9 Per Diem Nursing Pros and Cons

December 28, 2023


Fusion Medical Staffing


Working a typical 9-to-5 isn't the right decision for everyone in the medical field. If you're a registered nurse (RN) exploring a more flexible career path, you may be looking into per diem nursing. Some healthcare workers thrive as per diem staff: let's find out if you're one of them.


9 Per Diem Nursing Pros and Cons


What is per diem nursing?

You may have heard of per diem nursing, but what does that really mean? "Per diem" means "by the day," in Latin.

A per diem travel nursing professional works in clinical settings without a set schedule, and often fills in during high-volume times like flu season, for sick calls, or for full-term staff nurses who are taking time off. Per diem nursing shifts are not guaranteed hours, but allow for lots of flexibility and freedom. You might think of a per diem nurse as similar to a substitute teacher — they're not a full time employee, but they're not technically part-time nurses either.

Pros of per diem nursing

Flexible scheduling for per diem nurses

One of the biggest pros of per diem work in the healthcare industry is the ability to choose your own shifts. This means that you can take time off when you need it, or work extra shifts to earn more money. It's easier to achieve work-life balance than it is for those with full-time employment.

Being per diem professionals can also be a good option for parents who want to spend more time with their children, those who work multiple jobs, or someone working on their career growth or nursing skills through additional schooling or educational opportunities.

Per diem nurses have a variety of experiences

Per diem nurses work as needed, taking on very short-term assignments at different facilities. This allows them to work in a range of settings, from hospitals and nursing homes to clinics and rehabilitation centers. This variety not only keeps their work interesting but can also broaden their skill set and provide opportunities for professional growth.

A per diem nurse doesn't need to drastically change their regular work to enjoy this benefit — they can take advantage of the high demand for temporary and per diem healthcare professionals at different employers in the same area, maximizing mental stimulation and often earning extra money.

Per diem nurses earn a higher hourly rate

Did you know that per diem nurses make more money? Per diem nurses are hired on an as-needed basis, which means they can negotiate a premium rate for pay. Additionally, per diem nurses are often paid at a higher rate than their full-time counterparts, which can make a significant difference in their overall earnings.

You can decide which facilities you like best

Per diem nurses have an interesting perk - the ability to "try before they buy." Working as a per diem nurse is a way to see what it's like with a specific facility before making a permanent commitment. (Earning a higher pay while you're scoping it out doesn't hurt, either.)

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Cons of per diem nursing

Although per diem nursing may seem like an attractive option, it's important to consider the cons that come with it in addition to the other benefits.

Lack of job security

While per diem jobs can offer flexibility, they also come with a lack of job security. There may be times where work is scarce or non-existent, leaving per diem nurses in a difficult financial situation.

Employers typically prioritize their full-time employees when it comes to the best opportunities, so if you choose to pursue per diem work, keep that in mind. Hopefully the extra money in your pay makes up for this uncertainty, but last minute nursing shifts are trickier to budget than a temporary nursing job which requires longer contracts.

Lack of benefits

The unpredictability of per diem nursing also means that nurses may not have a stream of steady income, nor receive benefits. A per diem employee may miss out on benefits like health insurance and other healthcare benefits, vacation time, or sick time, but also any other special perks offered by the healthcare organization.

Make sure you know what benefits you are entitled to from your health care facility — unfortunately, it's often the case that health insurance, etc. is not part of the deal for per diem nursing jobs.

Difficulty building relationships with other nurses

It can also be difficult to build relationships with colleagues and patients when working only sporadic shifts. Although it makes sense that you may have to pay this price for the flexibility of avoiding set hours or shifts, it can feel lonely.

This isn't always the case, but simply spending more hours at a full-time job gives full-time nurses the advantage when it comes to making easy connections with co-workers.

Floating to other units

The entire point of per diem nursing is to fill in when and where you're needed, so it's likely that you'll be the first to get floated to other units. A full-time nurse is much more likely to stay in a single unit for their whole shift.

Per diem shifts can be canceled at the last minute

Since per diem nursing isn't typical part-time employment, your employer is under no obligation to give you a minimum amount of hours each week or month. Even when you think you have things planned out, you may be thrown for a loop with a surprise cancelation. Make sure you have another income option available to keep your work life balance solid.

Part-time vs per diem

What's the difference between part-time and per diem nursing? Although there are similarities between a per diem nurse and a part-time nurse, like an easier time with work life balance, they're very different.

Part-time employees are scheduled regular, predictable shifts and must work under a certain amount of hours each week (usually 35). A per diem nurse might work more than a typical full-time employee or far less, depending on the shifts they choose to pick up. A part-time nurse also can't turn down a shift offered to them — they're on the schedule, unlike a per diem nurse.

Per diem vs PRN nursing

What's the difference between PRN and per diem? PRN actually stands for another Latin phrase, "pro re nata," which means "as the situation demands." Most PRN nurses have more in common with per diem nurses than part-time employees do, and some facilities even refer to their PRN nurses as per diem nurses, to add to the confusion.

The biggest difference between per diem and PRN nurses is that per diem nurses can take shifts at other healthcare facilities, while PRN nurses do not. PRN employees are also liable to be sent home or to have fewer shifts available, but are guaranteed a base number of shifts, where per diem nurses are not.

Per diem vs travel nursing

Another avenue that allows flexibility, work life balance, extra money, and many of the other per diem nurse benefits is travel nursing. Traveling nurses take temporary contracts with facilities through a staffing agency for very similar reasons to a per diem nurse, without being at the mercy of an unreliable per diem shift. The main difference is a per diem nurse can stay in one area, and a travel nurse can select from locations across the country.



Working as a per diem nurse can be a great way to make extra money, enjoy flexibility, and discover your favorite facilities and healthcare settings. Make sure you weigh your options, know your limits, and consider the level of uncertainty you're willing to endure as you determine the nursing role and lifestyle that's right for you.