How To Become a Nurse Independent Contractor in 8 Steps

By Indeed Editorial Team

March 29, 2021

Nurse independent contractors help meet patient care needs on their own terms. They can determine where they want to work and what kind of care they want to provide. This career can require more education and business skills, but offers independence, with the options to travel and set your own schedule. In this article, we discuss what an independent nurse contractor does, where they work and how to become one.

What is an independent nurse contractor?

An independent nurse contractor is a healthcare professional who works on a contract basis rather than being employed full time at one place. They can travel to different locations to provide help during nursing shortages, or they can build an individual patient base in one location. Their patient or care facility doesn't deduct taxes or benefits from their pay, so they provide their own insurance and continuing education and handle their own taxes.

Where do independent nurse contractors work?

Many independent nurse contractors provide specialized care in patient homes, but they can also work in community clinics, wellness centers, schools, businesses or hospitals.

Some places hire nurses as independent contractors to save on labor costs, since they don't have to pay as many benefits for contractors as they do for employees. As you compare nurse contractor opportunities, evaluate how the job description compares to the IRS definition of contract work.

Related: Becoming an Independent Contractor: Pros and Cons

How to become a nurse independent contractor

Here are the steps you can take to become an independent nurse contractor:

1. Get a nursing degree

An Associate Degree in Nursing, called an Associate of Science in Nursing or Associate of Applied Science in Nursing at some schools, takes about two years to complete. These programs usually focus on a core program of nursing courses and have clinical components to provide students with nursing experience before graduation.

A Bachelor of Science in Nursing takes three to four years to complete. Besides the clinical skills covered in most ADN programs, a BSN includes coursework on leadership, research and management. A BSN may expand opportunities for higher-paying roles since it covers a wider range of material.

Some schools offer accelerated ADN and BSN programs for people who already work healthcare jobs, like licensed practical nurses, paramedics or medical technicians.

2. Pass the NCLEX

The National Council Licensure Examination is an exam from the National Council of State Boards of Nursing that certifies you to practice as a registered nurse. To take the exam, you first register with the nursing regulatory board in your state. When that board declares you eligible to test, you can schedule your exam. The exam uses computer-adaptive testing, so your answers to questions can change how many more questions you receive and how difficult they are.

The NCLEX covers content within eight topics:

  • Management of care

  • Pharmacological and parenteral therapies

  • Physiological adaptation

  • Reduction of risk potential

  • Safety and infection control

  • Basic care and comfort

  • Psychosocial integrity

  • Health promotion and maintenance

Your state nursing regulatory board sends your exam results about six weeks after you take the exam.

3. Work as an RN

After taking the NCLEX, you are eligible to become a registered nurse in your state and can begin gaining experience to build credibility with clients and find work. Specialization can help you build a brand identity as an independent contractor, so look for jobs that might allow you to work in an area you are particularly interested or talented in, like caring for patients of a specific age group or with a certain kind of illness.

Read more: A Day in the Life of a Nurse: Typical Daily Activities and Duties

4. Consider becoming an advanced practice registered nurse

The IRS determines the distinction between an independent nurse contractor and an employee. If the employer controls the nurse's work, then they are an employee. If the employer controls only the result, the nurse is an independent contractor. An RN usually works under the direction of a doctor or other specialist, making them an employee. An APRN has more authority over treatment, sometimes even prescribing medication, so they are less frequently classified as an employee. Becoming an APRN can help you work as a fully independent nurse contractor.

To become an APRN, you need to earn an advanced nursing degree, take a nationally recognized exam in your field and then register with your state. You might earn a Master of Science in Nursing or a Doctor of Nursing Practice. The American Nurses Credentialing Center and American Academy of Nurse Practitioners both offer APRN exams that focus on specializations. State registration processes vary but at least require proof of graduate studies and exam results.

Your APRN studies are a great time to specialize in a particular field, like midwifery, gerontology or pediatric care. A specialty can help you market your care for particular situations such as home care for a certain age group.

Related: Nurse Practitioner vs. RN: What's the Difference?

5. Join an independent nurse contractor organization

Groups like the National Nurses in Business Organization or the National Association for Health Care Recruitment can help you find jobs and transition into independent work. The NNBO specifically provides information on starting your own business and ongoing continuing education resources. These groups are also excellent resources for finding mentors who can share their experience.

6. Form a corporation

As an independent contractor, you need to incorporate your business as an LLC, corporation or sole proprietorship. Some states have restrictions on how a nurse can incorporate, so it may be best to find an attorney to help with any paperwork and potential contracts you may need.

7. Find clients

To find clients, use your professional network and be specific about the work you want. A nursing agency that contracts with hospitals or healthcare providers may be a good place to start as you are looking to build contacts and find clients. When working with an agency, you'll be a contractor for the business and not an independent contractor. Once you build your own client base away from a nursing agency, you'll be an independent contractor.

8. Maintain good business and nursing standings

As an independent nurse contractor, you'll likely take care of many business obligations that an employer would otherwise cover, like filing quarterly estimated taxes. You also need to carry your own liability insurance as an independent contractor. By providing your own insurance, you can protect yourself against lawsuits.

You have more responsibility as an independent nurse, such as finding your own training to renew your nursing license and keeping yourself up to date with any courses for your specialty. You also need to remain current with any state regulations and changes. It may be helpful to set calendar reminders for renewal or course dates.

Related: 17 Types of Hospital Jobs To Explore

Skills for a nurse contractor

An independent nurse contractor has both nursing knowledge and business skills, including:

  • Accounting: Even though many nurse contractors hire an accountant, they track many of their own expenses and hours for tax records, so accounting skills help in this position.

  • Sales: Independent nurse contractors must find their own clients, so they need strong sales skills, such as negotiation and persuasion.

  • Empathy: An independent nurse contractor works directly with patients, so they must have empathy to understand patient needs.

  • Punctuality: A nurse must be punctual to earn client respect, and they also use punctuality to submit paperwork and file taxes on time.

  • Time management: A nurse contractor sets their own schedule, so they need to balance their workload, travel time and patient needs.

  • Decision-making: A nurse contractor has good judgment to decide what work to take on and how to run their business.

Please note that none of the companies mentioned in this article are affiliated with Indeed.

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