Start a Specialty Nurse Staffing Agency (ICU, OR, L&D, Oncology)

1. 1

   Choose the specialty you can vet

   ICU and critical care, operating room, labor and delivery, oncology infusion, or NICU (including neonatal nurse practitioner coverage for hospitals that cannot keep full NNP staff). Your credibility test is simple: could you interview a candidate and know in ten minutes whether they are safe on that unit? If yes, that is your lane; the generic lanes are already covered by the big agencies and by the generalist agency model on this site.

2. 2

   Build the compliance file before the first order

   License verification, specialty certifications (CCRN, CNOR, RNC-OB, OCN and the like), skills checklists, background checks, immunizations, and references, organized so a facility auditor can approve your file in one pass. Some states also license staffing agencies or nurse registries; get your state's answer in writing.

3. 3

   Set up the money machinery

   LLC, professional and general liability, workers comp, and a staffing agreement template reviewed by an attorney. Temp staffing pays nurses weekly while facilities pay in 30 to 60 days, so line up invoice factoring or a credit line before you need it; the cash gap kills more agencies than competition does.

4. 4

   Recruit the bench from your own network first

   Five to ten specialty nurses with complete files who will actually answer the phone beat a database of two hundred maybes. Your former coworkers know you; pay transparently, publish the bill-to-pay math if you dare, and treat scheduling texts with respect. In staffing, the nurses are the product and the referral engine at once.

5. 5

   Pitch the shifts nobody else can fill

   Call directors of nursing and OR or unit managers with one offer: give me your hardest recurring hole (weekend ICU nights, call coverage, infusion Fridays) and I will fill it with a nurse whose file you can audit. One reliably filled impossible shift opens the whole schedule, then the sister facility.

6. 6

   Add lanes on evidence, not appetite

   Adjacent variants when the core runs clean: travel contracts in your specialty, camp nursing seasons for summer revenue, and eventually international recruiting of foreign-educated nurses (a long-cycle, visa-and-credentialing-heavy lane; partner with an immigration attorney before touching it). Track fill rate and rebook rate as the numbers that decide expansion.

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