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Private Practice for RNs: A Practical Path to Professional Empowerment

Do any of these comments sound familiar?

  • “My present RN position doesn’t allow me to practice nursing in a way that’s personally fulfilling.”
  • “The time and work pressures of my job shoot my stress levels through the roof.”
  • “I feel I could contribute so much more to the wellbeing of my patients than I’m permitted to do.”
  • “I need to make positive changes in my practice of nursing, but I don’t know how.”
  • “I work in a clinical setting that’s dysfunctional, bureaucratic, morally injurious, and not patient centered.”
  • “Many of my patients are bewildered, confused, or financially impaired, and I do not have the time to help them with what they are facing.”

Concerns like these contribute to the huge turnover in nursing that we see throughout our healthcare system. I myself have had multiple jobs in my forty-year career as an RN in a variety of clinical settings (multiple hospital positions, practice management setting, a rehabilitation facility, and teaching in a nursing school), but only in the last five years have I achieved my personal objectives in patient care…by establishing my own private practice in holistic RN patient advocacy to help patients and families get the care they need with less stress and more peace of mind. 

It didn’t happen overnight. In fact, taking my time to make the transition from RN employee to RN private practitioner was the key to my being able to manage the financial challenges of working for myself, to build my patient base with a carefully-crafted website and strong word-of-mouth referrals, and to find fulfillment with the high level of autonomy and independence that private practice provides.

Guided by many mentors, I followed a path that was practical, rewarding, and doable. I would like to help you find your path to a more satisfying nursing career.

My Personal Path to Holistic Patient Advocacy

What led me to take this path? Consider this:

  • Medical errors are the third leading cause of death in this country.
  • Our health care system is difficult to navigate causing patients and families to feel hopeless, frustrated, angry and anguished.
  • Health insurance is ridiculously expensive and many patients are under-insured or not insured and can’t get the care they need.
  • There are often hospital communication breakdowns with other hospitals, physicians’ offices, home health agencies, skilled and assisted living facilities, pharmacies, and even departments within the same hospital.
  • Nursing units in hospitals, skilled and assisted living facilities, and home health agencies are chronically understaffed with not enough Registered Nurses and Certified Nursing Assistants.
  • In addition to their already overburdened job responsibilities of taking care of patients, Nursing staff in hospitals are continuously being required to assume additional responsibilities such as housekeeping, laboratory functions, transportation, EKG and respiratory therapy functions.
  • Not enough focus on retaining experienced Nurses.  
  • Primary care physicians spend an average of only 8-15 minutes with their patients.

Patient advocacy is a relatively new field, but at its core are the standard practices required by state nursing licensure boards. In addition, there is an emphasis on the patient’s point of view. In my private practice, I have the time to explain to my patients:

  • Their medications and lab work results.
  • Understanding their diseases.
  • How to walk them through upcoming procedures.
  • The differences in costs, and the care provided, by a pharmacy’s “minute clinic,” an urgent care facility, a doctor’s office visit, an ER visit and all the way through a hospital visit, to assisted living and skilled nursing facilities.
  • What home health care is and how patients can obtain it.
  • Defining how an RN differs from a certified nursing assistant, or a skilled facility from an assisted living facility.
  • How patients and families can become smarter healthcare consumers.

Informed Healthcare Decisions

My objective is to help my patients and families make good, informed decisions. 

In my practice of holistic nursing, I can amplify my empathetic and patient-centered approach and listen to each patient from a mind, body, emotional, spiritual, financial, environmental, and soulful perspective.  This has had a dramatic impact on my patients’ sense of wellbeing and their ability to cope with their medical issues and has been the best experience in my long career.

I have studied the principles of holistic nursing for the last twenty years and have passed on this knowledge to other RNs through my second private practice in Holistic RN Patient Advocacy Training.

Four Steps to Starting Your Own Holistic RN Private Practice

What are the key steps on the path to private practice?

Step One: Go slow and set up the tools and timeframe your business will require to succeed.  While I had wanted to go into private practice for the last twenty years, I was frightened by the financial challenges. But my “aha! moment” came when I realized I didn’t have to go fulltime on Day One. In fact, I discovered it was better to take sufficient time to set up my business, including building my website, launching it, and allowing sufficient time for my patient base to increase through word of mouth and website hits. 

Step Two: Identify and implement complimentary streams of income and carefully manage personal health insurance expenses. I started my private practice while still working fulltime with full medical benefits. As my practice grew, I cut back my hours to part-time—first to a level that retained full benefits, and, later, to a level that required me to use COBRA benefits. I also decided to open an Air B&B in my home as an additional source of steady income, and, when I turned 65, I used Medicare to help manage my health insurance needs. All of this needs to be carefully planned. Don’t rush it.

Step Three: Research your Market and Do Your Homework. I used the database of the North Carolina Department of Health & Human Services’ Division of Aging and Adult Services to identify population demographics, especially for those 65 and older, many of whom now live alone and have higher levels of chronic disease. I learned that my region has an unusually high proportion of this demographic, which meant a promising source of patients I could help, and that there were very few RN patient advocates in my state. 

Step Four: Make sure your private practice follows State Nursing Practice Act Provisions, Standards of Practice, and Holistic Patient Advocacy guidelines.  Read your state’s Nurse Practice Act and familiarize yourself with these key provisions.  Call your State Board of Nursing and ask to speak with a nursing practice consultant.  Become familiar with the American Nurses Association’s Nursing Code of Ethics, and the American Hospital Association’s Patient Bill of Rights.  Incorporate these provisions into your practice.  Ask powerful questions, but also master the art of listening intently. Work at your patients’ individual pace and always place them first.

The Advantages of Private Practice

Private practice gives me greater peace of mind and far less stress than my work as an RN employee. I like the holistic approach as a way of overcoming “silo thinking.” I feel I’m better able to solve problems like these: patients who can’t always afford health care or don’t know all their options; health care insurance processes that are confusing, intimidating, or overwhelming; patients struggling financially; improving how nurses are instructed to communicate with patients.

Dual Purpose to a Path of Success

My dual purpose as an RN today: to serve my patients holistically and to be their advocate…and to teach other RNs how to set up their own private practices in this new and rewarding role. I welcome your calls or emails and invite you to consider attending my upcoming training institute in early April, 2020.

Setting up an RN private practice is easier if you know how…and I know how.

Contact Me Today

Please call or text me at 828-778-8882 or e-mail me at


Holistic, holistic nursing, Holistic RN Private Practice, Holistic RN Training Institute, Private Practice, RN Patient Advocacy, Training Institute

Karen Sanders, MSN, RN, AHN-BC, HWNC-BC

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