Is Being a Per Diem Princess Worth it? Opinion

After graduating from nursing school in 2008, I landed my dream job at a Level III Neonatal Intensive Care Unit (NICU) at a Children’s Hospital in a major city. I did everything a full-time employee should do. I joined committees, became certified, worked my way through the clinical levels - but then something changed. I realized that I didn’t want to be involved in the “hospital politics” anymore. I wanted to go to work, take care of my patients, save some lives, and leave. 

After gaining a little over a year of bedside experience, I landed my first per diem nursing position. I had a minimum shift requirement each schedule, but I could pick up extra shifts if I wanted to. My pay rate was significantly higher than at my full-time position, but there were some caveats. I stayed at that position until I found a different per diem position that paid more and had different shift requirements. The requirements varied depending on the position. Some required weekends, others I had to work summer and winter holidays, while others required a High Request Day (think Mother's Day, Easter, and/or Black Friday). 

As I continued throughout my career and found different per diem positions that either offered more money, had more shift availability, or were closer to home, I heard the term “Per Diem Princess” floating around. 

I distinctly remember asking a co-worker what a per diem princess was. I had never been called that before, but I got the impression that it wasn’t meant as a compliment. She explained that the term per diem princess referred to nurses who only work per diem. 

It’s a colloquial term for nurses who work at their own discretion. Sometimes it is meant as a joke, other times critical, or even playful.  I truly never paid much attention to it. I always thought that nurses who used that term to describe a coworker were simply jealous. Jealous of the lack of weekly commitment, jealous of the hourly wage, or even jealous of the assignments. Whatever their reasoning was, it was better to push the noise aside.

Benefits of Working Per Diem 

1. Set Your Own Schedule

Per diem nurses usually fill in the holes. Every hospital utilizes per diem nurses differently. So it’s important to speak to the manager and scheduler about the needs of the unit. 

Depending on the facility and unit, per diem nurses may be able to:

• Decline to work shifts they don’t want
• Cancel shifts 24 to 48 hours in advance
• Choose between day and night shifts
• Pick up extra seasonal work

Personally, I worked all different shifts and had varying levels of requirements as a per diem nurse. My one position was strictly per diem on weekends or off shifts. Off shifts referred to evenings or night shifts. I wasn’t able to schedule a Monday through Friday day shift unless I was specifically asked. 

2. Higher Hourly Wage

Typically, a per diem nurse will earn a higher hourly wage than staff nurses. Unfortunately, depending on the facility, this can create tension with staff members. 

Years ago, I had a per diem position at a NICU at a small community hospital, and I remember some of the staff members would make comments about getting paid more for doing the same thing as them. In fact, according to some of the staff, I actually did less because I was given the easier assignments, rarely got admissions or transfers, and never attended patient deliveries. 

Cons

1. Minimal to No Employment Benefits 

Perhaps the biggest downside of per diem nursing is that you forgo typical employment benefits, including health insurance, dental coverage, and vision, in lieu of a higher hourly rate. 

Some positions will offer a 401K but without the employer matching program. Other benefits you won’t receive include disability, sick days, maternity leave pay, or tuition reimbursement. 

Personally, this was one of the hardest aspects of per diem nursing for me. I attended graduate school and earned my MSN in Nursing Education without the benefit of tuition reimbursement, despite being in my one per diem position for over ten years and the other for five years.  

With each of my three children, I was never given a true maternity leave. Yes, I could take time off, but it was 100% unpaid. With my daughter, I was fortunate enough to take almost six months off from bedside nursing, but I did not earn a single dime during that time. No paychecks coming in. It was important that I planned accordingly and saved throughout my pregnancy.

2. First to Get Cancelled

This is probably one of the hardest aspects of per diem nursing. Before I was married and had kids, it never really bothered me too much when I was cancelled. In fact, at the time, if I was cancelled at one position, I would call a different hospital and see if they needed extra staff. 

Now, it’s harder. Per diem nurses can be cancelled up to two hours before a shift starts, which sometimes means you already slept all day if working nights or are already awake and getting ready for a day shift. 

Some parents might find the unpredictability difficult, especially with small children.  

3. Consistently Given the WORST Assignments

This is my BIGGEST complaint about working as a per diem nurse. It always has been, and most likely it always will be. I've come to find that per diem nurses generally possess a very specific skillset, and it is often underutilized. In fact, I remember my first per diem job, I was ONLY given babies that were admitted with a diagnosis of NAS, or Neonatal Abstinence Syndrome. My entire eight or twelve-hour shift would involve taking care of three to four newborns that were born addicted to some drug - usually opioids - while in utero. There was screaming. ALOT of screaming. 

Per diem nurses, historically, are given the assignments no one else wants. Difficult family - give it to the per diem nurse. Psychiatric hold patient - give it to the per diem nurse. Discharge everyone and then be open to several admissions - give it to the per diem nurse. 

This con is one of the reasons I consider taking a staff position somewhere. The truth is, I am good at my job. I have worked hard throughout my career, learned from some of the best, refined my skill set, become certified, and even expanded my clinical expertise. Do I feel like my skills are wasted at times? Absolutely. But I know that if I want to continue working only on a per diem basis, this will happen. Do I wish my skills would be recognized and utilized, sure. But honestly, short of reminding your charge nurse and supervisor, there's nothing more to be done. 

Popular Social Media

Over the years, social media has dramatized the role of the Per Diem Princess. It has been embraced, mocked, and even celebrated. 

@nursecolton Daddy Colton really embodies the per diem princess role. 4 hour shifts have become his specialty. Side note: all nurses know that finding a pillow in the ER is basically like finding gold. #nurselife #nurses #nursehumor #nursesoftiktok #nursedaddies #ernurse #nurseproblems #nurse #gays #nursetok ♬ original sound - Colton Lord

@dimplesqueennini #creatorsearchinsights I literally am so unserious about working all the time. I’m so happy nursing gives me the freedom to live the way that I love. Lord knows the day I have kids. I’m gonna have to settle down so right now it’s time to live free. #Nurse #PerdiemNurse #TravelNurse #HowToBeANurse #fyp #fypage #nursebae ♬ original sound - Dimples Queen

Over the course of my almost twenty years of bedside nursing, I have always had at least one per diem position. In fact, at one point, I had four per diem positions. Between everything, I worked essentially full-time hours every week. I personally have not had a staff position since 2014, but I have been lucky. This isn’t always the case for all per diem nurses. 

I don’t know what the future may hold for me as a per diem princess, but I do know that for right now, in my life, it works. Maybe eventually I will get a staff position when the timing is right. Until then, I will occasionally look at job boards - just to see if the next best thing is out there. 

🤔Nurses, are you a Per Diem Princess? Share your thoughts about Ned Brower below.