A Fresh Look at PRN Nurse Staffing Strategy in Long Term Care

A Fresh Look at PRN Nurse Staffing Strategy in Long Term Care

Post-acute nurse leaders are facing yet another wave of disruption—and this one might be the biggest opportunity ever. 

2022 has been named “The Year of Change” in nursing, with the charge being led by predictions of increases in demand in home health and a growing importance of staff well-being. But at the same time, a survey reviewing the long-term impact of the COVID-19 pandemic has found that about one-third of all nurses are considering leaving the profession.  

This phase of disruption in nursing means that nursing leaders will need to rethink their approach to contingent staffing—particularly how they build out and implement their pools of PRN nurse professionals and the strategies they use to keep turnover low, reduce costs, and ensure the best possible outcomes for their patients. 

Understanding PRN nurse pools 

Nursing leaders across the country are rethinking their approach to concepts that have been around for decades, including, in particular, PRN pools. 

Po re nata, or PRN nurses are fully licensed nurses who work on an on-call basis instead of as full-time staff. Unlike per-diem nurses, PRN nurses are employed by a single unit and are scheduled and guaranteed shifts. 

Nurses are attracted to PRN positions because of the flexible schedule, higher salaries, ample employment opportunities, and the chance to learn and apply multiple skills across different care environments.

What are the responsibilities of PRN nursing professionals?

PRN nursing professionals are responsible for caring for a wide variety of patients. In long-term care (LTC) settings they can be responsible for duties including: 

  • Collecting data from patients and family.
  • Creating, updating, and implementing care plans under the direction of a registered nurse.
  • Caring for patients, including administering treatments and medications, dressing changes, and maintaining established standards of care.
  • Upholding standards, including infection control, safety, communication, CQI, and teaching and research activities.

Due to the nature of their responsibilities and changing environments, PRN nursing professionals typically thrive on variety. 

Opportunities in working with PRN nursing professionals

As nurse staffing becomes more complex, LTC leaders will find it useful to refresh their understanding of the potential outcomes of working with PRN nursing professionals.  

How PRN nursing professionals can help you

Supporting nursing staff: Employing PRN nursing professionals as part of your staffing strategy can yield tangible benefits for your existing staff. PRN options lessen the overtime burdens on full-time staff, contributing to better work-life balance through more flexible work options and reducing factors that contribute to burnout and turnover.

Reducing costs: While PRN nursing professionals can appear to be more expensive on an individual nurse level, they can also be useful in reducing overall facility costs, especially when those costs are a result of staffing inefficiencies. For example, PRN staffing that complements full-time staff can translate to reduced need for per diem staff.

Additionally, using PRN can save on training, hiring, and upskilling, since there is always a pool of trained nursing professionals available to fill gaps from last minute call outs, planned vacations, and extra shifts during periods of high demand (e.g. flu season)—ultimately reducing the frequency at which you need to train or hire additional staff. 

Addressing shortages: Alternative nurse staffing options have been effective in addressing nursing shortages, including minimizing missed revenue opportunities because of issues like having to turn away referrals. Shortages vary by region and over time, and the flexibility of these contingent workers can be a powerful tool for nursing leaders looking for sustainable solutions to ongoing healthcare labor supply issues. 

Empowering nurse leadership: Contingency nursing professionals are a valuable and flexible resource in fleshing out a staffing strategy that aligns with the variability of today’s nursing challenges. For example, if you’ve implemented analytics solutions that have been able to accurately predict changes in supply and demand, PRN nursing professionals can help you build in sustainable flexibility for the future. 

Improving the patient experience: Staffing enhanced by PRN nursing professionals also supports facilities and leadership in providing patients with the best experience possible. Your patients can enjoy enhanced continuity of care, more attentive nursing professionals, and overall higher-quality encounters. 

How to implement and refine your PRN nurse pools

Most LTC organizations have recently undergone a period of significant change—and there’s more to come. Now is an excellent time to implement PRN nursing professional pools. As you move forward, consider some of these key actions

Prioritize engagement

Engaged nursing professionals typically have more positive attitudes and lower turnover rates. Take time to create a sense of community through efforts like professional development specific to the post-acute care setting, shared leadership models, and personalized awards and recognition. 

Establish shared governance

Your PRN nursing professionals are just as responsible for care quality and safety as other nursing professionals. Implementing organization-wide committee involvement in a shared governance model helps keep PRN nursing professionals in the loop and feeling connected to your facilities. 

Create PRN nurse pool visibility

Daily rounding with PRN pool staff helps foster manager visibility. This is crucial to making PRN nursing professionals feel valued and creating a sense of professional connection. These visits also give your nurse managers an opportunity to assess work environments and create relationships with leaders and staff who work with your PRN pool nursing professionals. 

Invest in recognition and professional development

Make sure to acknowledge your PRN pool as a specialty unit, including them in recognition and activities just as you would core staff. This type of initiative is also an opportunity to build in personalized experiences for your PRN staff, such as letting them choose public or private recognition and rewards that align with their shopping and dining preferences. 

Megan Williams head shot

Megan is a business writer with over 15 years’ experience in healthcare enterprise technology. She holds an MBA and B.S. in Healthcare Administration. She now keeps an ongoing eye on the latest developments and successes in healthcare admin technology and the people who use it to build a better world for providers, patients, and their care communities.

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