Per Diem Nurse's Pay-Stub Goes Viral: $19K in 2 Weeks!?

Is it really possible to make over $19K in 2-weeks as a nurse in California? Yes, it is possible says Mike Kearse, a Registered Nurse who works PRN per diem shifts in the Bay-Area. 

If you’re a nurse you’ve probably heard stories of nurses working per-diem in California for a few weeks and earning ridiculous amounts of money. Maybe you’ve met a nurse who has been flying to the golden state for years to work every few months. Maybe you are one of those nurses.

Per Diem In CA Pay What!? 

One nurse’s pay stub photo has gone viral. The photo is said to be a picture of a 2 week pay period print-out. Apparently, the nurse worked 8, 16-hour shifts within two weeks and earned $19,954.98, after taxes. The caption explains that the nurse never worked more than 4 shifts in a row. 

>> Related: Per Diem Nurse Salary Guide

Nurses Flock To Northern California

Some people have called the photo fake. Others have claimed that working that amount of hours is unsafe for patients and nurses alike. However, it is well known that nurses from other states frequently visit California to work per diem. After their per diem shifts are complete, they go back to their home state, where the cost of living is much lower. 

Nurses from other states typically target the Bay-Area - where wages match the expensive cost of living. According to the BLS, San Francisco is the highest paying city for Registered Nurses in the country. The mean hourly rate for staff nurses was $65.68/hr. in 2017. 

While the BLS doesn’t release data on the mean hourly rate for per diem nurses in Northern California, we have heard from multiple nurses who earn over $100/hr. working per diem. 

What does it mean to work “per diem”? 

Nurses who work “per diem” work by the day or as needs present themselves. They are able to let the hospital scheduler know their availability for a given time-frame and the scheduler will book them to work, as-needed. Per diem shifts can be scheduled directly with a hospital or through an agency. 

How much do per diem nursing jobs pay?

Nurses who work per diem typically earn higher hourly rates than their full-time counterparts. Each hospital will pay their per diem nurses differently. Nurses who work through agencies will also receive different pay depending on location, specialty, and shift. However, in northern California, it is not unheard of for per diem nurses to earn around $70-$100/hr. Furthermore, with overtime pay and shift differentials, they can earn over $2000 per shift. 

Nurses who work per diem in cities that pay their full-time nurse high salaries should expect to see exceedingly high per diem rates as well. 

We interviewed Mike Kearse, RN (@officialmursemike) about his experience working per diem shifts in the Bay-Area. Kearse works in the ICU and has been visiting California to work for a few years, he lives in Georgia. 

Instagram: @officialmursemike

Why did you choose to work per diem in California? 

“The main draw was flexibility. I was a travel nurse prior to this but, once I started a family I  knew I didn’t want to be away for 13-weeks at a time. Some older nurses had told me about per diem nursing in California and how well it paid. It sounded perfect for my situation.” 

You live in Georgia, why do you go all the way to California to work? 

“California, especially the Bay-Area, pays a lot more than other parts of the country. I work a lot of overtime while I’m there. California’s overtime laws make it possible for nurses to earn double-time and bring in a lot of money. In Georgia, it would take me multiple shifts to make what I make in one shift in the Bay-Area. California’s unions make working as a Registered Nurse more enjoyable because they hold their hospitals to higher standards on behalf of nurses. They also have mandated ratios. In the ICU, my ratio is 1:2. In Georgia it can be a lot more.”

What was so appealing about working overtime in California? 

“In most parts of the country, nurses get paid time and a half after they work 40 hours in 1-week. 

But, in California, overtime-pay is paid by the shift. The first 8 hours of the shift are paid at straight-pay. If a nurse works over 8 hours, they are paid time and a half. If they work over 12 hours, they are paid double time.

Hypothetically, if you make $100 per hour and work 16 hours you could gross around $2200 - for that one shift.” 

Important to note, some hospitals in California have implemented the “alternative workweek” since healthcare workers typically work over 8 hours per shift. If a hospital is on an “alternative workweek” they may not pay overtime until the nurse works over 12 hours per shift. 

How does scheduling work for PRN per diem shifts? 

“It is totally based on my schedule. When I have availability to work, I let the hospital know my dates. My schedule is capped at 40 hours per week. But, I always let them know I am available to work more hours and I often pick up extra time. I usually stay in California for 2-3 weeks to work.” 

Are your PRN shifts canceled often? 

“No, my hospital has a no-cancellation policy for per diem nurses. They can’t cancel me. However, I can cancel myself up to 72-hours in advance. Not every hospital does this, though.” 

You may be interested in: Highest Paying States For Registered Nurses

Do you work for a hospital or agency? 

“I work directly for the hospital.” 

How many hospitals do you work per diem at? 

“I only work at one hospital right now, they always have work available. I’m considering working at another hospital.”

How long did you take you to get a California license? 

“It only took about 6-weeks to get my California license, I flew to California to speed up the process. If I hadn’t flown there, it could have taken at least 6 months to get the license?”

How long did it take you to get a per diem job in California? 

“It took about 1.5 years of applying to multiple hospitals - the positions are competitive. I was an ICU, ER and Flight Nurse prior and thought I had enough experience but, it still took some time for me to land a job.”

Who pays your travel, housing, and transportation expenses while you are working in California? 

“I do. Unlike travel nurses, per diem nurses do not receive travel, housing or meal reimbursements.” 

You may be interested in: How To Make The Most Money As A Travel Nurse - 10 Tips

Do per diem nurses get benefits? 

“No, per diem nurses are not usually eligible to receive benefits or vacation pay. I have private health insurance, an IRA and take vacations at my leisure without pay. My private health insurance is about the same as I paid for my staff job.” 

What advice do you have for nurses who are interested in working per diem?

“This lifestyle isn’t for everyone and it includes some risk. Once I was able to look past the “typical” work week and step outside of my comfort zone, this lifestyle became priceless. 

For me, the pros outweigh the cons. I am able to work a flexible schedule, stay out of hospital politics and make more money than I would back home. Even better, because of California’s unions and ratios, I am able to provide better patient care and connect with my patients. 

But, if you are looking for a stable job with health benefits, potlucks, and staff meeting - this gig is not for you. 

Make sure to research the hospitals you apply to. We are in the year 2018 and there are many resources online - message boards, Facebook groups, blogs and more. Follow me on Instagram for more tips and advice as well @officialmursemike.”