What is Concierge Nursing?

A Concierge Nurse is a registered nurse (RN) in that provides personalized nursing care to clients in a variety of settings. The RN might visit you at your home, hotel room, AirBnB, hospital room, or may accompany you when you travel or when you visit your doctor or other medical provider. The types of services provided are only limited by the RN’s license and their individual area(s) of expertise. You may be familiar with private duty nurses who provide full-time, live-in care for a single client. Concierge nursing takes this concept and combines it with a little bit of home health and a big dash of entrepreneurial spirit.

How does Concierge Nursing Differ from Home Health?

A Concierge Nurse is an independently practicing professional RN. This means that they are not employed by a home care agency, hospital, or physician’s office.

Unlike most home health agencies, Concierge RNs do not bill insurance companies or government health plans so they are not limited by these plans when providing services to you. A Concierge RN can provide any service that you wish to pay for – that is, as long as the service is within the “scope of practice” of a RN or is something that does not require any special licensing (such as shopping, meal prep, home management, transportation, and companionship).

What Can Registered Nurses Do Without a Doctor’s Order?

In short; A LOT! It is a common misconception that a Registered Nurse only fulfills doctors’ orders. In reality, nursing is its own healthcare specialty. Nurses support the health of individuals and communities by working along side medical doctors and other medical providers. All Registered Nurses are licensed to practice nursing independent of a physician by their state’s Nursing Practice Act.

Yes; nurses are also licensed to fulfill doctors’ orders. Sometimes, doctors’ orders are required before a nurse can provide a certain procedure or treatment. When this is required, the Nurse works with the Doctor providing medical oversight and authorization (orders) to coordinate your care.

RNs provide an enormous range of patient care that does not require a doctor’s order. Like your doctor, your nurse uses specific processes, training, and skills to diagnose problems and develop a plan to treat them.

Your doctor uses things like blood and urine tests, x-rays, MRIs, biopsies, and EKGs to assign a diagnosis to your signs and symptoms and then prescribe medical treatments such as medications, surgery, or the use of prescription medical devices.

Your nurse uses a somewhat different process. The process of diagnosing and prescribing nursing treatments is call the “Nursing Process”. The RN uses this information to develop a Nursing Care Plan to meet your health goals.

Here’s a look at how the nursing process works:

The Nursing Process

  • Assessment
    • The RN assesses you in a holistic way. This means they evaluate your physical, mental, emotional, spiritual and psychosocial needs as well as your environment and socioeconomic situation.
  • Diagnose
    • The RN uses the assessment data collected to inform the Nursing Diagnosis – called a problem list – for you. A nursing diagnosis is different from a medical diagnosis. For instance, a nurse cannot diagnose you with a disease process (such as CHF). However, the nurse can uncover problems resulting from the medical diagnosis of CHF (for example; fluid retention or activity intolerance). Sometimes, the ‘problem’ isn’t a problem at all and instead is something that you need help to continue doing (health maintenance).
  • Plan
    • You and your nurse work together to determine the health goals you want to reach. Then, you’ll work together to set a time frame for reaching those goals. Using our examples above for CHF, your goals may be to reduce fluid retention and increase activity tolerance.
  • Implement
    • In this step, your nurse works with you to develop and implement a Nursing Care Plan to achieve your health goals. Continuing with the example CHF problem list, a care plan might include: nutrition education to help reduce fluid retention, education about monitoring daily weights, medication education & monitoring, among other interventions.
  • Evaluation
    • Along the way, you and your nurse will revisit the goals set back in the planning stage to determine if the Nursing Care Plan is achieving your goals. If it is, great! If not, the Care Plan is revised and the process continues.

How are Concierge Nurses Paid?

Some Concierge RNs provide services on a fee-for-service basis, and some provide a subscription based service that is similar to the way that Concierge Medical Providers operate.

Fee-for-service plans provide a one-time service for a certain cost – such as a one time “tuck in” visit after a hospital discharge. Fee-for-service plans generally focus on restorative care and illness recovery.

A subscription based plan generally bundles a group of services into a recurring monthly or annual fee. A typical subscription bundle may include a certain number of visits per month plus some combination of TeleNursing, email, or phone support. Subscription based services generally focus on health promotion and illness prevention.

Generally speaking, the Concierge RN isn’t paid by private insurance plans or government health plans. Instead, they are paid with private funds. Your health plan may reimburse you for money paid to a Concierge RN for certain services. Check with your insurance plan or HSA to see if this option is available to you.