Can a very experienced former hospital RN in an at-will employed state legally make him or herself available on his or her own for private duty nursing, such as in a hospital, a rehabilitation center or a patient’s home? Would this constitute a small business and require filing for state and federal licenses for Medicare, etc? Also, what about the liability issues and documentation on the patients? What if a patient or a family hires someone for private duty, but the facility or hospital will not allow private duty nurses to view the patient’s chart for physicians orders, document in the chart or give medications?
Nancy Brent replies:
Your questions certainly are good ones that should be explored and answers obtained. Your best bet in sorting out all of these issues is to consult with a nurse attorney or attorney in your state who can advise you about the concerns you raise.
As an example, the issue of the family hiring a private duty nurse, but the facility not allowing the private duty nurse to see the patient’s chart, etc., needs careful evaluation. It is a little difficult to understand why such a practice would exist, especially when the family or the patient has hired a private duty nurse to provide care at the hospital, but this concern would have to be explored carefully.
As you may guess, potential liability for a patient injury when one is providing care to him or her, whether on a private duty status or otherwise, may rest with both the facility and the private duty nurse.
If you decided to establish such a business, issues such as documentation of patient care, payment for services rendered, how those services would be billed and to whom and what organizational form your business should take (e.g., sole practitioner, corporation, etc.) would need careful planning consistent with state and federal mandates and standards of practice for the profession. A beginning resource to help you explore some of these topics would be the National Nurses in Business Association at https://www.nnba.net .
Also, a careful review of your nurse practice act and its rules would be essential in order to determine if there is guidance for you when practicing as a nurse entrepreneur.
Retaining an attorney to help you sort out these areas is an important first step in entertaining the idea of establishing this type of healthcare business.