Pros and Cons of Going Freelance as a Nurse

by Tera Tuten on November 10, 2014

soliant_freelance_nursingIn recent blogs, we’ve looked at the nursing shortage and – paradoxically – why it’s still hard to find a job as a newly-graduated nurse.

One solution to this could be to start working as a freelance nurse.

Whether it’s a way to break into the healthcare industry or a change of pace after years of full-time wok at a hospital or clinic, freelancing might be just the ticket for you.

Here are some of the plusses and minuses to a few aspects of freelance nursing:

Independent Contracting: Pros

An independent contractor, formerly known as a private duty nurse, can diagnose and treat a patient in the client’s home and is paid directly by the patient or a representative of the patient.

Nursing care must follow the nurse practice act of whichever state you’re working in, just like that provided by a staff nurse. (In some states, physician collaboration or supervision is required.)

The advantage here of being in business for yourself is that you set your own hours, charge a rate slightly above the amount a staff nurse would make, and your earnings are only limited by the number of hours you work in a day. 

Independent Contracting: Cons

The services of an independent contractor nurse are not covered by most health insurance carriers, and if you work for a staffing agency, the IRS considers you an employee, not an independent contractor, which could make you responsible for possible back taxes and penalties.

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soliant_freelance_nursing2Per-diem: Pros

Per-diem nurses literally work day-to-day, filling-in for shortages and easing work demands on a temporary basis.

They can work at a single facility in a specific department, at a number of different hospitals, or be employed by a staffing agency that sends them to wherever a need exists.

The upside of per-diem nursing includes an extremely flexible schedule – per-diem nurses choose their own hours, working as much or as little as they want.

The pay is another plus, as a per-diem job usually has a higher hourly wage than a staff position.

And if you want to check out a variety of facilities before (or while) applying for permanent work, per-diem nursing is the way to go.

Per-diem: Cons

The downside is poor job security.

With no guaranteed minimum hours, you can be working full-time one week and only put in a few shifts the next.

This can contribute to serious fluctuations in income.

Additionally, per-diem nurses are usually not entitled to insurance, benefits, or paid time-off (including sick leave, educational leave, or leaves of absence.)

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Travel Nursing: Pros

For adventurous types who crave a change of scenery, travel nurses choose where they want to work throughout the U.S., with a guaranteed contract for a 13-week assignment in your area of specialty at a single facility.

Travel expenses, a completion bonus, and housing are generally paid, although some agencies provide a housing stipend if you decide to secure your own place to stay.

Health insurance, 401Ks, liability and workers’ compensation are also regular perks, along with a high wage, and – of-course – travelling the country.

Travel Nursing: Cons

Travel nursing can be tough if you have to be far away from family for months at a time.

You’ll be expected to jump right in with minimal orientation in a new environment where hospital policies differ from what you know, and there’s not much time for co-worker bonding.

There’s also little flexibility to a travel nurse’s schedule, which means you’ll likely work a lot of holidays and weekends.

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Any types of freelance nursing we forgot? Have a story of how a freelance nursing gig worked out for you? Have your say in the Comments section below.

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{ 3 comments… read them below or add one }

Andy Millette 11.10.14 at 1:48 pm

Excellent! One of the biggest frustrations that I see is nurses not knowing the difference in pay between per diem and contract/travel nursing. The

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Jonathan Tubbs 11.10.14 at 2:03 pm

Yes if you want to keep traveling, then keep working in the similar settings when you’re not traveling. This way you can jump right back in when you’re ready.

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Alex Lane 09.18.15 at 9:00 am

Thanks for sharing your thoughts, Tera. My wife has been a nurse for three years and has had a couple of different work environments. I have to admit, the independent contracting cons you mentioned have kept us from trying that, but she loves working for a small, private clinic.

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