Female nurse wearing mask while writing on clipboard.

How to Become a Freelance Nurse

According to the International Council of Nurses,1 nursing promotes health, prevention of illness, and the care of ill, disabled, and dying people. Nursing can be hands-on care such as catheter insertion, performing vital signs or wound care; or, tasks such as disease process education, medication instruction, and any other instruction that promotes health or prevents illness. 

Benefits of Freelance Nurse Jobs

Benefits of being a freelance nurse include being in charge of your schedule, working as much or as little as you want, and the freedom to accept jobs at the facilities of your choice. 

Freelance nurse jobs could provide more freedom to set your own schedule. A typical full-time nursing schedule may involve long workdays and shifts to cover 24-hour care. One study found that more than half of hospital nurses work more than 12 hours a day,2 and more than a third of respondents worked more than six days in a row at least once in the past six months.  

Requirements for Freelance Nurse Jobs

If you are already a nurse and are looking to switch to freelancing, begin by researching applicable guidelines in the place where you plan to freelance. The requirements needed for a particular nursing position vary greatly depending on the type of nursing you want to practice and where you want to practice. Every state lists its specific requirements and nursing laws in a document known as the nurse practice act (NPA).3 Every NPA has six components:

  1. Authority, power, and composition of a board of nursing
  2. Education program standards
  3. Standards and scope of nursing practice
  4. Types of titles and licenses
  5. Requirements for licensure
  6. Grounds for disciplinary action, other violations, and possible remedies (NCSBN)4

You must become familiar with the laws in the state you want to practice in and comply with that state’s NPA. Be aware that some conduct is prohibited. For example, providing telehealth nursing to a patient in a state where you don’t hold a license is illegal. Find your NPA today by visiting the National Council of State Boards of Nursing.

Opportunities for Freelancing and Work from Home Nursing

The world of freelance nursing offers an abundant number of opportunities. You could decide to continue practicing the same type of nursing but choose to do so on a contract basis that allows you to choose your schedule. Or, you could decide to choose a nursing occupation that you can do from the comfort of your home. Below are some opportunities to consider if you are interested in work from home nursing or are thinking of becoming a freelance nurse.

Telehealth Nurse

Telehealth nursing is a type of work from home nursing that involves live video conferencing, and remote patient monitoring. Telehealth is changing the future of medicine. Medical facilities across the country have recently expanded the use of telemedicine to safely screen and treat patients for coronavirus, which has carried over to other forms of care.5  

There are no telehealth-specific certifications required for telehealth nurses.6 Those interested in becoming a telehealth nurse will need a nursing degree, an active nursing license, and the technological and communication skills necessary for providing remote healthcare support. Most telehealth employers also require one to two years of hands-on nursing experience in addition to triage experience. In some instances, the requirement might be three to five years of experience.

Utilization Review Nurse

Utilization review nurses evaluate patient medical records to ensure that health care services are being used appropriately. Utilization review nurses often work for health insurance companies, but hospitals or other healthcare facilities may also employ them. The minimum credential is to be a licensed registered nurse, and most employers require a bachelor’s degree in nursing rather than an associate degree.7

Case Manager

A case manager is a specialized Registered Nurse (RN) who works with patients and providers to determine the required care options and the best options for that care. Through a collaboration with multiple specialties, case managers ensure the patient is receiving quality medical care.8

Nurse Consultant

Nurse consultants identify problems and develop solutions and serve as a great example of a freelance nurse job. A nurse consultant can operate their business from a home office, although some work may be required at the customer’s facility. When you work and where you work are usually at the discretion of the nurse. Consultants often work for insurance companies, health care centers, or independently, reviewing medical care plans and providing health and safety consultations. The consultant must be a registered nurse.9

Nurse Clinician

Freelance or home-based nurse clinicians are often responsible for nursing staff’s education, creating materials to help identify patient care problems and guidelines on evaluating an approach’s effectiveness. This type of work is open to different specializations, such as cardiological nursing or intensive care.  A registered nurse clinician must hold a minimum of a bachelor’s degree and license in nursing.10

Business Operations

Operating as a freelance nurse means that you no longer get a regular check or the protection of an employer. It is now up to you to fill in the gaps to make sure your business as a freelance nurse is a success. 

Get Paid

One of the pitfalls of becoming a freelance nurse is no longer having automatic payments deposited in your bank account. Now, if you want to get paid, you have to invoice clients and collect payment yourself. 

If you can afford to get fancy with your invoicing and payment services, you might want to look at using a company like Physicians Group Management (PGM).11 PGM takes care of the paperwork for you, processes insurance claims, sends out invoices, and collects your payments. 

If you are newer to the world of freelance nursing or work from home nursing and are still working on building your business, you might want to keep things simple and keep costs low. You can invoice clients yourself and set up payment methods by accepting checks or using a money transfer app so clients can pay you digitally. 

Get Covered

As a freelance nurse, you’re working with people whose lives and well-being are on the line. Part of your job might involve lifting, bending, and squatting, all activities that might result in an injury. You are also directly exposed to ill patients that might expose you to contagious viruses. Of course, you do your best, but illnesses and injuries are still a possibility. It’s important to protect and plan for what you can.

In fact, the Bureau of Labor and Statistics showed in a 2019 study that nursing assistants and registered nurses were among the top ten occupations with the highest occurrences of days away from work due to nonfatal injuries and illnesses.12 More recently, analysis of COVID-19 hospitalization data from 13 sites indicated that 36% of adults hospitalized with COVID-19 were health care personnel.13

Disability insurance is one type of insurance that freelance nurses should consider getting to have income protection in the event they get sick or injured. Disability insurance helps cover your expenses if you are unable to work for a period of time due to a covered injury or illness. 

There are other types of insurance you should consider when you are in business as a freelancer and are on your own. Click here to learn more. 

Taking the Plunge

As we’ve explained throughout this post, there are many upsides that come with being a freelance nurse or choosing a work from home nursing position. You get to be in charge of your schedule, work as much or as little as you want, accept jobs at your discretion, and choose to work remotely, at a single facility in a specific department, at different hospitals, or be employed by a staffing agency.

On the flip side, being a freelance nurse doesn’t offer the same job security and benefits as having a full-time nursing staff position. You are on your own for finding opportunities and work, invoicing clients, collecting payments, and covering all of the overhead that would typically come with a full-time position. You are even on your own if you make a mistake and your client sues, or you get injured and are no longer able to work for any amount of time.

Freelance nurse jobs are not right for everyone, but if you are interested in taking the plunge, you should establish relationships with nursing agencies that can offer referrals and send jobs your way. Since patient care is non-stop, it’s vital to find nurses who can also fill in for your patients when you are unable to attend to them. 

It would also be to your advantage to consistently work on developing your skills, keeping up with advancements in technology, and adding credentials to your portfolio. Since you don’t have an employer to provide you with regular continuing education, it is up to you to do it on your own. Specializing in new and hard-to-find areas will increase demand for your services, making you a sought-after freelance nurse. 


  1. https://www.icn.ch/
  2. https://www.monster.com/career-advice/article/nurses-how-to-cope-long-hours-0716
  3. https://www.ncsbn.org/npa.htm
  4. https://www.ncsbn.org/index.htm
  5. https://www.healthaffairs.org/do/10.1377/hblog20200315.319008/full/
  6. https://www.relias.com/blog/what-is-telehealth-nursing
  7. https://thenerdynurse.com/utilization-review-nurse/
  8. https://nurse.org/resources/rn-case-manager/
  9. https://nursesbusiness.com/faq/nurse-consultant/
  10. https://study.com/articles/Registered_Nurse_Clinician_Education_Requirements_and_Career_Info.html
  11. https://www.pgmbilling.com/physician-medical-billing/
  12. https://www.bls.gov/news.release/archives/osh_11042020.pdf
  13. https://www.cdc.gov/mmwr/volumes/69/wr/mm6943e3.htm