Question:
Dear Nancy,
I'm a very experienced former hospital RN in an at-will employment state. Legally, can I make myself available 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 for the patients? What if a patient or a family hires someone for private duty, but the facility or hospital does not allow private duty nurses to view the patient's chart for physician's orders, document in the chart, or give medications?
Thank you,
Liz
Nancy Brent replies:
Dear Liz,
Your questions raise important points that should be explored, and answers should be 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.
For example, the scenario where a family hires a private duty nurse, but the facility does not allow the private duty nurse to see the patient's chart, requires 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, whether on a private duty status or otherwise, may rest with both the facility and the private duty nurse.
If you decide to establish such a business, issues such as documentation of patient care, payment for services rendered, billing procedures, and determining the organizational form of your business (e.g., sole practitioner, corporation, etc.) would require careful planning to ensure compliance 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.
Additionally, a thorough review of your nurse practice act and its rules would be essential to determine if there is guidance available for 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.
Cordially,
Nancy
