Per Diem Nursing Pros and Cons

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Written by Kathleen Walder Content Writer, IntelyCare
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Reviewed by Ayana Dunn, BSN Content Writer, IntelyCare
Per diem nurse on shift

When hospitals, nursing homes, and other healthcare facilities are understaffed, employers may turn to per diem nurses to fill the gaps. A study of the per diem nursing market projects a growth of 5.4% through 2030 to equal a total market value of $12.85 billion in the U.S.

That means nurses who are currently working per diem will likely have more opportunities to pick up work. It’s also good news for nurses who are looking to change their work situation to work fewer hours or by controlling their schedule to achieve a better work-life balance.

What Is Per Diem Nursing?

Before we talk about why you might want to become a per diem nurse, let’s define exactly what it is. Per diem nurses work one or more days at facilities that need to fill shifts. Per diem nurses find these shifts through a staffing agency or on their own, say by using a staffing app on their phone.

PRN vs Per Diem

Per diem is not the same as nurses who work pro re nata (PRN), or as needed. PRN nurses are employed directly by one facility, and agree to work as they are needed. They don’t get a choice of when they work, but most of the time, their employer guarantees a minimum number of shifts they will work in a year. They are usually entitled to benefits.

Per diem nurses work independently at a number of different facilities on an as-needed basis. They may be called on consistently during flu season, or summers when full-time nurses are taking time off. Per diem nurses are not employed directly by a provider and are not guaranteed a set number of working hours.

Pros and Cons of Per Diem Nursing

If you’re a nurse thinking about changing the way you work, we’ve put together some pros and cons of per diem nursing to help you decide if it is for you.

Salary and Benefits

Pro: You generally make more money per shift by working per diem than by working as a full-time staff nurse. You’ll probably make even more per shift on weekends and holidays.

Con: A lot depends on whether you are working per diem as a 1099 contractor or as a W2 employee. While you may win a bigger paycheck up front working as a 1099 contractor, the staffing agency that provides you with shifts actually saves money because you’re not on payroll and they don’t pay you benefits. So you’ll need to buy health insurance on your own and save for your retirement independently. You need to be good at budgeting when you work per diem 1099 because you may not make enough to cover your expenses if you can’t find enough per diem shifts to take. You’ll also likely have to plan to pay income taxes since it won’t be withheld from your paycheck. As a per diem nurse with a W2, your tax deductions will come out of your paycheck, and you may also be eligible for benefits.


Pro: One of the biggest reasons nurses work per diem is because you work when and where you want to work. You’re not obligated to work anywhere. You can take a vacation and days off to suit your schedule. If you’re a travel nurse, you can combine work and vacation.

Con: You can pick your schedule, but full-time staff always get the shifts they want first. You won’t be paid for time off, and you may not get paid sick time, depending which state you are in. Shifts can get canceled at the last minute. That leaves you no time to find another shift, which is bad news if you’re counting on the money.

New Skills and Contacts

Pro: If you’re looking to eventually work full-time, per diem nursing lets you test drive a facility or department. You might even make contacts that can help you land a job if one becomes available. You may also have the opportunity to learn new skills, work with new equipment, and observe a specialty area that may interest you.

Con: Per diem work gives you no job security. Your shift can be canceled or you can have difficulty finding shifts if there is a low patient count, or if a department becomes fully staffed.

Get All Pros With Per Diem Jobs on IntelyCare

Does per diem nursing appeal to you? Check out all the available per diem shifts available on IntelyCare right now, and start building a schedule that works for you.