Nurses as independent contractors...

What about taxes?

What about health insurance?

NurseMark,

You do not have to be an independent nurse contractor to write off all your uniform expenses, medical equipment, and continuing ed., professional magazines, etc,.

Any nurse can do that now.

I'm not convince making $40-50 dollars an hour is a great trade-off. Personally I think the hospitals will be the ones who make out on this kind of deal. Has anyone ever sat down to figure out what benefits add up to in an hourly rate. Things like health benefits, vision and dental benefits, PTO time, retirement plan, 401K, disability insurance, life insurance. Add it all up what would it come to, then we could compare apples to apples.

Would this contract guarantee your hours and your shift? Or are you at the mercy of the hospital and work anytime any shift they need you. And when they don't they call you off.

According to another post on this BB that is why hospitals prefer to spend $208,000 to fill one 40hr/week full time R.N. position through an agency rather than to have hire one full time staff person. Because when census is low they don't have to hire those people.

I think the hospitals would be delighted to sign a contract with you. Especially with the cost of health care benefits projected to increase four fold in the next few years. It would save them big bucks as opposed to going through an agency, too. Although I personally would rather see individual nurse contractors than agency's, who do nothing but make money on the hard work of others.

I see it as a very insidious trend that the hospitals are probably just smacking their lips over. I just hope I can hang in the 13 more years I need to retire!

Another excellent post NurseMark. Have checked in to doing exactly what you suggest. Here's what I found out from my accountant. First of all, you'll need to charge the hospitals more like $70.00 per hour because not only do you have to pay your own social security, unemployment tax and self employment tax, but also the regular federal and state/local stuff. And this is alot more tax than than you have to pay currently, because the employer you work for pays for your soc. sec. and unemployment tax now(called a "match"). However this is precisely why hospitals will pay an agency 65-75 bucks an hour rather than upping there own Per Diem rates to say 60.00 per hour to attract nurses. They don't have to pay the aforementioned taxes (which companies are required by federal law to "match" --without the self employment tax of course) in addition to not paying all other benefits(401k's health etc.)--which ends up being a huge chunk for these employers.The benefits to the contractor...Huge! You'll end up paying far less tax on far more money if you are diligent with receipts and have a halfway saavy accountant(make sure you find an accountant who has clients that are pc's/ic's). To PeggyOhio--do your own work and you'll see that buying your own benefits(health,dental,disability,life etc. is easily and affordably accomplished through places like guru.com for self employed people or through a couple of days calling insurance "brokerage" services. Currently I work Per diem at 40-50$ per hour and buy my own benefits for the year with 3 shifts of work and feel kind of sad when the fulltimers say "yeah the money is great for you but I couldn't do that because I need the benefits." These are comments from people who are ignorant(not stupid) of the possibilities before them. This is the prison which most nurses are in which you already wrote about in one of your recent posts nurseMark. As far as retirement goes with this business of being selfemployed as a contractor, look into SEP and KEOUGH plans that are available which are incredible 401k-like tax shelters for the self employed. The hurdles: Hiring a lawyer to write up a legal contracts for you in YOUR STATE which could cost anywhere from 500-1500$,

Hurdles continued: Becoming a LLC which your accountant will help you with(it's just a little money and a little paperwork which will make you a limited liability co. so you'll be fairly safe from suits). And some other hurdles which I will tell you about only through direct email if your'e interested. Good luck and Congratulations for trying to break out of the box!

A poster from Virginia and some other nurses started their own independent nursing business. Check out their site at .http://www.preferredrns.com They are a sterling example of the way nurses should go.

Carrie

[ May 24, 2001: Message edited by: cargal ]

[ May 25, 2001: Message edited by: cargal ]

Mark, I think this is what exactly is coming in the future, where else can they get nurses to staff their hospitals?? I thought of doing this myself. Fortunately, right here and now, my husband's job supplies the bennies, so I am free to think about it a little more than someone who is single or single parents, or married folks whose spouse doesn't have insurance.

One question, what do you mean by "register as a PC"? What does the PC stand for?

Not to make it sound glorious or anything, but I work for a staffing agency who staffs ICU's and CCU's. There is a CT ICU near me, who is having people resign left and right. I used to work there. I resigned d/t verbal abuse from one of the docs, and no matter what bonueses they give, etc, they can't keep staff. Well, today the owner of the company, she's a great person to work for, called to ask if I would commit any time on 7p's....for $63/hr!!!! I said...I'm listening!!! So, after all my B&M'ing, I guess I will sell my soul to the devil himself for that money. I have calculated that I can have my credit cards completely paid off BEFORE Christmas. I am toying with quitting my regular weekend supervisor job at a HH agency, but after much discussion with my husband, we decided this may not last if the hospital actually does hire staff, so we decided we will ride the gravy train as long as it lasts, hopefully until Christmas, and them into January to pay the Christmas bills, then maybe we can afford to go away on a vacation for the first time in 7 years!!!!!!!! I will be tired and cranky going back to nights, and I hate the hospitals, but I can't see how I can refuse this chance to get out of debt, and be able to order out take out without worrying it's too much money. (After taxes, with one 12 7p per week for them, and my regular job, I would take home ~$2100 q 2 weeks) I just hope I can take it, the stress of working there was horrible, but last time I worked there, just before I told my agency boss not to ever schedule me in that unit again, I told off the doctor, and it felt good! He got abusive on the phone, and I gave it right back, not in front of any pt's or family, so maybe I am older and stronger now, I will not allow him to dish out any crap. And if he EVER dares to try to make me look bad in front of a pt again, I will not hold back, I will tell the pt the truth. I have always tried to take the high road, so as not to upset my patients, but I swear, I will not allow him to make me look bad in front of a pt ever again, esp when I have done nothing wrong.

What do you think, am I nuts to go back, or should I go for the money?? My agency boss knows what a jerk this doc is, in fact, she has had it out with him many times, so she insisted to me that it will be in the contract that he must act respectfully to the nurses. Speaking of the contract, she also told this hospital, if she has nurses who work other places commit their time to this place, then this facility must pay the nurses even if their census is zero, AND the nurses will not be pulled to work anywhere else. For $63/hr, I think I would go to CCU, but their ICU is a pit! NO support staff, no one helps each other, yikes!

OK, I'm done, am I nuts???

NURSEMARK: I have been self employed providing a home care service for the past seven years. I receive referrals from area Home Care Agencies, physicians, Senior Centers and through word of mouth in the private sector; I have recently signed my second State Medicaid Waiver contract. I make good money (in my opinion), pay my taxes, am recognized by the State as a small business owner. I maintain a very busy office; I have taken on a nurse partner who has been working with me for the past two years; together we provide care to over 100 clients each month. My small business is VERY SMALL and does not even come close to the requirements for loans and other SB perks. Incorporation is not always necessary to safely contract services. I will say this: I did not go out on my own to make scads of money and be the big boss; I went out on my own because there was a need to fill and I could fill it better this way...I didn't think it would become so popular. And, just as aside, I am an LPN and I am an outspoken advocate for the self employment of nurses.

Originally posted by cargal:

A poster from Virginia and some other nurses started their own independent nursing business. Check out their site at http://www.preferredrns.com. They are a sterling example of the way nurses should go.

Carrie

[ May 24, 2001: Message edited by: cargal ]

Thank you so much for the vote of confidence Carrie!!.. We really have set the wheels in motion for nurses to become entrepreneurial and to form professional practice groups. For those of you who have interest in independent practice, please contact me directly or visit our website and sign the guestbook. We will be teaching teleclasses on business building and giving the correct information about what to expect...pros and cons. I have read the above posts and there is a bit of information that is misleading. So if you want the straight scoop...please contact me.

best regards

chas

Originally posted by PeggyOhio:

NurseMark,

I think the hospitals would be delighted to sign a contract with you. Especially with the cost of health care benefits projected to increase four fold in the next few years. It would save them big bucks as opposed to going through an agency, too. Although I personally would rather see individual nurse contractors than agency's, who do nothing but make money on the hard work of others.

I see it as a very insidious trend that the hospitals are probably just smacking their lips over. I just hope I can hang in the 13 more years I need to retire!

Peggy..while there are some short term benefits to the hospitals who contract for services, hospitals clearly want their own employees for a number of reasons. Hospitals have traditionally exercised a great deal of control over employees and to lose that control is a threat to them. It really is not in hospitals' best interests to promote independent practice, or for that matter, the professioanlism of nursing, because then they will have to deal with nurses like they deal with MDs. Whole systems are built to manage people in hospitals, especially nurses. Nurses who want to control their own destinies are finding out that they can have fulfilling nursing careers, have enhanced financial opportunities and have great lives by becoming independent practice RNs. I did it late in life, and hope that others will follow my lead and do it earlier...

regards

chas

Originally posted by LoisJean:

NURSEMARK: I have been self employed providing a home care service for the past seven years. I receive referrals from area Home Care Agencies, physicians, Senior Centers and through word of mouth in the private sector; I have recently signed my second State Medicaid Waiver contract. I make good money (in my opinion), pay my taxes, am recognized by the State as a small business owner. I maintain a very busy office; I have taken on a nurse partner who has been working with me for the past two years; together we provide care to over 100 clients each month. My small business is VERY SMALL and does not even come close to the requirements for loans and other SB perks. Incorporation is not always necessary to safely contract services. I will say this: I did not go out on my own to make scads of money and be the big boss; I went out on my own because there was a need to fill and I could fill it better this way...I didn't think it would become so popular. And, just as aside, I am an LPN and I am an outspoken advocate for the self employment of nurses.

I certainly applaud your efforts LoisJean...business skills are not an entitlement to anyone except for those who want it badly enough. Congratulations on establishing yourself as a business entity and controlling your own destiny!

best regards

chas

Hi Charles. It's great that can post how satisfied you are with your decision to become an independent practitioner. I think that many of us need to read about happy or satisfied nurses as an antidote to what we're going through.

I would like to know what type of safety net does independent practice provide for those whose health suddenly goes south especially if your spouse is self-employed or if you are single w/wo dependents? I really believe that the need for comprehensive cost effective group health insurance is one of the reasons why more dedicated nursing professionals don't strike out on their own.