Working for myself as a private caregiver....I have a couple Q's about this

november17, ASN, RN · Oct 2, 2008

It depends, are you an RN? Or a CNA? It sounds like the job you are trying to get would be better suited to a home health aide than an RN. You might be overqualified if you're an RN.

locolorenzo22, BSN, RN · Oct 2, 2008

Well, you describe in like a CNA/live in caregiver..but you would have to make clear that you are not operating in those capicities...lest someone(daughter, family) decide that you are influcing someone, and practicing outside your scope...

GingerSue · Oct 2, 2008

Is there a local senior citizens' centre that already

publishes a newletter with similar advertising? There

is in my location. It reaches many seniors.

tiak41 · Oct 2, 2008

hi, Im actually considering doing the same thing but if I was you, check with the board of nursing to make sure you don't break any laws, not to mention it wouldn't be a bad idea to get malpractice insurance in case something happens in your care..Good luck

Farmer Jane · Oct 3, 2008

I think you should consult someone who is an expert about nursing law in your state. You could be putting yourself in a very precarious position by working as a nurse without any oversight from an employer via policies/procedures/background checks/etc.

Neveranurseagain, RN · Oct 3, 2008

Another consideration that may pose a problem is taking pt's to MD appt. You need to check with your car insurance agent to make sure you are covered. Another option is to drive that person in their car (if they have one) but check to be sure they have insurance and get it in writing that is is ok. Most insurance will allow someone else to drive a person's car as long as it is only done occasionally. But check with their agent first.

Be familiar with your state nursing regs. Any meds must be prescribed and procedures need an MD order such as an enema for constipation. Don't do anything or give anything that you would need an order for just like in the hospital. And be sure to work only within the scope of your license, whether it be CNA, LVN or RN.

pagandeva2000, LPN · Oct 3, 2008

Another consideration that may pose a problem is taking pt's to MD appt. You need to check with your car insurance agent to make sure you are covered. Another option is to drive that person in their car (if they have one) but check to be sure they have insurance and get it in writing that is is ok. Most insurance will allow someone else to drive a person's car as long as it is only done occasionally. But check with their agent first.
Be familiar with your state nursing regs. Any meds must be prescribed and procedures need an MD order such as an enema for constipation. Don't do anything or give anything that you would need an order for just like in the hospital. And be sure to work only within the scope of your license, whether it be CNA, LVN or RN.

That is so true! You would be practicing without an order, and the liability is greater for you as a licensed professional with no chart to actually know the condition of the patient. What if you see that a person seems to need to be digitized, but you don't know whether or not they have heart problems? Or a diabetic, and not know the sliding scale (and the patient doesn't know, either).

The BON in my state is very informative and quick to respond, even friendly. I would consider emailing them or calling to gain as much insight as you can before you do this. It may be nice in theory, but the reality may be that you may be placing the patient and your license in jeopardy.

BinkieRN, BSN, RN · Oct 3, 2008

I think it's a really really bad idea. #1 being paid out of pocket is illegal, I'm assuming you won't be reporting it as income to the IRS? #2 you have no one to back you up on anything, you could easily be sued and lose whatever license it is that you have. You can go through an agency to get private duty work, you'll have backing and will pay your fair share of taxes.

Neveranurseagain, RN · Oct 3, 2008

"I think it's a really really bad idea. #1 being paid out of pocket is illegal, I'm assuming you won't be reporting it as income to the IRS? #2 you have no one to back you up on anything, you could easily be sued and lose whatever license it is that you have. You can go through an agency to get private duty work, you'll have backing and will pay your fair share of taxes."

Being paid out of pocket is not illegal. I occ. do private duty and report my earnings and get 10-99 from some clients. You are considered self employed, and can deduct your mileage and other expenses. Nurses have been their own employers for years--look under Entrepreneurs in Nursing on allnurses. We are considered Independent Contractors and cut out the middleman. As long as you understand the nurse practice act and work within your license boundries, there should be no problems. And being sued is not that easy, esp. when dealing with an elderly client in a state with a malpractice cap. And when did agencies start backing their nurses? They back up who pays them, not the person they have to shell $$$ out to.

As an RN, I have taken clients who only needed a CNA/HHA and recommended to the family and pt. that is all they need for the level of care provided. And the familys have refused, saying they would feel more comfortable if they were cared for by an RN. Most of the time it was an easy visit or shift, and I got paid to read, talk with the pt. and watch TV with the client and catch them up on current affairs, as well as heard some great history stories!

I think by out of pocket she meant she would only take private pay pts., not bill insurance/Medicaid/Medicare.

I write a note everyday that I see a client in a bound book. I chart wt, meals/snacks, level of activity, meds taken, phone calls to family and MD, any interventions or suggestions/teaching to the pt/family, hygiene, time of arrival/departure and occ will have a family member sign it.

pagandeva2000, LPN · Oct 3, 2008

It is not illegal in my state to work privately. I am just more concerned about other risks that may not be considered until you are already present before the patient, something occurs, and this patient or family is expecting professional intervention. No one wants to learn as an afterthought that this may be out of the scope.

I am learning now that even some agencies can place a person's license in jeopardy. I am an LPN that used to do flu shots for an agency. What happened in my case was that I was told that these were under standard orders. I went to sites freely and administered flu vaccines. I thoroughly enjoyed doing this for two years, going to really nice locations to perform this task. Thank God nothing happened to a patient, because this year, due to some static at my job, I contacted the State over a related issue, and decided to ask and I was told that LPNs in my state can administer flu and other vaccines under patient specific orders, only. Only the RN can administer vaccines under standard orders, with no chart or knowledge about the patient. I was strongly advised not to participate in these events because (and I quote) "many of these agencies fly under the radar, placing the LPN to work out of her scope of practice". I naively thought that if a nationally known agency hired LPNs to do this, then, it was legal...but it wasn't. And, if something happened to a patient that I administered a vaccine to, ignorance would not wash...because I am responsible to comprehend my scope of practice. Be sure that you do the same.

tiak41 · Oct 4, 2008

You sound very organized and I believe its an enjoyable job:) Thanks for the insight:)