What is per diem nursing?
Per diem nursing generally refers to any "by the day" nursing position. Often these jobs are found through a scheduling or job platform, registry, or agency that contracts with hospitals, nursing homes, rehab centers, surgery centers, and other healthcare facilities to help fill staff needs on any given day. There may be staff on maternity leave, or some other extended leave of absence, or they are hiring more full-time nurses, but still need some help with the patient load. Some hospitals also have a float pool where nurses share their availability and can be sent to different units on any given day. They may even be sent to different hospitals within a health system.
As a per diem nurse, you will need to bring experience to the table to thrive. Similar to travel nursing, per diem nurses must have a solid working knowledge of their specialty because there is little to no orientation. If a facility is short on staff, they may not always have the time to give you a lengthy or detailed nursing orientation since you’re there to fill a void. It helps to be flexible and willing to jump in and learn on the go.
What is PRN nursing?
PRN nursing is very similar to per diem nursing, but these 'as needed' positions are specific to a certain unit. To potentially make things more confusing, sometimes hospitals refer to these jobs as 'per diem,' meaning you aren't part-time or full-time, but have a lower or more flexible monthly shift requirement. Oftentimes a nurse in a PRN position will not be eligible for benefits like health insurance, retirement, or paid time off.
PRN nurses will be mastered into a particular unit, like an ICU or ER. Nurses will have all the competencies and classes to take any patient assignment, and may be expected to pivot throughout a shift. A PRN nurse may be a staff nurse that went back to school, or someone who wanted more flexibility and to spend more time at home.
Similarities
Greater Flexibility: One major benefit and similarity is having control and flexibility over your schedule. You can pick up shifts in your free time yet still spend time with your family, go to school, or work another job. Generally, there’s no minimums or commitments. As long as your license is active, you can maintain an active working profile.
Competitive Pay: Because facilities don't provide PRN and per diem nurses the same benefits as full-time employees, they are often offered competitive compensation.
Ability to Gain New Experiences: If you're looking to gain more experience, or want to try out a specific facility before committing to a full-time position, PRN and per diem shifts are great ways to get the feel of the culture, the role, and the responsibilities of the job.
Professional Development: After a certain amount of time, and to make yourself more marketable, you can make the case to cross-train to other units or departments. An example of this would be working in a long term care unit and asking to train as the wound care nurse, or on the rehab or memory care unit. The work is similar, and as a PRN nurse, you can help fill holes in another schedule while also learning a new skill.
Differences
Work Requirements & Schedules: Although per diem and PRN nurses can choose their shifts, PRN nursing jobs may have a more structured requirement, like four shifts a month or ten shifts in three months. PRN nurses are usually guaranteed their shifts, while per diem nurses are not. Per diem nursing jobs are far more flexible.
Annual Salaries: Both per diem and PRN nurses have a higher salary than full-time nurses, but per diem nurses tend to make more money than their PRN counterparts. This is because per diem nurses don't receive health benefits and may work more hours than PRN nurses. Depending on the organization, some PRN nurses may receive health benefits and other benefits, such as the ability to accrue paid time off. Additionally, per diem nurses can receive next-day pay.
Facility Commitments: If you decide a particular unit or facility is not the best fit for you, per diem nursing is perfect for you. After working your shift, you are not "stuck" working required shifts or hours, and you can decide not to return to the facility or unit. More often than not, when a per diem nurse finds a facility that fits and works for them, they mostly try to pick up shifts at that particular facility.
If you plan to work as a per diem or PRN nurse, make sure you’re comfortable in your current specialty. Your best bet will be getting hired into the same type of unit you are currently working in. Once you decide to become a per diem or PRN nurse, you may want to start doing it as your side hustle while keeping your full-time staff position. This way, you can find out which companies offer the best shifts and pay rates for per diem or the terms for PRN in your current unit (or negotiate what you want). Use all this information to your advantage to find the most lucrative, flexible, and fulfilling position available.
Giving yourself that safety net before leaving your staff job ensures that you won't be stuck taking the first job that comes along or out of desperation. Many nurses choose to add on a per diem or PRN gig in addition to their staff position to learn new skills and experience different nursing environments.