Agency Nurses vs. Staff Nurses: Overview and FAQ

A company is only as great as its employees, which makes managers a vital part of the hiring process for any healthcare organization. As you navigate urgent staffing demands, you might be weighing the options of working with agency nurses vs. staff nurses in your facility or long-term care residence.

To help, we’ll examine staff and agency nursing pros and cons. We’ll look at how these two types of working relationships for nursing professionals compare in key categories to help you decide whether working with a staffing agency could be a good fit for your organization.

Agency Nurses vs. Staff Nurses: Overview

Staff nurses are nursing professionals hired directly by a medical facility as part of their healthcare team, following the traditional hiring process. Staff nurses typically report to the same facility and work in the same specialty unit each shift, which can offer a level of continuity for the patients and team members. They may be hired to work full-time, part-time, or per diem as part of a core staff.

Agency nurses are nursing professionals hired by an outside staffing agency that fill open positions within a range of healthcare facilities. The facility reports open shifts to the agency, and agency nurses can pick up those shifts on a per diem basis. In a given month, an agency nurse could work in a variety of locations or fill a consistent opening in one facility — it depends on the needs of the facilities at the time.

The hiring process is impacted by the decision between staff or agency nurses. Staffing agencies take care of the recruiting and interview process for their agency nurses. This allows facilities to get nursing professionals more quickly than if they did the hiring on their own. Conversely, if a healthcare organization prefers to retain full control of the recruiting process for a certain position and is willing to spend more time hiring, a staff nurse might be preferable.

Additionally, if your organization is trying to decide between using agency nurse vs. travel nurse services, you’ll find that some agencies specialize in travel nursing. Others provide travel nurse options in addition to per diem nursing.

Agency Nurses vs. Staff Nurses: FAQ

Now that you know the fundamental differences between agency and staff nurses, you may have other logistical questions about working with a staffing agency. Below are answers to frequently asked questions about how benefits, compensation, and scheduling differ between staff and agency nurses.

What are the differences in benefits for agency nurses, compared to staff nurses?

Staff nurses receive PTO and benefits directly from the healthcare organization that employs them. These benefits can include retirement plans, tuition reimbursement, and PTO, in addition to health, vision, and dental coverage.

Agency nurses are hired by the staffing agency, so the facility or residence is not responsible for their benefits or retirement plans. This causes many to wonder: Do agency nurses get benefits? Ultimately, this depends on the agency.

Many healthcare staffing agencies hire nurses as 1099 contractors who don’t usually receive benefits. Some staffing partners, however, hire nursing professionals as W2 employees, which normally means that they can provide their nursing professionals with benefits and retirement plan options.

When deciding whether to partner with a staffing agency, it’s important to understand the implications of employee misclassification related to healthcare staffing laws in different states. This is a vital step in determining what partnerships will be best for your healthcare organization.

Is compensation different for agency nurses vs. staff nurses?

Staff nurses are typically salaried, W2 employees and the healthcare organization that employs them contributes to payroll taxes on their behalf. There’s an opportunity for staff nurses to earn at increased rates if they work certain shifts, such as overtime, nights, or holidays.

Agency nurses are usually compensated at an hourly rate. Their monthly pay can vary greatly depending on how many shifts they choose to work and whether those shifts have any bonuses or extra-pay incentives. Often, agency nurses are paid at a higher rate than staff nurses because they fill high-priority shifts that are necessary to maintain stable staffing ratios.

Additionally, when agency nurses are hired as 1099 contractors, they can be paid a higher rate than W2 employees because they must devote a larger portion of their paycheck to taxes at the end of each year — a downside for some nurses that isn’t always clear until it’s time to file tax returns.

The specifics of agency nurse compensation will depend on the staffing partner you choose. If you decide to work with a staffing agency, make sure they have a solid compensation plan for their employees. Well-supported nurses are typically happier and more likely to stick around.

Agency nurses vs. staff nurses: How is scheduling different?

Staff nurses work shifts that are arranged by their nursing management team and can include weekends, holidays, days, or nights. Nurses can coordinate with their team to switch shifts or use their PTO if they need some flexibility in their schedule.

Agency nurses, on the other hand, are able to sign up for shifts where, when, and however often they choose. If an agency nurse doesn’t want to work nights or holidays, they don’t have to — although many do choose these shifts to receive the associated pay increases. This flexibility can allow your facility to quickly respond to staffing needs that result from unexpectedly high patient census or unavailability of staff nurses to cover shifts.

While there can be disadvantages of using agency nurses, many facilities find that the flexibility and ease they provide helps facilitate smooth operations. Agencies differ vastly in the way they operate, the quality of professionals they hire, and the benefits they provide. Be sure to carefully research any agencies you consider partnering with to help prevent unintentional labor law violations.

Looking for a Trusted Staffing Partner?

Staffing a healthcare facility or long-term care residence is no easy task. If you’re weighing the benefits of agency nurses vs. staff nurses, remember that your experience will depend on the partner you choose. With IntelyCare, you’ll find reliable support to help you fill high-need positions with qualified nursing professionals.

IntelyCare writer Alexa Davidson, MSN, RN, contributed to the writing and research for this article.