“Per Diem” is a Latin term that means “by the day.” Per diem refers not to the specialty care that nurses give, but to how the nurse is hired: literally on a day to day basis. In other words, a per diem nurse is not a regularly employed nurse, working for only one division in a hospital, but someone who works on a variety of units and sometimes in a variety of hospitals and other facilities. Some per diem nurses work for one hospital, and are assigned to a unit depending on the patient census, and the patient needs in different units. Other per diem nurses work for per diem nursing agencies which provide nurses for a variety of facilities. These nurses might work two days at one hospital, and then three nights at another facility, all in one week. Find available positions today!
Hospitals require a lot of people to get their job done. Hospitals often use per diem nurses to cover staffing needs, since those needs may vary from week to week. For example, if an area was having a flu epidemic, a hospital might have a larger patient census than normal, but since the epidemic would usually subside in a few weeks, using per diem nurses lets the hospital cover the epidemic without having to hire staff permanently for a temporary need. Having a group of good per diem nurses available allows a hospital to keep their costs down by using those nurses only when they’re needed.
Per diem nursing can be challenging, since these nurses are often working in units and with staff they don’t know well. But there are a lot of good reasons for choosing this challenging and exciting field. These are some of those reasons.
1. Like I said before, per diem nursing is exciting and challenging! If you’re the type of nurse who gets bored easily or who likes the challenge of adapting quickly to a new environment, per diem nursing gives you that chance.
2. New to an area? Not sure which hospital you’d like to work at? Per diem nursing lets you get to know a variety of places before you commit to full-time employment.
3. If you have scheduling challenges because of family or school or other issues, per diem nursing can help you work around those. Let’s say you have a young child, and you and your wife are trying to be there with your child as much as possible. A per diem schedule lets you have more say over when you’ll be working. For example, you might tell the scheduling coordinator, “I can work this weekend on days, and next Tuesday and Wednesday nights.”
To be a per diem nurse, you’ll need to be a graduate of a nursing program, and have an unrestricted nursing license. You’ll also need education and experience that qualifies you for the areas you’ll be working at in a facility. For example, if you’ll be working in a surgical intensive care unit (SICU) you’ll need to have experience and expertise in that environment already.
Salaries for per diem nurses vary widely, depending on your area of the country, your background, your skills, and ultimately what you’re able to negotiate with the per diem agency that hires you. Pay will usually range from $25-50 per hour, but can go higher in high demand situations or in some urban centers. An average pay would probably be in the $30-35 per hour range. In many cases (unless you’re a full-time per diem nurse for one hospital) you will not be paid benefits, such as vacation or sick pay. Your hourly pay will probably be higher than your co-workers to compensate for not getting benefits. Many per diem nursing agencies will insist that you not discuss your pay with co-workers. This is because what you are paid is often highly-individualized, and not discussing it helps to prevent misunderstandings about pay. You should respect any such requirements, and even if it’s not specifically required, it’s a good practice to avoid discussing pay.
Q. What’s the difference between permanent placement nursing, per diem nursing, and travel nursing?
A. Permanent placement occurs when a nurse is placed into a permanent position at a facility. Travel nursing occurs when a nurse contracts with a per diem nursing agency to work in a non-local facility (usually 50 or more miles from the nurse’s home) for a given length of time. For example, a nurse who lives in Spokane might agree to work in an ER in a Miami hospital for 13 weeks. Per diem is when a nurse works for a variety of per diem nursing agencies or in a hospital staffing pool for different units.
Q. Do I have to sign a long term contract with a per diem nursing agency?
A. No. Part of the attraction of per diem nursing is that you can work for a variety of agencies.
Q. Can I use multiple per diem nursing agencies at the same time?
A. Yes. Most agencies will assume you’re also working for others, and if you’re good (and you should be!) you can use that to your advantage, getting agencies to bid better pay for you to get you to work more for them.
Q. Will I get benefits (health, dental, etc.)?
A. This depends on particular agencies. It’s a good idea to get all benefits in writing, and make sure you understand what you’ll be getting.
Q. How much control do I have over which shift I get assigned?
A. A lot! One of the benefits of per diem nursing is that you can control when and where you work.
Q. Is there job security in per diem nursing? Can I be a full time per diem nurse?
A. Again, this depends on the area where you’ll be working, but there are many nurses who work full-time (and make a full-time salary) as a per diem nurse.
Q. As a per diem nurse, am I constantly on call, or is there sufficient notice before a shift?
A. In most cases, you’ll know in advance (sometimes weeks) when and where you’ll be working. Being on call is completely negotiable with agencies you’ll be working for. If you want to be on call, you can, but you’re not obligated. It’s important that you are fully aware of the details of what an agency expects from you — and what you should expect from an agency.
Q. Are per diem nursing agencies reliable to deal with?
A. In almost every situation, per diem nursing agencies are reliable, helpful, and good to deal with. But an agency should have a local office or at least a fixed location, there should be a manager you can deal with in case of emergencies, and there should be someone (at the agency) on call at all times in case there’s a problem with the facility you’re working at. If any of these are not available, you might want to consider working with another agency.
By James Huffman
Jim Huffman, RN (@jimhuffman) is a community health nurse and freelance writer in North Carolina. Learn more about James on Google+