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What is Per Diem Nursing and How Does it Work?

5 min readFebruary, 09 2024

Maintaining adequate nursing staff can be a challenge for health care facilities. Staffing issues may be due to the nursing shortage or stem from a busy time of the year (e.g., the holidays, flu season). Temporary needs can also occur due to vacations, sick leave, or extended medical leave.

Per diem nurses can help fill gaps to ensure that a unit meets its staffing needs while still providing a healthy work-life balance and accommodating nurses’ time off.

If you’re wondering whether per diem nursing is the right fit for you, read on to understand how it works.

How Does Per Diem Nursing Work?

The per diem definition in health care is the same as in Latin, meaning ‘per each day.’ For the per diem nurse, temporary employment could be a day or several days. Coverage requests may even occur a few hours before a shift for a call-off. 

A per diem nurse can work in various health care settings such as hospitals, nursing homes, and clinics — and the demand for per diem nurses continues to grow. The specific kind of work depends on your experience and qualifications, the type of facility, and their needs. After providing your availability to the facility scheduler or an agency for a given time frame, you’re scheduled for work as needed.

This type of supplemental work can work well if you’re looking to slow down the pace of a full-time schedule, are nearing retirement, have caregiving or childcare responsibilities, or just want to control your schedule and create a better work-life balance. 

Per Diem vs. PRN Nursing

Unlike pro re nata (PRN) nurses (meaning “as the need arises”), a per diem nurse can work for multiple facilities. Per diem nurses aren’t bound by a facility’s workplace policies regarding a minimum number of hours per week and have more flexibility in choosing work hours. However, this also means you aren’t guaranteed any specific number of shifts and don’t receive workplace benefits like a PRN nurse. 

Per Diem vs. Travel Nursing

There are similarities between per diem nurses and travel nurses. However, per diem nurses usually work within a specific location near their home, while travel nurses generally travel further to work for the duration of their contract. 

Skills Required for Per Diem Nursing

If you’re working as a per diem nurse, it may feel like it’s always the first day on the job at a new facility or unit. However, if you enjoy a fast pace work or require the mental stimulation of an ever-changing work environment, you may thrive as a per diem nurse. 


Essential Per Diem Nursing Skills

  • Clinical competence. A solid foundation of clinical skills and experience is necessary to adapt to different patient populations, care environments, technology, and facility policies and procedures. 
  • Strong communication skills. The ability to quickly establish rapport with patients and families — and work well with the established interdisciplinary team — is necessary to maintain continuity of care.
  • Ability to work independently. Without the same level of support for training and orientation as full-time staff, you’ll need to be self-motivated to seek answers about procedures, supplies, and patient needs independently.
  • Adaptability. Each facility may use different electronic health records (EHR), electronic medical records (EMR), or other technology to provide patient care. It’s helpful if you embrace continuous learning and are open-minded to trying new methods. 

Pros and Cons of Per Diem Nursing

Hiring per diem nurses can enable health care facilities to provide consistent patient coverage and offer nurses a flexible schedule. A con for one nurse may be a pro for you.

Per diem nursing pros and cons include: 

  • Scheduling
    Having no set schedule can be an advantage by providing freedom and time for other priorities. However, this can also mean the work gets offered at the last minute. Hours may be plentiful or absent. If you require a steady income, having more than one per diem position may be necessary.
  • Wages
    Higher wages usually accompany a per diem position, although this comes with giving up employee benefits and the security of a full-time job. You may also be responsible for independently planning for taxes and retirement savings.
  • Variety
    Per diem nursing can offer a variety of work settings and experiences, minimizing feelings of burnout from a stressful or monotonous work environment. But working at numerous units and facilities also requires quickly adapting to new policies and procedures. 
  • Knowledge
    One of the benefits of per diem nursing is the opportunity to try different specialties, settings, or health care technology to assist in learning new skills or making decisions regarding your career path. Stepping into these new opportunities requires quickly learning and adapting to diverse situations since per diem nurses often have less access to ongoing training. 
  • Network
    Exploring new facilities, clinical settings, or areas of a city can expand your professional network and offer potential career opportunities while avoiding workplace politics. But working as a per diem nurse often means you have less support from management and the regular nursing staff and will need strong interpersonal skills to develop relationships.

Is Per Diem Nursing for You?

Per diem nursing can offer flexibility, exposure to diverse health care settings, and potential financial advantages. However, being a per diem nurse comes with the challenges of inconsistent work, limited employee benefits, and a lack of job security. Consider your personal and professional goals to determine if per diem nursing is the right choice for your nursing career.


Images sourced from Getty Images

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