America is the only industrialized nation without a universal health care system. U.S. Congress took an important step earlier this week by passing the Families First Coronavirus Response Act, which provides free coronavirus testing to uninsured workers. According to Section 105 of the Act, the National Disaster Medical System will reimburse the costs of COVID-19 diagnostic testing provided to individuals without insurance.

However, testing does nothing to cover the cost of treatment for those who have COVID-19 and require treatment. So what is a Nurse who is out in the field to do when working per diem for Home Health Nursing agencies up to sometimes 60 hours a week due to the shortages of qualified nurses and the cost of insurance is just too high to afford?

That is the dilemma that so many Nurses, RN’s, LVN’s face and have been trying to live with for at least the 15 years that I have been in home health as a Case Manager RN. Take a FT job some say.. but many have other jobs, other obligations and many agencies only offer “per diem” which means “as needed” and always means “Tons of work!” Including “on call” and nights and weekends if you want to “get real!” Usually is over 40 hours a week as you just never know (the agency does not either) just HOW many patients will be discharged that week.

So “what to do when the agency ONLY hires “per diem” meaning 1099 contract but has your work over 40 hours and won’t give you insurance? One could say “Look for another job” and that’s an option. Fact is, Many amazing pharmacies, infusion companies and nursing agencies still ONLY offer per diem!

Many LVN/RN are not eligible to work in hospitals as they have been Home Health nurses for many years and hospitals demand “current” acute care experience inside hospital.. even though most nurses I know, do the same or more in the patients home as in the actual hospital.  So now with ever increasing demand of nurses “in hospitals” where before they were not allowed, is kind of a slap in the face. Nurses WANT to help. That is our Calling, our Nature and our Passion! 

In addition, WHY have I constantly heard throughout the last TEN years stories of nurses who have been in one and two year WAITING LISTS JUST TO GO TO SCHOOL? With such a Nursing shortage for so many years, WHY is it not a priority to get these thousands of nurses graduated? Last I heard the cost to get an RN license was almost $100,000! This is criminal… in my opinion..

The powers that be CAN make a way to fast track healthcare without having to wait for years just to get accepted. My opinion only BUT also the opinion of someone who has had to scout, beg and bribe nurses to come work at whatever agency I happened to be in because we had such a shortage and so many suffering patients who NEED THEM!

 “I am faced with going out and working with already Immune compromised patients,  Transplant patients and I am terrified as I have NO Insurance and my agency does not offer it! 1. “I have to work to live and pay my bills and 2. I have no insurance” states one of my colleagues. Many RN’s have tried unsuccessfully to move out of California and the paperwork and loopholes and dealing with the State level make it almost impossible.

California is one of the only two states that does NOT offer reciprocity. Meaning an electronic system whereby a nurse can go to another state and work; Basically holding Nurses hostage to the state and not allowing their transfer paperwork to go through. I have personally gone through the paperwork three times, only to have it sent back for such things as “FBI could not read fingerprints..” although they were done at a government agency by their employees.

Now don’t get me wrong, California is an amazing place to live. I live here and Love it. Just laying out the information as I have seen it. I am not saying “all nurses” are in this category as many have amazing lives and careers doing what they love, and I am extremely happy for them. Many of my friends, colleagues and clients are of course Nurses, Doctors and everything in between related to health care.

For many Nurses, knowing just how many injustices we see in the health care system along insurance denials on items or care daily for our patients that they truly need,  we are now having to choose between 1. Getting another job and letting these many patients down leaving amazing home health agencies without nurses  or 2. knowing if we get sick, we are NOT covered and will likely be in debt for the rest of our lives to get out of it.

It’s a very hard struggle. One nurse told me she looked into health insurance and the cost was over $1100 a month JUST FOR HERSELF.  She said “I may as well just NOT work even though I feel so guilty with all of the agencies calling her BEGGING to help them out.

So what is the answer? Please leave your comments below. I am hoping and praying that after/during this Covid19 pandemic that the powers that be, will ONCE AND FOR ALL FIGURE OUT HEALTHCARE FOR ALL AND ESPECIALLY FOR THOSE ACTUALLY WORKING IN HEALTHCARE.. THE TRUE HERO’S!!!

If this is the situation for healthcare workers, Can you imagine the stories we have heard working with our patients and their families? If you are looking for a Realtor who is ALSO a seasoned Registered Nurse who will 100% Understand your families needs, Please reach out to me to see how I can help you at

by Niki King, RN