The Ultimate Guide to Per Diem Nursing

One of the best perks of being a nurse is the wide range of scheduling flexibility the profession allows. You can work as a “career nurse” working full-time for a facility, usually 36 to 40 hours a week, as a part time nurse, or even as a travel nurse. But did you know that nurses can work a “per diem” or “PRN” schedule where they can choose exactly when they want to work? Often while getting paid a premium to do so!

This article will explain what per diem nursing is, what it is like to work on a per diem schedule, the pros and cons, and how much you can make. 

Per diem nurses, sometimes referred to as PRN nurses, are nurses who work “by the day” or as needed by the institution where they are employed, rather than working a set schedule. 

Essentially, these are on call nurses who can be hired to fill in for nurses who called out sick, to fill in for staff that are out, hired for seasonal or holiday coverage, etc.

Per diem nurses tell their employers what shifts they can work on the front end and are called off if not needed.

The expectations and arrangements for per diem nurses can vary between facilities. However, this is generally how the process works:

1. Provide Your Schedule Availability

The per diem nurse provides the facility with their preferred scheduling for the month and is expected to be available to come in on those days.

2. Get Called in When Needed

The facility calls the per diem nurse a few hours before the shift starts to inform them if they should come to work. If the per diem nurse is not needed, they are told not to come in and are not paid for that shift.

3. Work Your Shift 

If they are needed, the per diem nurse works the entire shift and is paid a higher hourly rate for their scheduling flexibility.

What Are Resource Per Diem Nurses?

Some facilities offer an option to work as a “resource” per diem nurse. This means that the nurse will train on several different units and be available to work on those units when the situation demands additional staffing. 

This arrangement isn’t for every nurse. Some nurses enjoy the flexibility of working per diem on a unit they are already familiar with, while others enjoy the challenges and learning opportunities that come with working in several different departments. 

The average per diem nurse salary is $33 per hour, with rates as high as $42 per hour, according to ZipRecruiter. This is a slight decrease from the average registered nurse hourly rate, which is $41.38 per the BLS.

Some of the factors that will impact how much you earn as a per diem nurse are:

• The city and state where you live
• The type of healthcare facility you work in 
• Whether you work 8, 10, or 12 hours shifts
• How many shifts you work in a week
• Whether you work holidays and weekends (which offer a higher shift differential)

One thing to remember is that most per diem nurses do not earn employment benefits such as retirement, disability, sick days, maternity leave pay, or tuition reimbursement. 

Only you can decide if working as a per diem nurse is the right financial decision for you.

Per diem nurses work in almost every specialty in the hospital setting, but they usually have several years of experience working as floor nurses for a particular specialty before taking a per diem position. 

Per diem nurses must have the same credentials as every other nurse. Here is how to become a per diem nurse:

Step One: Become a Registered Nurse

Per diem nurses, like all nurses, must earn either an associate's degree in nursing (ADN) or a bachelor's degree in nursing (BSN) from an accredited nursing program and then pass the NCLEX and maintain a current and active license in their state.

Step Two: Gain Several Years of Working Experience

Most units require several years of working on the unit before accepting per diem shifts. 

For example, emergency room, critical care, and operating room nurses must have several years of experience training on that floor before working per diem shifts. 

Many med-surg units allow nurses to cross-train on many units.

Step Three: Apply for Per Diem Nursing Jobs

Some nurses even work per diem shifts at two different facilities, depending on the needs of the hospitals. There are also new apps like Nursa that can connect per diem nurses with healthcare facilities looking to fill shifts immediately. 

Being a per diem nurse can be both convenient and frustrating because even though you pick your own schedule (and have a higher hourly wage!), there are times you won’t be needed when you want to work. If you don’t work, then you don’t get paid.

Every facility has its own rules and manages per diem scheduling differently. In general, here are a few of the pros and cons of being a per diem nurse:

Pros 

1. You Can Set Your Own Schedule

Career nurses do not have the same scheduling flexibility as per diem nurses. Depending on the facility, 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

Many retired “career” nurses work per diem to keep their skills sharp and earn extra money without working full time.

2. Higher Hourly Wage

Per diem nurses often make anywhere from $9 to $30 more than career nurses for working the same shifts at the same facility.

 3. You Will Become a Jack-of-Many Trades

Per diem nurses who work on many units learn a wide range of new skills that may make them more marketable when interviewing for other jobs.

4. Plan Family & Vacation Time Into Your Schedule

You won’t need to ask for vacation time because you will just build it into your schedule.

Cons

1. No Employment Benefits

Per diem nurses usually forgo all of the typical employment benefits in lieu of a much higher hourly wage. This may mean you won’t have retirement, disability, sick days, maternity leave pay, or tuition reimbursement. 

Before accepting a per diem position, you will want to ensure that working without employment benefits is not a dealbreaker for you.

2. You Risk Not Being Paid If The Hospital Has No Staffing Needs

If the hospital has no staffing needs for a shift, you don’t get paid for that shift.

Per diem nurses can add additional shifts to make up for the days they don’t work. But if consistency is important, per diem nursing may not be an excellent choice for you.

3. Per Diem Nursing Can Pose Additional Challenges for Working Parents 

Per diem nurses with children must schedule child care without knowing whether they will work that day or not. 

If you do not work a per diem shift, you will usually still need to pay for childcare that day.