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.


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.)


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.


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.


{ 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

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.

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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