How I Plan to Get Out of a Rut in 2020

2019 has been a bit of a rut for me. Here’s what I plan to do to shake things up in 2020!

My accomplishments through the 2010’s:

December 2012 Completed BSN

February 2013 Passed NCLEX

March 2013 Started 1st nursing job

August 2014 Started BSN-DNP

December 2016 Completed MSN & Passed ANCC Boards

January 2017 Started 1st NP Job

July 2017 Completed DNP

March 2018 Opened Telepsychiatry Business

2019 *Crickets*

It’s a strange feeling. My entire life I focused on achieving the next academic success or the next best career move. Now my academic career is complete, my practice is as big as I want it… and what now? How do you mentally shift from measuring your success through academics and career achievements when that has been your measure of success for so long? In 2019 I have struggled to find my next move. Earlier this year I thought I would try medical writing and quickly realized I don’t have the knowledge or experience I would need for that. Then I thought I would try to break into the field of research. Again I realized that I don’t really have the knowledge or experience. What I am trained to do and what I do best is take care of patients. So, how do I grow from here? As I watch everyone else discuss their accomplishments from 2019 I realize that I have had no major accomplishments this year *Yikes*. I think 2019 has been a bit of a rut for me professionally. And being in that rut leaves me feeling burnt out. So, today, on this very last day of the decade I am going to make an action plan to get out of a rut in 2020.

My professional goals for 2020

Educate others and share my experiences. As I started blogging over the last week I began to feel a passion and excitement professionally that I haven’t felt in a long time. I realized I love teaching. I love sharing my experiences. I’m excited to carry this excitement into 2020.

Reevaluate my patient encounters. I currently do 15 minute medication checks. I’m going to research how to make these encounters more meaningful. On the practical side of that, I will see if I could maintain my current compensation by billing for longer appointments. I’m going to see how I can strike a balance between quality and quantity.

Study a new subspecialty. I am very interested in adding another subspecialty. There is a huge gap in the healthcare system between women’s health and mental health. I’m very curious to investigate and find new ways to help and educate my female patients. I’m also interested in weight loss within the mental health community. I don’t know if I can commit to becoming certified, but at the very least I would like to increase my knowledge about how to help my patients live healthier lifestyles.

My Personal Goals 2020

I have to say exercise, right? Isn’t that mandatory on this list? Seriously though, I attempted a good exercise routine multiple times in 2019 and it would stick for a few weeks and then fade away. I tried Orange Theory (which I absolutely loved by the way), but then I got tired of waking up at 5am (I am NOT a morning person at all). I got into a cycling routine for a bit and thoroughly enjoyed that, but it just kind of faded away too. So 2020 is the year to establish a routine. I don’t need it to be insane. I will take any routine I can get… more to come another time on what that routine will look like.

I will start a hobby. I have never had a hobby. EVER. I have been invested in academics for so long that all my mental energy went to writing papers, studying… all the school things. Now I am so used to spending all my time doing something I had to do, that I don’t know how to enjoy doing something just for the sake of doing it. I don’t know the hobby yet, but 2020 will be the year of hobby!

I have never put my goals in writing. So, here it is, published on the internet for everyone to see. At the end of 2020 I will come back and evaluate how I did! 2020 won’t be another rut year and I don’t need academic structure or a new career to make that happen! This is going to be a totally new experience for me and I will provide updates periodically on how it’s going.

Have you been in a rut recently? What are you going to do to make 2020 a better year? I’m open to any suggestions you might have to add to my list! I can’t wait to hear from you! Please leave your thoughts in the comments below and go to the home page to subscribe and get the latest content!

8 Steps to Set Up Your Business as a Contracted Healthcare Provider

Here are the steps I took to set up my business as a contracted psychiatric mental health nurse practitioner

Today’s post is dull, but necessary. It’s not going to be a pleasure to read, but it’s information I want you to have. Today we are going to discuss how I set up my business as a contracted nurse practitioner in Georgia. It took me a lot of digging and research to figure this out. So, I hope laying out these steps will save you a significant amount of time and stress! Please keep in mind I am not a professional in legal or tax matters. These were the steps I took and it has worked for me!

If you are trying to make the decision to be a contracted or salaried employee check out this post: https://nursekierston.com/2019/12/24/my-first-blog-post-contracted-or-salaried/

Why do you need a business as a contracted healthcare provider?

Let’s start by talking about why you need this information. If you are a contracted employee, it’s a great idea to set up a business to employ yourself for two main reasons. First, it can help you save money in taxes (and we all love saving money). Second, it can provide you a legal layer of protection. Now let’s jump into how to do this. It’s grueling, but I promise to make it as concise and easy as possible!

Step 1: Choose a business name

This is fun, but don’t overthink it! It can be your name or a name you come up with. Think about what you plan to do with your business in the future. Will you use this name to start your own practice? Do you just need this name for contracted employment agreements?

Here’s the link you would use to see if your business name is available in Georgia:

https://ecorp.sos.ga.gov/BusinessSearch

Step 2: Register Your Business

Go to this link https://ecorp.sos.ga.gov/Account to create an account with the Georgia Corporations Division. Once logged in go to “Create or Register a Business.” From here just follow the prompts. I created a “domestic limited liability company.” I selected NAICS code “Healthcare and social assistants (62) and NAICS subcode “Office of mental health practitioners (except physicians) (621330).” When entering an address for the business recognize that this address is going to be public record. So, you may want to choose a PO box if possible. Complete the rest of the information, pay $100, and voila! You are now a proud owner of an LLC! Be sure you keep receipts and any emails you receive confirming your registration to provide your CPA during tax season. You can also deduct (or expense??) your start up fees!

Step 3: Apply for an EIN

An EIN is like a social security number for your business. This number is how the IRS will be able to identify your business. You will receive your EIN to write down once you complete your application and you will receive it in the mail a few days later.

Here’s the link to apply for an EIN:

https://www.irs.gov/businesses/small-businesses-self-employed/apply-for-an-employer-identification-number-ein-online

Step 4: Apply for a state tax ID and withholding number

This is not required in all states. In Georgia this is required. You will be making tax payments to your state and to the IRS. Your state tax ID allows you to make your state tax payments. Here is the link for the starting point to get a state tax ID and withholding number:

https://georgia.gov/popular-topic/state-taxpayer-identification-number

Step 5: File form 2553 with the IRS to be taxed as an S Corp (optional)

This step is completely optional. Completing this step allows you to file your taxes as an S Corp instead of a sole proprietorship. I am not a tax professional. If you have read my other posts you know how much I hate taxes. So, in simplest terms, if your business is taxed as sole proprietorship (which is what your LLC will automatically be taxed as if you do not file to be taxed as an S Corp) all your income is subject to all the taxes you pay. If you are taxed as an S Corp, you will pay yourself a reasonable salary which will be fully taxed. All your other income is taxed at a lower rate. Once the IRS has received and approved form 2553, you will receive a letter in the mail stating you will be taxed as an S Corp. This can take several weeks.

Here’s a link to IRS form 2553 and the instructions for the form:

https://www.irs.gov/forms-pubs/about-form-2553

Step 6: Sign up with a payroll service (if you are going to be taxed as an S Corp)

If you are going to be taxed as an S Corp and need to pay yourself a salary, you will need a payroll service to manage your salary and payroll taxes. I use OnPay. They have been super simple to use, very reliable, and have been very responsive when I needed help (and I needed A LOT of help).

Step 7: Sign up with an accounting software

Register with some type of accounting software. I use Quickbooks online. I don’t find it to be the most user friendly and my CPA usually has to fix some things at the end of the year, but it’s cheap and it gets the job done. I just connected my bank and credit card accounts and each month I go in and make sure all income and spending has been categorized. To be totally honest, I really only do this quarterly and sometimes less, but even when I put it off it only takes me about an hour to get all caught up. Quickbooks also allows you to generate all the reports your CPA will need to plan and complete your taxes which has definitely made tax season much easier for me.

Step 8: Get a fantastic CPA

I am a big believer in having people around who are experts at what they do so I can focus on being an expert at what I do. So, find a fantastic CPA so you can just give them the documents they ask for and you can be on your merry way. Filing my taxes as an S Corp typically costs about $800-$1000 per year.

You are all set! Hopefully I made this process easy-ish for you! If you have questions or thoughts, please comment below. Do you hate taxes as much as I do? Let me know in the comments! Also, go to the home page and subscribe to be notified each time I make a new post.