In recent months, the conversation around worker misclassification — and the distinction between nurses who work as 1099 independent contractors, and W-2 employees — has entered the mainstream. Concerns about work-life balance have increasingly taken center stage as we battle an ongoing nurse staffing crisis, with many nurses experiencing untenable levels of stress due to rigid schedules.
In a recent editorial, titled “Maintaining the Right to Work as Independent Nursing Professionals is a Fight for Equality,” Milwaukee-based RN Lauren Goston argues that being able to work as a 1099 independent contractor is central to her ability to practice nursing while maintaining the flexibility to coach track and manage her other family responsibilities. I agree that flexibility is vitally important; nurses should be able to schedule their shifts around their lives, rather than scheduling their lives around their shifts.
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But what Ms. Goston does not mention is that nurses do not need to operate as independent contractors to achieve these freedoms. Staffing companies that employ W-2 nurses offer this same level of choice and flexibility. Using app-based workforce management platforms, nurses that work with W-2 staffing companies can choose the shifts they want, when they want, while enjoying the benefits, clinical supervision, and legal protections offered to actual employees.
Staffing agencies that designate their nurses as independent contractors avoid the costs of employment-related benefits like insurance, workers’ compensation, and overtime pay. These agencies also lack necessary clinical and professional oversight over their contractors, which increases the risk of substandard care. And the legal risks faced by healthcare institutions that use independent contractors as part of their workforce are very, very real. In 2021, the Department of Labor launched an initiative focused on improving compliance in certain healthcare settings. Since then, the DOL has conducted more than 1,600 investigations, identifying violations a staggering 80 percent of the time. Among the most common violations cited are the use of independent contractors who should, based on the nature of their work, be classified as employees. These investigations have resulted in tens of millions of dollars in damages.
To put it simply — not only does the independent contractor model put workers and patients at risk, but it is also harming a beleaguered industry. It is for this reason that a coalition of 30 leading staffing companies recently issued a letter to the Department of Labor (including my employer IntelyCare), citing the above concerns and requesting a letter of opinion on this issue.
I applaud Ms. Goston’s passion for the field of nursing; her commitment to her family; her call for equality. I wholeheartedly agree that nurses deserve the right to pursue their chosen profession while still being able to work on their own terms — celebrating holidays, attending concerts and school sporting events.
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The good news is that W-2 employed nurses can still do all these important things, while protecting themselves, their employers, and most importantly, the vulnerable patients they serve.
Photo: FS Productions, Getty Images
Lynn Barry, MSN, RN is the senior director of clinical operations at IntelyCare. She is an innovative, results-oriented nursing leader committed to improving health outcomes and health equity. Lynn excels in developing collaborative cross-team relationships to reduce risk and meet quality and compliance goals. Prior to joining IntelyCare, Lynn was a clinical nurse manager and a nurse administrator at Atrius Health.
