Start Your Own Nurse Agency

Advance Your Nursing Career

2011-01-13T04:33:00.000-08:00

Many nurses today are frustrated with their work situation. Are you one of them? If so, it is time you take control and make that first step. Quit thinking about a change …DO IT …quit saying I am going too… DO IT…Quit day dreaming, procrastinating, making excuses, waiting for “the right time” ….DO IT. Now is the time to expand your nursing career and enjoy the many benefits that is offered as an Independent Nurse Contractor. Visit http://www.independentrncontractor.com WE CAN MAKE IT REALITY!

Nurses wake up and take advantage of this extraordinary opportunity. Are you tired of having no input in your career, little money in the bank, lack of respect for your profession and little compensation for the long hours and years of dedication? Independent Nurse Contractor is a great way to renew your interest and rejuvenate your nursing career. As An Independent Nurse Contractor you will Gain back your independence and enjoy freedom: more choices; as to how often, when and where you practice, substantially increase your wages, increase overall job satisfaction and best of all just plain recognition of your worth as a professional. Now is the time to Achieve your goals and recognize your dreams Do not settle for mediocre pay and benefits when you can have the best .

Visit our website at http:/www.independentrncontractor.com

Nursing Career Choices

2008-11-01T04:22:00.000-07:00

Independent RN Contractors Are Taking The Nursing Profession by Storm

Nurses wake up and take advantage of this extraordinary opportunity. Are you tired of having no input in your career, little money in the bank, lack of respect for your profession and little compensation for the long hours and years of dedication? Independent RN Contractor is a great way to renew your interest and rejuvenate your nursing career. As An Independent Nurse Contractor you will increase your choices as to when, where and how often you work, substantially increase your income and most of all gain professional autonomy.

An Independent Nurse contractor contracts with a healthcare facility to provide nursing services, usually by the hour. An Independent contractor can contract his or her nursing services directly with a healthcare facility or with a patient and continue bedside practice. The contract is similar to those used by nursing agencies and travel companies outlining the services to be provided, the responsibilities of both the healthcare facility and the nurse, and the length of time the services are to be provided.

Nurse Contractors practice in all aspects of the Healthcare Industry; Home Health, Nursing Homes, Hospitals, Rehab Centers and Doctors Offices, all aspects of Nurse Consulting just to name a few. No advance degrees are necessary unless your business includes diagnosing and treating medical problems. State nurse practice acts do no prohibit a nurse from starting up their own business as an Independent Nurse Contractor. Independent nurse contractor is one who contracts with a healthcare facility for nursing services. A contractual agreement is drawn up between you and the institution. You will be able to negotiate your compensation, hours worked and length of time your services will be needed.

Visit http://www.independentrncontractor.com for more information.

WHERE TO OBTAIN BUSINESS LICENSES

2008-08-21T11:05:00.000-07:00

Business Structures

2008-03-16T13:19:00.000-07:00

Types of Business Entities
The type of business entity you choose will depend on three primary factors: liability, taxation and record-keeping. Here's a quick look at the differences between the most common forms of business entities:

A sole proprietorship is the most common form of business organization. It's easy to form and offers complete managerial control to the owner. However, the owner is also personally liable for all financial obligations of the business.
A partnership involves two or more people who agree to share in the profits or losses of a business. A primary advantage is that the partnership does not bear the tax burden of profits or the benefit of losses-profits or losses are "passed through" to partners to report on their individual income tax returns. A primary disadvantage is liability-each partner is personally liable for the financial obligations of the business.
A corporation is a legal entity that is created to conduct business. The corporation becomes an entity-separate from those who founded it-that handles the responsibilities of the organization. Like a person, the corporation can be taxed and can be held legally liable for its actions. The corporation can also make a profit. The key benefit of corporate status is the avoidance of personal liability. The primary disadvantage is the cost to form a corporation and the extensive record-keeping that's required. While double taxation is sometimes mentioned as a drawback to incorporation, the S corporation (or Subchapter corporation, a popular variation of the regular C corporation) avoids this situation by allowing income or losses to be passed through on individual tax returns, similar to a partnership.
A hybrid form of partnership, the limited liability company (LLC), is gaining in popularity because it allows owners to take advantage of the benefits of both the corporation and partnership forms of business. The advantages of this business format are that profits and losses can be passed through to owners without taxation of the business itself while owners are shielded from personal liability.

Retrieved From

Nurse Entrepreneurs

2008-01-29T13:02:00.000-08:00

Nurse entrepreneurs combine their nursing background with business savvy, creativity and ingenuity to start their own businesses. Companies may provide patient care, equipment, consulting, education or other services related to nursing.

Nursing as a whole will be one of the top 10 fastest growing professions in the United States in the next decade, according to the Bureau of Labor Statistics.

Autonomy, can be more lucrative than traditional nursing

An independent nurse contractor is a self-employed nurse. The central theme of independent practice has many variations. Some practice in traditional settings, either as a sole proprietor or within a group practice; some deliver services directly to the healthcare consumer; and some own medically related businesses. Regardless of the particular form, the unifying idea is self-employment.
WHY PRACTICE AS AN INDEPENDENT NURSE CCONTRACTOR?
Substantial increase in income
Increased professional autonomy
More control of our personal lives
Independent practice will result in substantial increases in our compensation. Recognition of our worth to the healthcare delivery system will further our professional autonomy and increase our ability to set the terms of our services. These more attractive terms will be an incentive to attract and retain the more highly skilled people to our profession. In short, more money, better hours, and increased choices as to how, when, and where we practice.

VISIT http://www.independentrncontractor.com/

Business Resources

2007-12-25T19:13:00.000-08:00

"If you're ready to take the risk of starting a new enterprise, research your business carefully before taking the plunge," says Tony Lee of StartupJournal. Even though business failure rates aren't as high as we think, aspiring entrepreneurs still need to do their homework. These resources can help boost your odds of success:

SCORE is one of the best (yet often overlooked) resources for small business startups. Volunteer SCORE counselors can provide free one-on-one advice, or you can ask questions by e-mail. A counselor will review your business plan, discuss your goals and offer feedback - all at no cost to you. Plus, the SCORE Web site has loads of helpful tips, articles and resources to help you on your way. Visit www.score.org or call (800) 634-0245.

Small Business Development Centers (www.sba.gov/sbdc), or SBDCs, are an excellent, free counseling and information resource sponsored by the U.S. Small Business Administration. There are nearly 1,000 service locations at colleges, universities, vocational schools, chambers of commerce and economic development corporations nationwide. For locations, click the "SBDC Locator" at www.sba.gov/sbdc.

StartupJournal.com is a great all-around resource for startup entrepreneurs. The same folks who publish The Wall Street Journal run this site, so the information is solid and trustworthy. The main page lists daily features and links to resources such as PR tools, financing, technology, a trademark search and creating business plans. The site is also loaded with tips on small business technology and management. Visit http://www.startupjournal.com/.

The U.S. Small Business Administration Web site offers good basic advice and information for business startups. Go to www.sba.gov and click on "Starting Your Business."
eVenturing is a non-commercial site for entrepreneurs that is run by the non-profit Kauffman Foundation. The site offers articles on topics ranging from financing and accounting, to human resources, sales, marketing, operations, strategy and many others. Visit http://www.eventuring.com/.

StartupNation aims to be America's "go-to" resource for business startup. This dynamic site offers helpful advice and inspirational support through online seminars, newsletters, radio spots and other avenues. Visit http://www.startupnation.com/.

All Business Schools is an online directory of college business schools. You can search the site for those offering entrepreneurship programs. Visit www.allbusinessschools.com.
Daniel Kehrer (editor@business.com) is Editor at Business.com, the leading business search engine.

Start Your Own Nurse Agency or work as an Independent Nurse Contractor visit http://www.contractornurse.com/

Employee or Independent Nurse Contractor

2007-11-22T13:28:00.000-08:00

Article of interest found at allnurses.com and thought you might too. While this article refers to CRNA; the application of independent contracting can be considered for most, if not all, areas of nursing. The key area I found of interest is concerning the IRS differnces of employee versus independent contractor. Here is the link and the article:http://www.aana.com/legal/legbrfs/2002/02lb02.asp

CRNAs as Independent PractitionersBy Gene A. Blumenreich, J.D.Nutter, McClennen & FishBoston, Mass.Keywords: Employee, independent contractor, liability, respondeat superior, supervisionOne impact of the shortage of anesthesia personnel in the past few years has been the number of CRNAs who consider themselves as independent contractors rather than as employees. The shortage, together with the availability of moonlighting insurance coverage pioneered by AANA Insurance Services, has created a number of opportunities for CRNAs to provide services other than as full-time employees of hospitals or nurse anesthetist or physician groups. In some cases, nurse anesthetists no longer even have a primary employer but contract out their services to several parties as they are needed.

The presence of nurse anesthetists who consider themselves as independent contractors rather than employees has given rise to a number of questions concerning the status of nurse anesthetists as independent contractors, such as who is liable for the rare episode of negligence? How has the US Internal Revenue Service (IRS) adapted to this new career option? The difference between an employee and an independent contractor is control. An employer has the right to control an employee not only as to what shall be done but also how it shall be done.

On the other hand, when someone retains an independent contractor, he or she can control the result but not the details and means. The distinction between an employee and an independent contractor is often litigated in the areas of taxes and liability for negligence committed by the worker.Employers are liable for the negligence of their employees "committed within the scope of employment." The legal phrase is respondeat superior, the superior answers for the negligence of the employee. The justification is that since the employer controlled the employee it is fair to hold the employer responsible for negligence that arises under the employer's control. Or, stated positively, by making the employer pay, society encourages the employer to exercise its control in a way that will not permit the negligence to happen again. Since an independent contractor is not controlled, it does not seem quite so fair to hold someone liable who had no ability to change the contractor's behavior.As applied to anesthesia, these relatively simple and straightforward concepts can become muddied. First, healthcare is often provided by very complex organisms.

Being a healthcare employee is not like being an 18th century blacksmith's apprentice or a 20th century factory worker who had a single boss. Who is the "boss" and whose employee are you if (1) your paycheck is signed by the hospital treasurer, (2) your hours and working days are dictated by the vice president for nursing (who may be employed by the hospital's independent management services provider), (3) you are assigned to an operating room by an independent physician who is chief of the hospital's anesthesia department, and (4) in the operating room, yet another independent physician supervises you by dropping in and changing the settings on your anesthesia machine when you are not looking?

Second, some states or hospitals have laws or policies requiring CRNAs to be supervised. How can someone be an independent contractor if the person has to be supervised?Tax considerationsIn many areas a person's legal status will have little or no bearing on what status the person has for tax purposes. For example, in some circumstances, corporations pay tax at a lower rate than do individuals. The tax laws allow the IRS to challenge whether an entity incorporated as a corporation under state law is a corporation for tax purposes, and the IRS has developed its own criteria. In determining whether someone is an employee, however, federal tax laws follow the same rules as everyone else (Rev. Rule 87-41).

The consequences of being an employee rather than an independent contractor for tax purposes can be rather dramatic. Employees are entitled to participate in employee benefit programs, while independent contractors often are not. Employers maintain workers' compensation insurance on behalf of employees, while they do not for independent contractors. Employers pay payroll taxes on wages paid to employees, while they do not on payments to independent contractors. In addition, if the employer is a corporation rather than an individual, an appropriate officer may have individual liability to the IRS if some of these responsibilities are not satisfied, even though an officer's personal liability may be rare in most other areas.

Because some employers have tried to categorize their employees as independent contractors to secure favorable tax treatment, the IRS frequently audits relationships that are claimed to be independent contractors to see if they are really employment arrangements.The basic difference between an employee and an independent contractor is that the contracting party normally controls only the result to be accomplished by an independent contractor but has the right to control the details and means by which an employee accomplishes the result. It may be helpful to consider examples in the area of anesthesia. Nurse anesthetists administering anesthesia for a surgeon may be told, "Keep him relaxed, keep him quiet, don't let him move!" or, "He's pushing! You better do something!"

These orders reflect control only of the result to be accomplished. On the other hand, a person directing a nurse anesthetist might require that the nurse anesthetist "Administer 100 mg of Anectine because the patient is quite overweight." or "This looks like a difficult airway. Do an awake fiber-optic intubation!" These orders reflect control of not only the result to be accomplished but also the details and means by which it is to be accomplished.Even the IRS admits that it is difficult to distinguish an independent contractor from an employee. While the issue of control is defining, the IRS has identified 20 factors that courts considered under common law cases in deciding whether a particular relationship is one of employment or independent contracting.

An employer can: · (i) require the worker to comply with instructions about where, when and how the person is to work; · (ii) train the worker; · (iii) integrate the worker's services into its business operations; · (iv) require a particular person to per- form the services; · (v) hire, super vise and pay assistants for the worker; · (vi) have a continuing relationship with the worker; · (vii) set the hours of work for the worker; · (viii) require the worker to devote substantially full-time to the employer's business; · (ix) require the worker to perform services on the employer's premises; · (x) require the worker to perform services in a certain order or sequence; · (xi) require the worker to submit regular or written reports; · (xii) make payment by the hour, week or month instead of by the job or on a straight commission; · (xiii) pay the worker's business and/or traveling expenses; · (xiv) furnish tools and materials. · An independent contractor often (xv) makes a significant investment in facilities that are used by the worker in performing services and are not typically maintained by employees; · (xvi) realizes a profit or suffers a loss as a result of the worker's services; · (xvii) performs services for a number of unrelated persons at a time; · (xviii) makes his or her services available to the general public on a regular basis. · An employer (xix) has a right to discharge a worker; · and an employee has (xx) the right to end his or her relationship with his employer at any time he or she wishes without incurring liability (Rev. Rule 87-41).

Not only are these merely guides, but also there is no specific instruction as to how many factors need to be present for a relationship to be classified as employment or an independent contract. Moreover, in any relationship it is possible to have a mix of factors--some indicating employment and others indicating independent contractor.

Determining when a nurse anesthetist is an independent contractor can be very difficult for both courts and the IRS because, as we noted, in a complex healthcare organization, a number of unrelated entities may be responsible for different aspects of the relationship. But courts and the IRS also have been confused by various state laws and/or institutional policies that require that a nurse anesthetist be supervised or directed by a physician. As previous columns have discussed, a statutory requirement of supervision is not equivalent to a requirement of control. However, some institutions have drafted procedures that purport to require a supervising physician to control the nurse anesthetist.

Such procedures can create liability for the physician or institution where none would otherwise have existed or may justify a finding that the nurse anesthetist was an employee for tax purposes.Control or supervision?It also is difficult to determine whether a person is an independent contractor when the person for whom the services are performed has the ability to control certain aspects of the relationship but does not have the right to control others. To impose vicarious liability, courts must determine whether control, as opposed to mere supervision, actually exists. If it does, is it control over the result or the details and means?

Finally, if it is control over the means, was the control directly related to the negligence? The fact that a CRNA may be supervised or even controlled in the operating room should not be the sole factor that determines whether the CRNA is or is not an independent contractor. For all of the years when surgeons were captains of the ship, and nurses, anesthesiologists, and otber personnel were borrowed servants, the IRS never suggested that surgeons should be paying federal withholding taxes or arranging workers' compensation insurance on their borrowed servants. Healthcare relationships are varied, complex, and often not susceptible to quick analysis. In healthcare, there are numerous examples that control in one area is not necessarily inconsistent with an independent contractor.

The fact that a hospital administrator can require a CRNA to be in operating room 1 at 5:30 AM should not, in and of itself, make the hospital liable for a negligent intubation. The ability of a surgeon to tell a moonlighting CRNA that he or she wants this patient quiet and still or the ability of an anesthesiologist to order the use of a particular anesthetic agent should not, in and of itself, entitle a part-time CRNA to participate in the hospital's employee-only dental insurance program.Employee or not -- Courts and juries confused

When reviewing cases that have been decided, it is apparent that both courts and juries are confused by anesthesia. Factors and circumstances that lead one court to conclude that the anesthetist is an employee are cited by other courts to prove the opposite. It would be foolish to pretend that the confusion is not there or that it is possible to structure the relationship in a way that courts and juries are guaranteed to uphold. The reality is that this is not an area with a high likelihood of predictability. Nevertheless, it is important to be aware of the way in which courts and juries look at these structures.In Hohenleitner v Quorum Health Resources, Inc (10 Mass. L. Rptr. 31, 1999), a woman suffered an angina attack. Believing that she had suffered a heart attack, she went to the hospital, where the nurse in charge of triage allegedly misread her electrocardiogram and delayed her examination by the doctor. When she was examined, she immediately went into cardiac arrest. The triage nurse's salary was paid by the hospital, but the hospital was being administered by Quorum, a hospital management services company. The patient attempted to collect damages from Quorum for the negligence of the triage nurse.

Although the jury had found that Quorum had the right or power to control or direct the manner in which the nurse provided treatment to patients in the emergency room, the court granted judgment in favor of Quorum despite the jury's verdict. Quorum's specific responsibilities included the supervision and management of all employees of the hospital including the determination, from time to time, of the numbers, qualification, establishment of wage scales, rates of compensation, employee benefits, and other matters. T

he Massachusetts court noted that it was the hospital, not Quorum, that paid the nurse's salary and benefits, scheduled her hours of work, provided the facilities and equipment she needed to perform her job, and received payment for the services that she provided to patients.

One of the key factors in the court's decision that Quorum did not control the nurse was the fact that Quorum could not, as a matter of law, control or direct medical decisions regarding patient care since none of Quorum's administrators was a licensed physician or nurse. I

n Doctors Hospital v Bonner (195 Ga. App. 152, 392 S.E. 2d 897, 1990), the Georgia Court of Appeals affirmed a jury verdict against a hospital and a group of anesthesiologists. The patient suffered a laryngospasm after the endotracheal tube was removed. The jury found the anesthetist had been negligent trying to reintubate the patient. The hospital objected to a finding that it was liable, claiming that the anesthesiologists who employed the anesthetist were independent contractors, as was clearly stated in their contract. The Georgia Appellate Court stated that labeling a relationship in a contract is not determinative of status. The jury was justified in determining that the anesthesiologists were, in fact, hospital employees, not independent contractors.

The anesthesiologist group was required to treat all patients at the hospital who required anesthesia services; it could not choose. It had to provide its services in the hospital's 4 operating rooms during the time periods set forth in the contract. The hospital had the right to approve the rates charged. No other anesthesiologists were allowed to practice in the hospital. The hospital retained the right to approve anesthesiology services and the conduct and operation of the anesthesiology department. Most important, a provision of the contract stated that "to the extent required by the laws and regulations governing the operation of hospital, hospital retains professional and administrative responsibility for the [anesthesia] services provided hereunder."In Bird v United States (949 F 2d 1079, Oklahoma, 1991), a CRNA had been hired through a placement service to work at a government hospital in Oklahoma. State and federal governments cannot be sued except with their consent.

The Federal Tort Claims Act allows the federal government to be sued for acts of its employees but not for acts of independent contractors. The contract between the nurse anesthetist and the hospital provided that the nurse anesthetist would be an independent contractor and that the hospital would not be liable for the negligence of the nurse anesthetist. The court, however, considered other factors besides the terms of the contract. In particular, the court relied on the CRNA's testimony that his functions, attire, hours, and similar matters did not differ from those of other employees. The court also found, in determining that the CRNA was an employee, that he was required to work with patients designated by others, had no separate office, used hospital equipment exclusively, and could see patients in no other place.The court also referred to an Oklahoma statute that provided that nurse anesthetists could only provide service under the direct supervision and control of a physician.

The Oklahoma statute had already been amended, but the amendment did not go into effect until 5 days after the injury, which gave rise to the lawsuit. It now provides that nurse anesthetists can administer anesthesia "under the supervision of a medical doctor, an osteopath physician, or a dentist licensed in this state and under conditions in which timely onsite consultation by such doctor or dentist is available." Evidence showed that in reality whether or not there would be control depended on capacities, personalities, competency, and other factors. But the court also noted that the hospital medical staff rules provided that in the event of a disagreement between the surgeon and anesthetist, the surgeon would make the final determination.

The consideration of the effect of a statute requiring control reinforced the court's decision in this case because the supervisor was a hospital employee, but what would the court have done if the supervisor had been another independent contractor?In Skillman v Riskalia (1994 WL. 879645 (Mass., 1994)), an anesthesiologist who had negligently treated a patient was trying to take advantage of a Massachusetts statute that an employee of a government-owned hospital was not liable for his or her own negligence.

The rationale behind the statute was that because government-owned institutions could not be sued (unlike the federal government, Massachusetts had not given its consent to be sued), if employees of state hospitals could be held liable, the employees would insist on being indemnified by the state government and patients would be able to accomplish indirectly what they could not do directly. Patients would obtain recovery from the employee who would be reimbursed by the state-owned hospital.The hospital had contracted with a professional services corporation to obtain its anesthesia services. The contract specifically stated that the anesthetist provided by the service corporation would be an independent contractor and not an employee of the hospital. However, the chief of anesthesiology, a hospital employee, was required to monitor and review the quality of professional services and clinical judgments rendered by the anesthetists provided by the service corporation. The chief also set the on-call schedules, assigned members to specific surgical procedures, and supervised the continuing education of doctors who worked in the anesthesiology department. The anesthesiologist who was being sued was paid a flat salary by the service corporation, and the salary did not depend on his patients' billings or his overall productivity.

The court concluded that he was an employee because his work was governed and regulated in all respects by procedures dictated by the hospital's chief of anesthesiology. The question remained, even if he was an employee, whose employee was he? The court determined that the control possessed by the chief of anesthesiology, a hospital employee, was sufficient to make the anesthesiologist a hospital employee as well. As a hospital employee, the anesthesiologist was immune from suit for his negligence. Note that the court is choosing which of the possible employers was likely to have had the greater impact (and control) on the actions claimed to be negligent.In Briggins v Shelby Medical Center (585 So. 2d 912, Alabama, 1991, Chief Justice Hornsby concurring), the question was whether the hospital could be liable for the negligence of a CRNA employed by an independent anesthesia service.

The nurse anesthetist was subject to the hospital's regulations and procedural guidelines. In addition, the nurse anesthetist worked only at the defendant hospital. The court held that this was sufficient evidence to allow a jury to decide whether or not the nurse anesthetist was a hospital employee and whether the hospital was liable for the nurse anesthetist's negligence.In Drennan v Community Health Investment Corporation (905 S.W 2d 81 1, Texas, 1995), the court affirmed a motion for summary judgment that a hospital was not liable for the negligence of a nurse anesthetist where the nurse anesthetist was retained by the surgeon and not by the hospital. The nurse anesthetist testified, without contradiction, that he was an independent contractor who determined the details of providing the anesthetic with the surgeon without control by the hospital. T

he court concluded that the hospital was not liable. "Where an employer is interested only in the results, and the contracting party independently determines the details of the method by which the desired results are obtained, an independent contractor relationship exists and the rule of respondeat superior does not apply."Hospitals seem intent on developing strategies to create liability for themselves where none would otherwise exist by adopting unnecessary policies or taking other acts.

Even if a physician or healthcare professional is an independent contractor, the hospital can take actions that make the physician appear to be its agent. In those circumstances, the courts may rule that patients were misled by the hospital to believe that the independent contractor was the hospital's agent or employee and that the patient has the right to sue the hospital for the negligence of someone who is, admittedly, an independent contractor. For example, in Sword v MKC Hospitals, Inc (714 N.E. 2d 142, Indiana, 1999), a patient sued a hospital because of the violent headaches she suffered as a result of an epidural administered by an anesthesiologist. Although there was no question that the anesthesiologist was an independent con- tractor, the hospital heavily advertised its obstetrical services including the availability of anesthesiologists who were "experts in administering continuous epidural anesthesia." The Supreme Court of Indiana sent the case back for trial as to whether the anesthesiologist had become the apparent agent of the hospital and whether the hospital should be liable for the anesthesiologist's negligent placement of an epidural.But the most unusual independent contractor case is Anesthesiologists Affiliated v Sullivan (the Secretary of Health and Human Services), (941 F 2d 678, US Court of Appeals, 8th Circuit, 1991). Because employers do not have to pay withholding taxes on independent contractors, in much of the litigation over independent contractors, the United States government, through the IRS, frequently claims that the relationship is one of employment.

In the Anesthesiologists Affiliated case, the federal government claimed that the anesthesia group had submitted 28 false claims for services provided by CRNAs as if the CRNAs were employees when the group should have known that the CRNAs were not employees. The court agreed with the government that the CRNAs were not employees. The evidence showed that the degree of control and supervision retained by the anesthesia group over the CRNAs was "minimal--and intentionally so." Not only were the CRNAs not considered by the group as employees, 2 of them were partners and a third had entered into a contact that explicitly stated that he was an independent contractor and not an employee.

ConclusionThe fact that some states may require a nurse anesthetist to operate under a physician's supervision does not logically bear on whether a nurse anesthetist is an independent contractor or an employee. As we have noted many times in this column, supervision is not equivalent to control. Nonetheless, some hospitals have adopted requirements that require that nurse anesthetists not only be supervised by a physician but also be controlled. These requirements are unnecessary and serve only to create liability where none would otherwise exist. A second problem in the area is the basic mistake that surgeons make in failing to distinguish between their ability to control the result ("Keep him relaxed; don't let him move!") and the ability to control the details and means that are required to hold the surgeon liable for the negligence of the anesthesia provider. In many cases where surgeons were held liable for the negligence of the anesthesia provider, the surgeons were asked if they controlled the anesthesia. The surgeon's response, "Ultimately, I control the anesthesia" represents confusion between results and means. The surgeon is encouraged to answer in terms that make it sound like the surgeon controls the details and means. However, there is a huge difference between having ultimate control (and being liable) and having control over the ultimate result (for which there is no liability). Every surgeon knows what is needed from anesthesia ("Keep him relaxed, don't let him move!"), but it would be a rare surgeon who could tell a CRNA that a particular patient required 100 mg instead of 50 mg of Anectine.CRNAs have been working as independent contractors for years, a relationship that would seem to be beneficial to surgeons and hospitals. Nonetheless, through ignorance or misdirection, surgeons and hospitals continue to be their own worst enemies, adopting policies that invite liability, failing to distinguish between control of results and control of detail and means, or assuming that state requirements of supervision have any bearing on the relationship.This article is not intended as legal advice nor is it advice on the law of any state. If legal advice or other expert assistance is required, the services of a competent professional person should be sought.

WHERE TO OBTAIN BUSINESS LICENSES

2007-10-08T17:20:00.000-07:00

Excellent resource for state business license
http://www.sba.gov/hotlist/license.html

US Nurse Licensing Boards

2007-09-30T12:50:00.000-07:00

Alabama Board of Nursing
Alaska Board of NursingOccupational, professional nurse licensing agency.
Arizona State Board of NursingAccess job boards, community resources and liscencing policies for nurses in Arizona.
Arkansas State Board Of Nursing
California Board of Registered Nursing
California Board of Vocational Nursing and Psychiatric Technicians
Colorado Board of NursingRegulatory agency governing nurses in Colorado.
Connecticut Department of Public HealthContains licensing and other information for nurses.
Department of Professional RegulationRegulatory board responsible for the licensure of several professions and the investigation of alleged violations of any regulatory statutes under the department's jurisdiction.
Florida Board of NursingBoard overview.
Iowa Board of Nursing
Louisiana State Board of Nursing
Maine State Board of Nursing
Massachusetts Board of Registration in Nursing
Michigan Bureau of Health Services Licensing DivisionUmbrella agency that serves the board that licenses nurses.
Minnesota Board of Nursing
Missouri State Board of NursingRegulatory board that governs licensed nurses, sets standards for nursing schools and licenses registered nurses and licensed practical nurses.
Nevada State Board of NursingInformation on licensing procedures, continuing education and a tool for verifying state licenses.
New Hampshire Board of Nursing
New Jersey Board of Nursing
New Mexico Board of Nursing
New York State Board of Nursing
North Carolina Board of NursingRegulatory agency governing nurses in North Carolina.
North Dakota Board of NursingRegulatory board that governs licensed nurses, sets standards for nursing schools and licenses registered nurses and licensed practical nurses.
Oregon State Board of NursingRegulatory agency governing nurses in Oregon.
Pennsylvania Board of Nursing
South Dakota Board of NursingResponsible for safeguarding life, health and the public welfare, and for protecting citizens from unauthorized, unqualified and improper application of nursing education programs and nursing practices.
Texas Board of Nurse Examiners
Texas Board of Vocational Nurse Examiners
Virginia Board of Nursing
Washington State Nursing Care Quality Assurance Commission
West Virginia Board of Examiners for Licensed Practical NursesRegulatory agency governing licensed practical nurses in West Virginia.
West Virginia Board of Examiners for Registered Professional NursesRegulatory agency governing nurses in West Virginia.
Wyoming State Board of Nursing

Journey of a Nurse

2007-09-16T16:36:00.000-07:00

Hello World,
My name is Tammie Lynn Mericle I am now a whopping 41 years old. I absolutely love life and all the crazy little things that make it CRAZY. Life is such an adventure full of all kinds of secret doors to explore. I have a constant smile and genuinely am a very happy person. I can always find humor in any situation and believe there is more positive than negative at any given time. Yes, some days are plain rotten but there is always tomorrow and Walmart! Walmart is our local have everything store. I am a firm believer that your life is what you make it. It is simple, “You live and you die and what you do in between is totally up to you, so follow your heart and do what makes you happy”.
I chose the path of a nurse and what a wonderful, challenging, heart felt career. It has touched every aspect of my soul and honestly can say that it is my true passion in life.
I have thought back many times as to what prompted me to go in this direction. There was no inspiring person or dynamic experience. I hate hospitals and I still get light headed when I have my blood drawn. It just felt like a natural part of me. One day I woke up and told my now ex-husband I wanted to be a nurse and here I am 16 years later and no signs of ‘burnout.”
My journey actually started when I was 20. I already had two children and was in a marriage that was doomed to fail from the beginning. I had quit school at 15 and was working as a waitress making $2.01/hr plus tips. I needed to make a change fast! I started College in around 1988. College was rough because of my lack of education and sheltered life. Growing up we moved around quite a lot and my education and my social skills suffered. I worked my way through college and ended up on the deans list I was able to get scholarships because of my high GPA and grants because of my low income. Life was an uphill battle for a while. I went through the big “D”. Wow, what a reality shock that was. After the divorce I took a short break to get myself and my family back on track. I had two small children and was always feeling guilty for investing so much of my time in school. I managed to get things in perspective and we all enjoyed the time we had together. Things were always a little crazy and I still have vivid memories of: the day that my daughter had taken my birth control pills to school for show and tell, the day a strange man was standing in the middle of my living room and the kids were screaming and shooting him with their Nintendo guns, and the day I was at the laundromat with the whole back end of my shorts ripped out. I could go on and on but I will keep these with me. During all this craziness I met my soul mate, Steve.
Steve-o is another part of my life that is wonderful. Steve had a construction company and was now going to be a nurse. I do remember his dad thinking that I had corrupted his son and his family was in complete shock. But like I always say, “You live and you die and what you do in between is totally up to you, so follow your heart and do what makes you happy”.
I graduated in 1992 and worked at a local hospital. I was eager to learn and be the best possible nurse that I could be. I loved bedside nursing and thought I would do that until the day I died. The people I met were so interesting. I had awe for the doctors and looked at them as if they were a superior life form. I thought it was nuts how the nurses would jump up and offer them their seats and wait on them hand and foot. I remember my days as a new nurse and it was filled with many new learning experiences and “stress.” I remember crawling out of a room because I was starting to pass out. I was supposed to be offering support to my patient as a central line was being inserted. I was embarrassed for a short while but learned new ways to cope with invasive procedures. I have to laugh when I think of the days as a new nurse. There was a time when the doctors actually smoked at the nurse’s station and nurses wore their caps. Wow, am I feeling old! After a couple of years I took my certification through ANCC in med-surg specialty.
I thoroughly enjoyed med-surg. The variety of patients was refreshing. I would go and watch as many surgeries as I could and enjoyed expanding my knowledge base and improving my skills. I worked med-surg for six years but the fast pace and increasing number of patients that I was expected to care for was causing me to dread my job. I felt that my patients deserved the best of my services and I was not able to give it. I then moved on to pediatrics for the next three years.
I wanted to adopt every one of those kids. Pediatrics’ is a field that really opens your soul to the human spirit. I found this group of patients to be so different from what I was used to. I am not just talking about the obvious physical things. Everything about these little people was so unique. It made my realize just how much my voice tone, movements, facial expressions and touch affected a person. Pediatrics helped me to focus in on my nonverbal skills. Children seem to have a special gift of honing in on your true mood. During this period in my career I received my Pediatric Emergency Certification and developed the tender raw experience of emotional sharing. It was such a different experience to cuddle and hold these little ones compared to standing at the side of a bed with my adult patients. Just a smile from a sick child would brighten my whole day. Since, my husband worked in the same hospital I would often call him down to admire these beautiful little people. The one thing that would break my heart was the abuse cases. It just got to be too much. It seemed that after a while I started taking my work home with me. I had not learned how to separate my work and personal life. I was trying to save the whole world and losing me in the process.
I then wondered through the different fields of nursing lost for a period of time. I felt as though I was losing the passion that I had once had. I drifted through brief journeys on an oncology unit, and an adult psych unit. I decided those were not for me. I then decided to try Home Healthcare. I felt that this may be my true calling. The beeper I carried was going of 24 hors a day and the time limits I had to adhere to were unrealistic. I remember my last days as a home health nurse…one particular event stands out. I was teaching a newly diagnosed diabetic patient to give herself insulin injections. She had an extensive history of mental illness but her medication seemed to be controlling those symptoms. Well, that’s what I thought, until the day she had me trapped in the laundry room. She lived in a group home. She suddenly went berserk and started repeating, “I am not a needle.” I remember this huge figure coming toward me. I really thought she was just joking at first but when she wanted to shove me in the dryer I knew I was in trouble. Well to make a long story short the police came and took her to the local hospital. I was laughing when I really felt like crying and decided to take a break from home health.
In 1997 we put our house up for sell and sold it a week later. We started to build our dream home. I literally mean WE BUILT IT. It was a family project that mainly involved Steve, his parents, me and our three children. We had always talked about a log cabin with a huge porch and a peaceful view so that’s what we built. My nursing career was on the burner and the flames were just barely burning. Other things in life were more important, mainly getting my children through the teenage years.
In 1999 I found my calling. I took a job in the critical care unit and the passion was back. I felt that I was contributing to the well being of my patients. I started enrolling in programs to improve my skills and took an extensive six week critical care enhancement course. This specialty opened up a magical, financially rewarding, exciting and memorable journey.
My husband and I quit the hospital, that we had worked in for over ten years and in 2000 decided we were going to embark on a new journey. Watch out nursing world the Mericle’s were coming through. The new world of the “Traveling Nurse” opened up many opportunities. I found that one great advantage was all the perks. Where else could a nurse make $60.00/hr? I was just amazed. I specialized in critical care which was in high demand. The last thing I wanted to do was further my education at this time. My brain was like a sponge.
My first assignment was at Riverside Hospital on Open Heart. I ended up working in several of the critical care units; Open Heart, ICU, And NICU . It was hard juggling family life and long drives to work. I started becoming confident in my skills and knew that when I left work my patients and their families had received my best. I was also mastering the skills of a patient advocate. The biggest challenge was all the new people I was meeting. I will remember many of these people as long as I live. I have made many lifelong friends. There was the nurse that swore she could read my aura as she outlined the air around my body, the nurse that read my palms, the nurse that made the stinky soap, the nurse that embraced me as a young brain dead boy rolled in the unit, the nurse that could tell when I was struggling and came to my aide, and the one that simply broke the tension by making me laugh. I worked at Riverside Methodist as a Travel Nurse for a total of 18 months with several gaps in between.
Cleveland University hospital was another wonderful experience. I experienced every emotion that a human being could go through. The unit I worked on was a 26 bed critical care unit. It amazed me that I could stay utterly busy for 13 hours in one room. I worked hard at giving the best care I could. During this time a story was written about me and published in Guide Post Magazine. The story was written by the father of one of my patients. He described the care and kindness that I demonstrated to his daughter. He contributed my persistence to part of her healing process.
During this time I had seen many true miracles, became closer to God and realized that life was indeed an uphill struggle. There were many days I felt I had been drained emotionally and physically and just could not give one more part of me away. I gave myself permission to cry with the families instead of doing it at night alone. I discovered that I didn’t have to have all the answers. A kind word or gesture meant more than any words I could say. The most important thing that I learned was that hearing and listening were two completely different things. When I listened I actually felt what was being said. I along with my husband Steve-o did the travel nurse deal until 2003. Steve and I worked the same units and same shift. We both were always full of stories. It amazed me that we still had so much to talk about after working together all day. I believe that this is the time that my career became “We” I noticed people didn’t say Tammie or Steve it was always Tammie & Steve.
Along this journey we discovered a well hidden secret in the per diem business of nursing and it was worth gold. We had discovered that there was a huge difference it the pay rate that we were getting and what the agency was charging the facility. The agency was making a fortune off us. So, the new adventure began. My husband and myself decided to cut out the so called,”middle man” and contract our nursing services out to hospitals. It took about three months to get through all the red tape and get everything up and running. We established our company, Mericle RN Staffing LLC, in October of 2003. Steve and I landed a huge contract with a chain of hospitals called SCCI. These hospitals specialized in long term acute care; vent weaning, wound healing, and rehabilitation. The population of patients usually stayed at the facility three to six weeks. It was nice getting to know the facilities and patients so intimately. The patients usually came to us with broken spirits and hesitant about recovery. These patients had been through the hospital system and viewed this facility as their last hope. SCCI had a network of 13 other facilities across the United States. Steve and I became a two person team traveling to these hospitals as Independent Nurse Contractors. I can’t explain the great feeling of freedom. We took a plane to work and at the end of our six 12 hour shift we would enjoy a week off with our family in Ohio. We were lucky to have my sister who manned our home, dogs and teenage children while we gone. I often felt guilty and homesick but made the very best of family time when I was home. I felt that things couldn’t get any better in my career. We mainly traveled to Colorado and Texas and also worked at one close to our home in Ohio. It was a lot of responsibility as we arranged everything from booking the plane, rental car, housing and the ever changing terms of our contract. In 2006, we became “nana & papa”. We gave up the traveling back and forth as it was becoming a burden especially with the increased delays at the airports and long work week. During this time Steve and I started a consulting business to help other nurses become entrepreneurs.
We wrote a manual that we market online that has become a useful tool to many nurses. The manual appears to be a success and the feed back has been great. Its sole purpose is to assist nurses in business. Eventually our home business grew as we employed up to twenty nurses at one time. Life was becoming all work and no play. I went back to my favorite saying, “You live and you die and what you do in between is totally up to you, so follow your heart and do what makes you happy”. My next journey begins the road back to school.
I am not totally sure what exactly I want to be when I get through my education. I do know that I want to obtain at least my Masters and work in an area of Advanced Practice Nursing I truly believe that along the way I will discover an area that will spark an undeniable interest and grab my soul. Those old feeling of excitement and newness will take hold. I see myself working for at least the next 15 years, retiring in an area of advanced practice nursing, but nothing is ever set in stone. I just never know when the bug will bite and a new adventure in this world of nursing will take hold. I do know that my partner Steve-o will be a part of this decision, whatever it may be. I have found the wonderful world of nursing to be a rewarding and satisfying career. My career has been one of many educational opportunities, life experiences and has truly added to the all aspects of my life. Will see what the next chapter in my career brings. I anticipate a more active role in that of patient advocate and community education. There are so many opportunities and it is hard to settle on just one!

Independent Nurse Contractor rates

2007-09-11T14:49:00.000-07:00

Independent Nurse Contractor Rates
This is a common question, what should I charge a facility for my nursing services ?
Don=t be afraid to ask. The current industry baseline rate should be taken into consideration. Make phone calls as some agencies ( travel; per diem) will share this information especially if they use independent Nurse Contractor. Human Resources is another good source as you will be negotiating your pay rate with them at times. Ask other Independent Nurse Contractors, as many will to share this information and are willing to help out a fellow INC especially if you make it clear that the information is for your next contract.
For RN travelers, I can give you couple of rules of thumb to calculate rates. You can generally take an agency pay rate (assuming that they are paying for housing etc.) and double it if low, and add $25 dollars to it if high. Traveler pay rates are currently about $25 to $40 an hour and bill rates typically range from $50 to $65 an hour. (Higher in places like SF and NYC where housing costs are extreme). A good average is $58 an hour. Desperate hospitals usually will not think twice about this rate.
Some facilities will also give a discounted rate on close by hotels/housing. Make sure and ask Human Resource Department about this. They also may be able to recommend private individuals that rent out rooms for temporary staff.
How to find out agency rates? Agency pay rates are advertised on many websites, travelers may tell you what they are making although many are bound by contracts not to talk about pay. It is a good idea to be signed on with several agencies. ( lag time between contracts) The agency will tell you their pay rate in a variety of areas and facilities.
Once you have a market rate, you can go from there. I started my first Contract at the low end just to get my foot in the door as an INC. Once my name and business were established I was able to charge at high end.

Independent Nurse Contractor Guide Nurse Agency Start up

2007-09-10T15:41:00.000-07:00

2007 Professional Guide
This guide offers step by step plans for setting up your own nursing business. Detailed and easy to understand. Whether your goals are to become an Independent Nurse Contractor or to set up a business as a nursing agency this package covers both! Our package covers all 50 states and is jam packed with information, forms and documents that you will use again and again. The most comprehensive guide offered on the internet today.
Researched and written by Nurses who are currently practicing as Independent Nurse Contractors. You will have access to all the ins and outs of this competitive business.

CE Requirments By State

2006-09-01T04:54:00.000-07:00

CE Requirements By State
Alabama 24 contact hours every renewal period (two years).
Alaska Two of these following three options are needed for license renewal: 30 contact hours, or 30 hours of professional nursing activities, or 320 hours of nursing employment.
Arizona None currently required.
Arkansas None currently required
California 30 contact hours every renewal period (two years).
Colorado None currently required.
Connecticut None currently required.
Delaware 30 contact hours every renewal period (two years).
District of Columbia None currently required.
Florida 25 contact hours every renewal period (two years). One hour must be on HIV/AIDS and another hour on domestic violence.
Georgia None currently required.
Hawaii None currently required.
Idaho None currently required.
Illinois None currently required.
Indiana None currently required.
Iowa 45 contact hours every renwal period (three years). First time renewals need only 30 contact hours.
Kansas 30 contact hours every renewal period (two years).
Kentucky 30 contact hours every renewal period (two years). Two hours must be AIDS related, and approved by Kentucky Cabinet for Health Services. Three hours must also be domestic-violence related. Domestic violence requirement is required only once, and must be completed within three years of licensure. First time renewals are exempt from CE requirement.
Louisiana Five contact hours for full-time employees; 10 contact hours for part-time employees; 15 contact hours for those not employed or worked less than 160 hours.
Maine None currently required.
Maryland None currently required.
Massachusetts 15 contact hours every renewal period (two years).
Michigan 25 contact hours every renewal period (two years).
Minnesota 24 contact hours every renewal period (two years). Two hours must be infection-control related.
Mississippi None currently required.
Missouri None currently required.
Montana None currently required.
Nebraska 20 contact hours every renewal period (two years).
Nevada 30 contact hours every renewal period (two years).
New Hampshire 30 contact hours every renewal period (two years).
New Jersey None currently required.
New Mexico 30 contact hourse every renewal period (two years). First-time renewals are exempt from the CE requirement.
New York Four contact hours on infection control every four years. Two contact hours on child abuse, which is a one-time requirement for first-time licensure.
North Carolina None currently required.
North Dakota None currently required.
Ohio 24 contact hours every renewal period (two years).
Oklahoma None currently required.
Oregon None currently required.
Pennsylvania None currently required.
Rhode Island None currently required.
South Carolina None currently required.
South Dakota None currently required.
Tennessee None currently required.
Texas 20 contact hours every renewal period (two years).
Utah 30 contact hours, or 200 practice hours and 15 contact hours, or 400 practice hours every renewal period (two years).
Vermont None currently required.
Virginia None currently required.
Washington None currently required.
West Virginia 30 contact hours every renewal period (two years).
Wisconsin None currently required.
Wyoming 20 contact hours, or 500 practice hours every two years, or 1600 practice hours every five years, or a refresher program.
http://www.independentrncontractor.com

Work As An Independent Nurse Contractor

2006-08-31T19:20:00.000-07:00

Many nurses today are frustrated with their work situation. Are you one of them? If so, it is time you take control and make that first step. Quit thinking about a change ...DO IT ...quit saying I am going too... DO IT...Quit day dreaming, procrastinating, making excuses, waiting for "the right time" ....DO IT. Now is the time to expand your nursing career and enjoy the many benefits that is offered as an Independent Nurse Contractor. Visit http://www.independentrncontractor.com WE CAN MAKE IT REALITY!

One of Tammie's favorite sports

2006-08-31T19:15:00.000-07:00

I have a NEED FOR SPEED ! Family vacation. Lots of Fun.
http://www.independentrncontractor.com

Agencies That Hire Independent Nurse Contractors

2006-08-31T18:50:00.000-07:00

In an ideal world, we would all do direct contracts with hospitals. In this world, many hospitals limit the number of agencies they use. Using one of the below agencies expands your choices and reduces your workload (and net pay too). There are other agencies that may do this as well (most smaller ones seem to have been asked at least once). So if an agency has a hospital that you want, ask them.

*Aerohealth Staffing (888) 905-2376 http://aerohealth.com/ Based in Denver. Current job list on Website.

Attentive Healthcare (877) 499-7606 http://www.attentivehealthcare.net/ Wyoming based. Lots of postings that appear current.

C2 Professional Services (877) 796-5852 http://home.earthlink.net//u126%20~c2pros/home/index.html IC only. In Maryland. Contracts in Baltimore/D.C./Texas/Mississippi (LPNs)/Oregon. No positions listed on website. IC rates mailed with application package.

CMSI the Travel Nurse Company (800) 437-0349 http://www.travelrn.com/ IC only but with different rates for those that would like some benefits such as housing. Based in Texas. Numerous positions on web site do not represent actual availabilities. Suggest call.

Comforce Nurse Staffing (800) 660-9544 http://www.comforce.com/ Part of a larger company based in New York. Nothing useful on the web site. Lots of posting on Delphi for California. *HEALTHCAREseeker.com (888) 331-3431 http://healthcareseekers.com/ New Jersey. Extensive website with old and new positions posted.

*Hospital Support (888) 451-9996 http://hospitalsupport.com/ Texas based. Either IC or employee. Web site poorly updated but lots of positions when it is. Suggest calling. Frequent poster here with some of the best rates.

Independent Nurse Consultants, Inc. (866) 878-8207 http://www.independentnurse.com/ IC or employee. David Magee's company. Of note, he has developed an unusual business structure to "partner" with nurses. It is not required to become a partner to do assignments. Frequent job poster on this forum. Nevada based (or is it New York?).

Medical Staffing Partners (800) 896-4164 http://www.medicalstaffingpartners.com/ Minnesota based. They have about a dozen "Hot Jobs" listed. Has a "Not a complete list" disclaimer.
*Medtrust (formerly Kinetic Healthcare) (866) 298-9553 http://www.medtruststaffing.com/ Texas based. No job listings on website.

*Millenia Medical Staffing (888) 686-6877 http://milleniamedical.com/ They don't advertise IC but they do it. South Carolina based.

National Medical Registry (800) 451-7811 http://www.nmr4jobs.com/ Mostly California. Seem to be all corrections ER per diem $50 to $55.

Nurse Associates (866) 772-0984
www.nurseassociates.com South Carolina based. Per diem positions. "We currently have numerous independent contractor opportunities in the following locations: Cleveland, OH, Charleston, SC, Columbia, SC, Greenville, SC"

Supplemental Healthcare
http://www.supplementalhealthcare.com/ Many local staffing offices. 1099s for per diem work for sole proprietors. A couple of offices will let sole proprietors subcontract as well. If you are incorporated you can do travel contracts for any office per Supplemental's head office policy.

Helping Prepare You for Advanced Cardiac Life Support Certification

2006-08-31T18:30:00.000-07:00

http://www.acls.net/newalgo/vfpvt.htm Be prepared for ACLS with this helpful guide. Helping Prepare You for Advanced Cardiac Life Support Certification

2006-08-31T18:26:00.000-07:00

The NEWLY UPDATED 2006 Professional GUIDELINE MANUAL Edition of Success In Business As An Independent Nurse Contractor will walk you through everything that you need to know about opening and running a Nursing Registry or Nurse Staffing Agency. From choosing a name, forming a business entity, to charging your clients and paying your nurses. Whether or not you are familiar with healthcare or a complete novice without prior business experience. Every step, from the planning phase to marketing and recruiting is meticulously laid out clearly and concisely, in a manner that is logical and easy to follow. We have included all the necessary forms and material that you need to get your business started as soon as possible.
You don't have to be a nurse to start your own Nurse Agency or Nurse Staffing Agency. All you need is our packages and the desire to be self employed. This is the only industry where there will always be a shortage. There is never a fear for competition. Get our packages now and you can be in business. It is time for any ambitious person to tap into this multi billion dollar industry.
This guide offers step by step plans for setting up your own nursing business. Detailed and easy to understand. Whether your goals are to become an Independent Nurse Contractor or to set up a business as a nursing agency this package covers all 50 states and is jam packed with information, forms and documents that you will use again and again. The most extensive guide offered on the internet today. Registered Nurses, Licensed Practical Nurses, Certified Nursing Assistants and consumers, start your own home-based Nursing staffing agency or private home care business using all the information supplied in our packages http://www.independentrncontractor.com

Grandama Tammie with Grandbabies Fun Fun

2006-08-31T18:23:00.000-07:00

Grandma having Fun! http://www.independentrncontractor.com

Business Structures

2006-08-31T18:18:00.000-07:00

SOLE PROPRIETORSHIP (synonym is self employed): This is what you will default to if you do not formally set up another type of business. You simply add an easy to do Schedule C (Business profit or losses) to your 1040 tax return.

CORPORATIONS . All are limited liability, which does not do a lot for a single nurse business. You are still personally responsible for your professional practice - get insurance. All corporations are state level creations with federal tax implications. Any profits left in a (regular or C) corporation will be taxed. This can be an advantage for highly taxed individuals and large corporations - probably not so much for us. Don't leave money in your corporation; pay it out in expenses, wages, and benefits.

C CORPORATION . This is the traditional corporate form. The most benefits, and the most paperwork.
S CORPORATION . You can elect that a corporation pass through all profits and losses to the owner. This simple election turns your C corp into a subchapter “S” corporation. All profits not expensed or paid out as wages will be passed to the owners as a K-1 distribution. This has a distinct advantage of not being subject to FICA, a savings of 15.3%. But your salary must be reasonable, a difficult standard to determine, either before or in an actual audit. However, it is the choice of millions of small business owners and it works well for them.

LIMITED LIABILITY COMPANY (LLC). This is a relatively rare form for an agency or single practitioners. It is similar to an S corp or sole proprietor for benefits and pass through taxation, but does not require annual corporate niceties. A major issue is that while all states recognize this recent type of business, the rules vary a lot from state to state. I don't believe this is the best choice for a nurse planning on operating in other states. Some of the IRS rules are still being worked out as well. I believe that an audit situation would be more difficult to defend than a traditional corporation. Remember that travel nurses have fairly unique tax circumstances compared to traditional occupations and businesses. Compounding that with a fairly new entity type that does not have a lot of court and regulatory history behind it could add dramatically to the complexity of an audit.

http://www.independentrncontractor.com

Advance Your Nursing Career Work As An Independent Nurse Contractorhttp://www.independentrncontractor.com

2006-08-31T18:03:00.000-07:00

The NEWLY UPDATED 2006 Professional GUIDELINE MANUAL Edition of Success In Business As An Independent Nurse Contractor will walk you through everything that you need to know about opening and running a Nursing Registry or Nurse Staffing Agency. From choosing a name, forming a business entity, to charging your clients and paying your nurses. Whether or not you are familiar with healthcare or a complete novice without prior business experience. Every step, from the planning phase to marketing and recruiting is meticulously laid out clearly and concisely, in a manner that is logical and easy to follow. We have included all the necessary forms and material that you need to get your business started as soon as possible.
You don't have to be a nurse to start your own Nurse Agency or Nurse Staffing Agency. All you need is our packages and the desire to be self employed. This is the only industry where there will always be a shortage. There is never a fear for competition. Get our packages now and you can be in business. It is time for any ambitious person to tap into this multi billion dollar industry.
This guide offers step by step plans for setting up your own nursing business. Detailed and easy to understand. Whether your goals are to become an Independent Nurse Contractor or to set up a business as a nursing agency this package covers all 50 states and is jam packed with information, forms and documents that you will use again and again. The most extensive guide offered on the internet today. Registered Nurses, Licensed Practical Nurses, Certified Nursing Assistants and consumers, start your own home-based Nursing staffing agency or private home care business using all the information supplied in our packages
http://www.independentrncontractor.com