Jan 17, 2013

Being self-employed and being an independent is exactly the same thing. That's for starters. :)

We do not have the kind of job security employees do (though any job can end unexpectedly in this economy); our next case is as near, and as far, as our marketing and networking gets us. We are always on call. We can take vacation anytime we want ... but we don't get paid for days we don't work, so we are never really away.

You get a good accountant to manage your taxes and withholding; you get a good attorney to make sure everything is protected; you Get business insurance (some more than nursing malpractice, but not a lot more, and essential). You pay for your own health insurance, 401K deposits (no matching from an employer), office supplies, continuing education, licensure.

Not for the faint of heart, but I wouldn't work for anyone else ever again.

HealthyNurse · Jan 20, 2013

Even if you have RN experience by the time that you graduate as an NP, that does not completely prepare you to be a fully functioning NP upon graduation. The role of the NP is much different from that of the RN. I believe you would be better served by getting NP experience in a setting in which you have a lot of support. And then venture out on your own after a year or two.

As far as picking a specialty that is more conducive to self employment, I think you would be better off to choose what you are most interested in. If you have a passion, it is much easier to invest the time and energy into a business idea. You also want to look into the laws in your state for independent NP practice. I can't speak much to that, but I know it could affect what type of independent practice you can have.

Being self-employed is rewarding, but it is also very challenging. Even if you have a great service to sell, it takes a lot of time and effort to get your name out there and get people interested in your service. It is NOT as easy as "build it and they will come". That's another reason why you may want to consider getting NP experience before starting your own business. What will make your service so special that a patient will choose to go to you rather than someone else? If you have no prior NP experience, that will not be a great selling point. I am not trying to discourage you because I think that self-employment is a wonderful option in nursing and I think the profession would be much better overall if more nurses went this route...but it's just something for you to consider.

Job security with self employment comes as you become more established. And it takes time, sometimes A LOT of time, to build up a business. The best way to do it is to have a full-time job and start the business on a part-time basis. As your business grows, you can decrease your working hours at your full-time job (ideally) until you are ready to take the plunge and go into your business full-time.

tlancio · Jan 28, 2013

I agree with healthynurse, job security as a self employed NP will take time, alot of time, especially if you're not good at marketing yourself. It's best to start your business when you have a full time job, it's what I am doing now. I have been able to get myself down to 3 days a week and hope by this time next year I will be a full time nurse entrepreneur. And yes, being self employed and an Independent Nurse contractor are the same thing.

Hope this helps -

tinalancio