A per diem nurse is a nurse who is employed on a day-by-day or as-needed basis by a medical or healthcare facility, nursing home, outpatient clinic, or healthcare agency.
Per diem nursing refers to a type of nursing employment arrangement where nurses are hired to fill temporary staffing needs or to provide coverage for absences or shortages.
In per diem nursing, nurses are not employed full-time or part-time with a set schedule. Instead, they have the flexibility to choose the shifts they want to work based on their availability.
What is a PRN or Per Diem Nurse?
PRN is a Latin term for pro re nata, which translates in English to “as the situation demands.”
“Per diem nursing” and “PRN nursing” have essentially the same meaning and are often used interchangeably.
Whether your nursing job title is per diem nurse or PRN nurse, you only work when your institution has additional staffing needs that they cannot fill with their own “career” nursing staff.
The increasing demands of medical professionals in today’s healthcare environment – and the fact that patients are living longer (and are often sicker) than ever before – makes having the option to employ a per diem nurse even more essential.
Types of nurses that can work in per diem nursing include:
Registered nurse (RN)
Licensed vocational nurse (LVN) or licensed practical nurse (LPN)
Certified nursing assistant (CNA)
Advanced practice registered nurses (APRNs), such as nurse practitioners (NPs)
In addition, nurses can take per diem jobs in a variety of different facilities, such as:
Hospitals
Nurse staffing agency
Nursing homes
Outpatient surgery centers and clinics
Home health care
Some per diem nurses work back and forth between multiple institutions or as travel nurses!
About Per Diem Nursing
Many hospitals have their own per diem nursing staff. The fundamental responsibilities needed to be a per diem nurse are the same as career nurses. These nurses may be assigned to one particular unit in a hospital or can be resource nurses who can cover shifts in many different specialties within the hospital setting (as long as they are trained to do so).
Hospital staffing needs usually increase during holiday seasons or during times of high census in the hospital (such as during the COVID-19 pandemic).
In addition, there are nurse staffing agencies that arrange for nurses to work in hospitals that have additional staffing needs they can’t fill. These nurses work for “per diem nursing agencies” and may end up working multiple jobs in a variety of different facilities. Often, these nurses might work a few shifts at one hospital, and then a shift in another facility, all in one week.
Per Diem (PRN) Nurse vs. Full Time Nurse: What Should I Choose?
Most nurses work full-time, at least for their first few years after graduating from nursing school. Novice nurses need to put the time in and develop their clinical and critical thinking skills.
It takes many years to build up nursing expertise at the bedside, so I would never recommend that a new grad nurse work per diem. If you are considering per diem work as a nursing avenue for your nursing career path, ensure you are experienced enough to manage the stress of working in many different environments.
As a former per diem nurse, I have found many benefits to working per diem nursing jobs that I would not have had if I was working as a “staff” or “career” nurse. If you are teetering on making a change into the per diem nursing career environment, these are the benefits of working as a per diem, or PRN, nurse.
Benefits of Being a Per Diem/PRN Nurse
#1. Higher Pay
Per diem nurses may earn higher pay rates compared to other full-time nurses part-time or part-time career nurses for several reasons:
Flexibility
Per diem nurses provide a valuable service by offering their availability on short notice or during high-demand periods. The flexibility they offer allows healthcare facilities to fill staffing gaps quickly, ensuring continuity of patient care – without making a permanent commitment to the facility.
Premium Pay Rates
Many healthcare facilities offer premium or differential pay rates for per diem nurses. This is because per diem nurses are not entitled to benefits like health insurance, paid time off, or retirement plans that are typically provided to full-time or part-time employees. The higher pay rate for per diem employees helps offset the lack of benefits and compensates for the additional flexibility required.
Specialized Skills or Experience
Per diem nurses often possess specialized skills or experience that make them particularly valuable to healthcare facilities. For example, they may have expertise in critical care, emergency medicine, or other specialized areas. In such cases, their higher pay rate reflects their advanced knowledge and the demand for their specific skills.
Short-Term Commitment
Since per diem nurses are not employed on a regular basis, the higher pay rate may serve as an incentive for them to take on temporary assignments. It compensates them for the uncertainty associated with their work schedule and provides an incentive for more nurses to prioritize per diem shift shifts over other potential opportunities.
NOTE: It’s important to note that while per diem nurses may earn higher hourly rates, they do not receive benefits or job security that full-time employees enjoy. Additionally, their income may vary based on the availability of shifts and the demand for their services, which can fluctuate over time.
#2. You Can Make Your Own Schedule
Per diem nurses have the advantage of being able to create their own schedules based on their availability and preferences. Those in need of a flexible schedule may want to consider becoming a per diem nurse. Here’s an overview of how per diem nurses can make their own schedules:
Per Diem Nurses Communicate Their Availability
Per diem nurses typically inform the healthcare facility or staffing agency about their availability to work. They may provide their availability on a weekly, monthly, or periodic basis. This allows the facility to know when the per diem nurse is willing and able to work.
Shift Selection
Based on the nurse’s communicated availability, the facility or staffing agency will present available shifts for the nurse to choose from. These shifts can vary in terms of timing, duration guaranteed hours, and clinical setting. Per diem nurses can review the available options and select the shifts that align with their preferences and availability.
Flexibility in Accepting Shifts
Per diem nurses have the freedom to accept or decline shifts based on their personal circumstances, preferences, or other commitments. They can choose to work as few or as many shifts as they desire, depending on their needs and availability. This flexibility is one of the primary benefits of being a per diem nurse.
Ongoing Schedule Adjustments
Per diem nurses can update their availability and adjust their schedules as needed. They may communicate changes in their availability due to personal commitments, vacations, or other factors. Similarly, they can request additional shifts or reduce their availability if necessary.
NOTE: It’s important to note that while per diem nurses have the freedom to create their schedules, the availability of shifts is subject to the staffing needs of the healthcare facility. The demand for per diem nurse shifts can fluctuate, and there may be periods of high or low availability based on factors such as patient census, seasonal variations, or unforeseen circumstances.
Also, per diem staff and nurses should remain proactive in maintaining regular communication with their facility or staffing agency to stay informed about available shifts and to ensure a smooth scheduling process.
#3. Per Diem Nurses Can Pick Up Seasonal work
Per diem nurses have the flexibility to pick up extra seasonal work if it aligns with their availability and preferences. Many healthcare facilities experience increased demand during certain seasons or holidays, such as flu season, summer vacations, or winter holidays.
Per diem nurses can take advantage of these opportunities to earn additional income or gain experience in different clinical settings too.
Unlike career nurses, who often have guaranteed hours and do not have complete control of their schedules, per diem nurses can choose to decline shifts if they don’t jive with their schedule.
This means that if you don’t want to work nights, holidays, or weekends, you usually don’t have to (or at least not as often).
#5. Per Diem Nurses Can Add a Shift at the Last Minute
One of the best benefits of a per diem nursing career is that PRN nurses can work between different hospitals at the same time. This often works well because if they end up getting canceled at one hospital, they can call the staffing office at their other hospital to see if they have any per diem nursing needs.
#6. Cancel a Shift at the Last Minute
Working parents understand the need for flexible scheduling. If your child (or yourself) becomes ill the day or two before a per diem work shift, then you have an opportunity to cancel yourself ahead of time. You don’t need to worry about whether or not you have enough paid vacation time or sick time saved up.
#7. Opportunity to Cross-Train in Different Specialties
Per diem nursing often offers additional learning and career growth opportunities at a healthcare facility because staffing needs require coverage in many different specialty areas.
For example, a per diem emergency room nurse, who also floats to ICU units, might also be able to cross-train for a PACU unit if they have staffing needs. Or a per diem pediatric ER nurse might get training to work in the adult ER if the need for a per diem nurse arises.
Another example is a per diem nurse who specializes in the NICU might be cross-trained for post-partum or antepartum units if they need additional nursing support.
Nurses who can be flexible and want mental stimulation may find that they have more opportunities than ever to work. When you have experience working in multiple facilities and several different nursing specialties, then you have a decreased chance of being canceled and not making any extra money for that day. Having experience in many different per diem nursing jobs can provide increased job stability and add valuable work experience to your resume.
#8. Per Diem Nursing Allows You to Add Vacation Time Into Your Schedule Without Taking Time Off
For per diem employees of nurses, there is no need to ask for paid vacation because it is possible to build vacation time right into your schedule. So go ahead and book that summer vacation!
For example, full-time per diem nurses often work three 12-hour shifts a week. You can schedule yourself to work on Sunday, Monday, and Tuesday one week, and then on Thursday, Friday, and Saturday of the next week. That leaves you with eight days off in between your shifts to hop on a plane for a week’s vacation.
Or just add in extra shifts early in the month and take the rest of the month off!
#9. Part-Time Per Diem Nursing
Many nurses who only want to work part-time appreciate the option to work in per diem nursing. Whether you have small children at home, want a better work-life balance, or have other side careers that you are pursuing, per diem nursing allows you to have that flexibility without altogether leaving the bedside, or your profession, behind.
As nurses get closer to retirement, some may choose to work a little less. If that is the case, then per diem nursing work is a great option. You can keep your foot in the nursing industry, keep your nursing skills and knowledge sharp, and continue to bring in some income while also having time to dedicate to the other passions in your life.
In conclusion
I hope this article helped you clarify whether or not being a per diem or PRN nurse is right for you. There are many factors to consider, but it is wonderful to work in a profession where this type of work environment is possible.
You did it! You finally graduated from nursing school.
Now it is time to put all of your clinical and critical thinking skills to work so you can start helping patients. But first, you need to land your first nursing job.
Unfortunately, though, even when you have all of the skills needed to be a great nurse, finding your first RN position doesn’t always come easily. This may come as a shock to many new nurse graduates, especially since the US Bureau Of Labor Statistics states job openings in healthcare are supposed to increase by 14% from 2018-2028.
The good news is that once you get your feet wet as a novice nurse, subsequent nurse jobs won’t be as challenging to find because you will already have the experience on your resume.
In the meantime, here are a few things you can do to land your first nursing job successfully. Good luck!
Research the different types of nursing specialties
Pediatric nursing is one of the many specialties that nurses can go into.
Do you want to be involved in a fast-paced hospital setting? Or, would you prefer working with older individuals in a senior center? Perhaps you have your heart set on working in pediatrics or on a postpartum unit?
Alternatively, you may want to consider working in the ICU, emergency room, operating room, or on a med-surg floor unit. There are so many directions that your nursing career can take.
Some specialties require that you have additional certifications. For example, you must have your PALS, ACLS, and EKG training to work in most emergency rooms. It may be worth your time to invest in getting them before you interview for the position. Achieving certifications beforehand show that the interviewer that you are both qualified for and serious about getting the job.
Do an internship through your nursing program (and consider it an interview for a job!)
All of your clinical experiences in the hospital as a student nurse are potential job opportunities after you graduate.
One of the best places to get more information on how to gain experience is through your school or nursing program. Often, they’ll have internships with area hospitals or clinics, where you can get hands-on experience working around other nurses.
Some schools even have programs that allow their nursing students to work there during nursing school. It can give you a leg up if an opening for a new graduate becomes available.
Apply to the nurse graduate or nurse residency programs in your area
If you’re fresh out of nursing school, you might find it frustrating when every job post you see suggests that they require experience. After all, how are you supposed to gain experience if no one will hire you?
Many hospitals have nurse graduate programs or nurse residency programs that will hire a handful of new nurses once or twice a year. These programs are tailored to the novice nurse who needs training about and beyond what a more experienced nurse would need. These programs are anywhere from 6 weeks to 6 months and are an excellent way for new nurses to get better experience and training then they would otherwise.
Brush up on your interviewing skills
Brush up on your interview skills so and impress the employer with what you have to say!
You need to shine during your interviews. Having a successful series of interviews is key to getting your first nursing job.
The University of Southern California suggests that employers need to use more psychological tools in their hiring process. They focus on things like revealing strengths, encouraging self-awareness, and cognitive ability tests. It is essential to have a clear understanding of what employers are looking for in the interview process so you can show your strengths and skills with more clarity.
Most importantly, practice as many interview questions as you possibly can before your interviews. There are many books online that are full of potential interview questions for nurses. Grab a nursing school friend and interview each other. Practice answering the questions out loud.
Let everyone know you are looking for a nursing job
Put yourself out there and let everyone know you are looking for a new nursing job
Nowadays, it’s not always enough to apply for a job online or in-person and expect a phone call in return the next day. Over 165,000 people graduate from nursing school each year, and they are all trying to land their first job that same way you are.
Sometimes, it’s not what you do but who you know. Reach out to family and friends for any job leads. Contact your nursing school or alumni association to see if they know of any positions to hospitals that are hiring. Don’t be afraid to put yourself out there wherever and whenever you can to talk about potential leads for your career. You never know who might have the right connections that can help you to get your foot in the door.
Write a professional thank you note the day of your interview and then follow up with them a week later
After you crush your interview, don’t forget to follow up.
You must write a thank you note to the people you interviewed with after the interview. Thank them for taking the time to speak with you and write a sentence or two reminding them about why you are the right person for the job.
It may take them a while to get back to you. The hiring process at many institutions can take several weeks or even months. Many institutions interview hundreds or thousands of nurses every year, and the process can take a lot of time.
One thing you can do to be more proactive is to write a follow-up email about a week after your interview. Be professional, tell your interviewer that you are still really excited about the position, and ask when you might receive any follow up about the next steps in the hiring process.
In conclusion
Take pride in your career choice, and understand that the job hunt is not going to be easy. But if you can successfully make it through nursing school, then you can do just about anything! No matter where you end up working, you will find a unique opportunity to help people who need your help.
The right nursing job for you is out there. Stay motivated and keep working hard. Good luck!
I have a confession. My biggest nursing career fear is working for an hourly wage as a floor nurse forever.
Of course, there are other things I fear in my nursing career as well. Such as staying burned out working 12’s hour shifts, physically being unable to work after decades of wear-and-tear, and not reaching my full career potential.
But the one thing that really keeps me up at night is the idea of not creating a future for myself that has flexibility, freedom, opportunity, and more money. I have ambition, dammit. And it’s about time for a big change.
In order for me to make career decisions that will help me reach my fullest nursing career potential moving forward, I thought it was wise to revisit my career history. What inspired and motivated me in the past? Where are my strengths and weaknesses? What are my biggest priorities from here moving forward and how do I reach them?
So, (deep breath) here we go…
I was once an aspiring writer in college.
Way, way back in the day, before I ever even considered becoming a registered nurse, I was a journalism major with a minor in women’s studies. I wrote for our student newspaper, The Orion, and I loved it. I enjoyed the teamwork and even though I felt way in over my head a lot of the time I absolutely loved the challenge.
But then I graduated with a little debt and decided I was tired of being a poor college student. I wanted the money! After looking at a few options and going on about 50 intense interviews I finally got my first job as a medical device salesperson.
Reflective takeaway: I have experience working for an award-winning college newspaper. I enjoyed the challenge and the teamwork aspect.
They say hindsight is 20/20. Can a deep dive into my career history inspire my future career as a nurse?
In my first career, I sold medical devices to hospital operating rooms.
I spent the next decade working in the competitive field of surgical equipment sales for a Fortune 100 company and a few medical device startups. It was intense and I did very well, but there was always a feeling that I could be doing something even more important. My soul was craving more clinical education and critical thinking. I remember thinking to myself “I don’t want to work my whole career just being a salesperson!” I needed a bigger purpose.
So after years of soul searching, I made the difficult decision to leave the field in pursuit of greater clinical medical knowledge. I went back to school and achieved a BS in Nursing.
Reflective takeaway: I have many valuable professional skills that I can apply to other careers. And I’m hyper-competitive.
I became a second-career nurse.
I began my career specializing in a Neuroscience and Stroke unit and earned certifications as a Stroke Certified Registered Nurse and Public Health Nurse. In 2017, I began a new phase in my nursing career as an Emergency Room RN.
I love that I help others for a living and I enjoy the mental stimulation I get at work during my 12-hour shifts. Becoming a nurse has even helped me deal with the craziness of motherhood in some ways because it helps me distinguish things that I should be concerned with things that are not a big deal. (I have my time on a neuroscience floor and as an ER nurse to thank for that!)
However, the physical wear-and-tear and caregiver fatigue has got me feeling completely spent at times. And upper-management within the hospital is not something I am interested in at all.
Reflective takeaway: I enjoy using my clinical expertise to help others. But I also need to make my own health needs a priority.
I want to be a working mom who makes my own rules. Having children changes everything.
Starting a family intensified my biggest nursing career fear: a lifetime of working 12-hour shifts at the hospital
Having children really does change everything. I am grateful for all of the amazing experiences I have had in nursing. However, I see the future through a different lens now. My husband and I are currently raising two toddlers and my priorities are forever changed. My purpose for success was so completely different. Now my reason for success is my family.
And so, here I am seven years into my nursing career and I have this gnawing sensation that I need to “blow up” my career again. It is time to make room for more professional growth and development.
As a part of this process I made a list of my future career priorities:
Cerebral stimulation
Being a positive role model for my children
Freedom
Flexibly
Money
Reflective takeaway: Becoming a parent changed my career priorities and needs. Work-life balance is key.
Next (baby) steps…
In 2016 I created a nurse mom blog called MotherNurseLove.com. In the sparse amount of free time I have, I am creating a website, writing blog posts and taking courses to hone in on my new craft. My venture is being crafted out of my love for writing, my business management experience, my clinical knowledge as a nurse and life experience as a mother. I am creating my own opportunity that is more in line with my current career priorities (as mentioned above).
For clarity, my niche (or at least the niche I am striving to create) is: “nurse mom lifestyle blogger with an emphasis on nurse self-care” My goal is to write about nurse mom lifestyle topics that interest me and finding helpful ways for nurses to take better care of themselves.
In conclusion
Turning my nursing career fear into a catalyst for growth is a process. As I grow older (and hopefully wiser!) I am discovering that there are so many paths that nurses can take. The sky is the limit as long as I work hard and continually open myself to learning new skills.
My ultimate goal: To create a career for myself where I can combine my journalism degree with my nursing knowledge and motherly experience. This is the first “career” I have ever had where I didn’t have to fill out an extensive application and interview for the position. For the very first time, I am warming to the idea of being my OWN boss. And I’m really looking forward to what the future will hold.
I hope you enjoyed this post. If you are a nurse who is looking for alternative career options or wants to find ways to take better care of yourself as a working mom and RN please join my email list below!
If you have taken a peek over at my About Me page you may have read that nursing was NOT my first career. If fact, I did’t even discover that I had a calling for nursing until after I had been working in the medical sales field for about 9 years.
Ill press rewind for just a minute… Once upon a time, I worked in the competitive field of surgical equipment sales for a fortune 100 company and a few medical device startups.
I knew I didn’t love the career, but I made a pretty good living. It also allowed me to travel for work and I was able to afford to take a lot of incredible overseas trips. After a few years in the sales grind, I knew I wanted to do other things. The problem was that my resume said I was a medical device salesperson. So what was I supposed to do?
That voice in the back of my head continued gnawing at me, little by little. Every day a small piece of my soul was being eaten up by working in a career that I had no real passion for.
Until finally one day, after a near mental break down I made the difficult decision to leave the field. I went on a quest in pursuit of greater clinical medical knowledge and a desire to help humankind. After years of scratching my head I had finally discovered my new path.
It has been 9 years since my near mental breakdown that forced me to make an incredible life change. Nursing school was one of the hardest thing I have ever done in my life. But I am so thankful everyday that I did it. Ultimately, it was the best decision for myself and and for my family.
My whole point in writing this post was to talk about a really cool experience that I had recently…
A journalist at the Huntington Post recently contacted me through my blog. She asked if my husband and I would be interested in being interviewed for a piece that she was doing about what it was like being married to an ER nurse. Of course I said yes!
(I was a journalism major in college and still have an itch to write, which is one of the reasons I blog).
Nursing is challenging.
I want to be an advocate for nurses because I think we tolerate things that would never be tolerated in any other field (but we do it anyway because we’re awesome). I also really, really want to find a way to help nurses take better care of themselves. Plus, I am extremely passionate about being a nurse and have a passion for helping others. So, I was excited to share some of my thoughts (and I was also intrigued to see what my husband had to say about being married to an ER nurse).
