By Nena Hart, PhD., RN, BC-TN, CDONA, CHPN

Partnering with consulting firms can bolster your self-employment income while providing invaluable learning and networking opportunities. However, it’s essential to understand the potential pitfalls faced by nurses who are accustomed to the security of employment, including guaranteed hours, benefits, and a set paycheck.

If you’re interested in exploring consulting options as a nurse and aren’t sure what that would look like for you, subcontracting is a great way to start. Subcontractor, independent contractor, or just “1099 “, are just different ways to work with an organization or another consulting firm without being an employee, yet still having structure created for and having a great amount of flexibility with how you do the work, and when.

The benefit of subcontracting is that since you’re an independent contractor, most subcontracts range from $75-$150 an hour. Just starting out I would expect to ask for around $75 an hour and go up from there. This can also depend on how specialized the project is and the skills that you’re using for it.  If you are serving as an expert on a team for a highly specialized or niche area, you can easily start at $100/hr.

Working with other consulting firms can help boost your self-employment income until your own business can provide you more stability and get valuable consulting experience and networking opportunities at the same time. The problem is that many nurses have never done anything outside of direct employment and the “guarantee“ of certain hours, certain benefits, and a regular paycheck.

This can become a disadvantage for nurses who have employee expectations going into subcontracting opportunities and project based, independently led roles. When nurses are employed, they often function within the safely predefined systems and protocols established by their employers. While this can provide stability and a sense of security, it can also limit their ability to think outside the box and find creative solutions and even recognize potential opportunities.

The familiarity of routine tasks and established guidelines can handicap creative solutions because, as employees, we become conditioned to ‘doing things the way they’ve always been done.’ This thought process stifles innovation and limits the capacity to find unconventional approaches that would improve future outcomes to healthcare challenges.

Here are a few things you need to know about subcontracting:

• It’s not always hourly pay and hours are usually limited and monitored carefully.
  • You may have set budgeted hours per project and if you go over, you don’t get paid for them unless they are preapproved.
  • You are most often given a chunk of time to complete a specific task and that’s what you get unless otherwise specified.
• You are not an employee, you get no benefits of any kind, so you do not get paid the same way, unless that’s the specific project you are on. There is often no set hours and no “shift”. Although some EMR support projects I’ve done did have paid 12-hour shifts!
• Only directly client-related tasks are billable. This could be auditing time, education, time, and time on calls directly with the client providing support that is contracted.
  • Researching information, searching for items, and trying to figure out the task at hand, and phone calls for getting help or questions, are not billable and are not directly related to client deliverables.
  • Time spent figuring out how to do something, or troubleshooting problems and other tasks is not paid time unless that is directly part of the project you’re working on to troubleshoot those items.
• You will not get orientation, training, or onboarding time and if you do it will not be paid.
  • Even orientation modules or certifications related to onboarding with the consulting firm is not paid time.
• As the consultant, you are the expert and you are expected to know how to conduct yourself as an independent contractor free of that entity. Part of the actual legal requirements for an independent contractor is that the company is not allowed to manage you or tell you how to accomplish a project, this means you need to take the initiative to figure out how to do it and your only success measure is reaching the goal completely and efficiently.
  • You decide whether you can take a project on, whether you travel or not, and control the details around your availability!
• You may be asked to create deliverables that are reports, data, or content that the company uses.
  • Clarify whether any materials you create for the project become the clients’ intellectual property.
• If you’re subcontracting with another firm or consulting agency, the client is not your employer or your client. Do not reach out directly to the client. Issues with hours, project goals, pay, tasks, communication, and other concerns should go through the consulting firm.
• You don’t receive immediate payment or a routine paycheck. Instead, you get paid when the client pays the company for that part of the contract or payment. This means you need to track your time as you go and submit detailed invoices for both your time and any travel expenses. Your payment is dependent on the client’s payment to the firm or agency, which can take up to 30 days or even longer if any complications occur.
  • Travel expenses are initially paid by you upfront but will be reimbursed if it’s specified in your contract (so make sure it is before you sign!).

Entering the world of consulting as a subcontractor offers a transition to not only boost your income but also gain invaluable experience and networking opportunities. It’s a chance to break free from the confines of traditional employment and embrace the new possibilities for increased flexibility and earning potential. However, it’s crucial to understand the shift in mindset and expectations that come with this change in how you view your work.

As a subcontractor, you’ll need to adapt to project-based work, set budgets, and a different approach to teamwork and contributions. You’ll become the expert, responsible for finding innovative solutions independently. Communication with clients will go through the consulting firm, and payments will be contingent on the client’s payment schedule.

If you found these subcontracting tips helpful, then you are going to love my pre-conference workshop, Building Consulting Packages That Convert. In this session, I’ll help guide you through the process of identifying and effectively communicating the solutions you bring to the table. You’ll learn how to craft a comprehensive consulting package that clearly outlines the nursing services you can provide to enhance an organization’s operations and outcomes. There is a limitless income potential and consultants are in high demand!

Author’s Bio

Nena is a registered nurse and consultant, with expertise in hospice, home care, and long-term care, She empowers nurses to overcome limiting beliefs, supporting them with achieving self-employment through consulting, courses, and digital passive income streams. For more guidance and encouragement, contact her at nena@harthealthcaresolutions.com

Pre-conference Workshop (referenced above) https://nursesbusiness.com/product/nnba-2024-pre-conference-building-consulting-packages-that-convert/referral/27/