CA ‘Gig-Worker’ nurses could soon book directly with hospitals as independent contractors


Finally, a big change is coming for the nursing industry. Is it finally safe staffing ratios? How about a pay rise for nurses who have endured literal years of a global pandemic? Protections for nurses on the job and policies that don’t require them to clock in when infected with a dangerous virus?


It’s Uber for nurses. Yes, it’s true.

Instead of leadership-level policies that could enact positive and lasting change for current and future nurses, there is pressure to introduce legislation that will make nurses independent contractors working on an “on-demand” basis with nurses. hospitals and institutions as they are. needed. But some fear the move could further exploit nurses and negatively impact the travel nursing industry, in particular.

Here’s what nurses need to know about the movement to make RNs independent contractors.

How it works

It would work like this: instead of being hired by a stand-alone recruitment agency, nurses could become independent contractors and be hired directly by hospitals upon request. For example, the CareRev app already offers this service. According to CareReve’s website, the platform is one that “seamlessly connects local and flexible healthcare facilities and healthcare professionals.” A facility displays open shifts, then healthcare professionals can book the shifts directly from the app, with no staffing agencies, contracts, or maximums or minimums involved.

Since healthcare workers using the service are acting as independent contractors, this also means that they will not have any protections or benefits from the facility they work in or any agency. recruitment. The nurse as an independent contractor is then responsible for:

  • Deduct and pay your own taxes
  • Take out all insurance, including health insurance, other medical insurance and liability insurance
  • Set up your own pension plan

Additionally, the nurse may not have access to employee benefits or services, such as mental health or wellness resources, educational benefits, and training. Some critics of the app have also warned that there are no placement protections and nurses have been placed in unsafe staffing conditions and internships outside of their scope of practice.

On the other hand, some nurses were delighted with the flexibility offered by the application. There is no need to sign up with a travel agency, they can book shifts only as they want or need, and if they don’t need benefits, it’s an easy way to create their own schedule and generate the income they want. .

The legislation

With the advent of apps like CareRev and other nurse-for-hire services, California introduced legislation to legally declare any nurse or healthcare worker using digital services to book shifts to be classified as an independent contractor. The main purpose of the bill is to classify healthcare workers who use digital platforms and meet certain criteria, as independent contractors. This means that, just like an Uber driver, they will not be considered employees and will not have access to employee protections and benefits.

The measure was filed last week with the state attorney general’s office and was submitted by the same law firm that participated in the Uber (Proposition 22) campaign to keep DoorDash, Uber, Lyft workers and Instacart as independent contractors instead of employees. Coincidence? Maybe not, especially since the company is probably well aware that the healthcare industry is expected to be one of the fastest growing in the entire country.

And as we all know, the shortage of nurses, exacerbated by the pandemic, is also expected to reach critical levels. California alone is projected to need 40,567 full-time equivalent RNs, a gap of 13.6%, through 2026.

MarketWatch revealed that the group proposing the ballot initiative is called Californians for Equitable Healthcare Access and has not yet disclosed its funders. But Silicon Valley is already heavily involved in healthcare staffing tech, pouring millions into apps and websites that will connect healthcare workers directly with open shifts.

MarketWatch also pointed out that California tends to lead the rest of the country in health policy and legislation, so if the initiative passes, it could very well impact the rest of nurses and nurses. health workers in the country very soon.

How might this affect nurses?

The biggest concern with a bill like this is that it could further exploit nurses, who some say are much more than gig workers.

“Nursing…is fundamentally different from on-demand work,” Sarah Gray, founder of Trusted Health, an on-demand staffing agency that treats nurses as employees, not contractors, told Market Watch. “There is a high barrier to entry. It is a professional career, and to pursue this career and provide high quality care, nurses must themselves receive this appropriate care in the form of benefits.

Other experts took their caution even further, warning that turning nurses into construction workers would only worsen the understaffed, for-profit model that hospitals operate on. There are also fears that the initiative could have a ripple effect, affecting all healthcare workers, from nursing assistants to home healthcare workers, depriving them of protections, benefits and even lower wages. Currently, California nurses earn the highest salaries in the entire country, with an annual salary of more than $120,000, according to the Bureau of Labor and Statistics. Turning state nurses into gig workers could have a significant impact on wages and, of course, benefits.

Notably, the move to reclassify nurses using digital services to book work as independent contractors would also distance them from unions, which offer protection. And while flexibility is touted as the primary benefit of gig work, it also leaves out the bigger picture: that “flexibility” means taking shifts that may not be ideal if nothing else is wrong. is available, and a market which, by definition, puts workers in constant competition with each other.

Also, as another source pointed out, it’s important to remember that the client market for apps that hire nurses for open shifts isn’t actually nurses, it’s hospitals looking to save money on labor costs.

So the real question – Is it really in the interests of nurses?


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