Per-diem nurses

Nurses Activism

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I am a registered nurse who works as a per-diem nurse in several hospitals in Florida and want to create awareness among the healthcare industry (mostly hospitals) about the plight and silent injustice that is being perpetrated on per-diem nurses since the inception of its concept.

Per-diem nurses supplement and fill the gaps for hospitals during their acute shortages of nurses such as during holidays or when the hospitals' census is high.

Typically, 4-week schedules are drawn up a month or two in advance and per-diem nurses are scheduled according to hospitals' projected needs. However, for per-diem nurses, that schedule is not worth the paper it is written on because they can be canceled by the hospital any time before the commencement of the shift. Per-diem nurses are often canceled as late as 30 minutes before the shift starts or sometimes even after reporting to the unit "because there was a mistake in the schedule" or "our census went down." In reality, a scheduling slot is created for regular nurses who might have missed a shift during that pay-period.

Per-diem nurses are held accountable for their end of the commitment but the hospitals are not.

A schedule is an unwritten contract between a per-diem nurse and a hospital; as such, each party should be responsible to live up to its committment. There has to be some reasonable compensation for per-diem nurses (like payment for half of the shift) when a hospital's needs have changed at the last minute.

Per-diem nurses have families and bills to pay just like everyone else. They have adjusted their social calendar assuming that they would be working. Sometimes, per-diem nurses have turned down offers from other hospitals for the same shift, only to be canceled by the first hospital. Upon cancellation, it is then too late for per-diem nurses to be accommodated by the other hospital that had offered that shift because it has already made its own arrangement.

It is not unreasonable to think that there are nurses who may consider working per-diem but just do not want to deal with the uncertainty of working on a per-diem basis.

I believe that there ought to be a law where a schedule is honored like a contract and the offending party is required to reasonably compensate the other party for breach of contract.

I live in Orlando but I am from Chicago. The cost of living here is far more as I don't have any family or help with my children. I'd actually probably fare better financially there working nights and getting paid $33+ an hour. I can even live at home and have my mom pick up the kids.

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Specializes in Pediatric, LTC , Alzheimers, Behavioral.

If per diem nurses here in town are cancelled they must be cancelled at least 4 hours before the start of their shift or they are paid 4 hours for the inconvenience.

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Specializes in Pediatric, LTC , Alzheimers, Behavioral.
ajjones1322.......Sounds like you would do much better back home in Chicago. Especially having Mom close by. I know there's a lot of job postings from over that way!!
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I am working per diem, and not only do I NOT get paid extra for being per diem, I also have to pay union dues as if I were a full-time employee. So, my wage is mediocre and the union is robbing me blind by making me pay the highest rate. Unbelievable! I wish I could find a part or full-time job, but now hospitals are advertising for per diem nurses because they can rip us off. I have been unable to find any other job and I have 30 years of experience.

I work per-diem at two hospitals but I don't get paid extra per hour either. I could get a bonus of $35/8-hr shift or $60/12-hr shift at one hospital, but only if those shifts would be paid a shift differential, and bonuses are paid quarterly. I also worked per-diem at a different hospital but in the same corporation, and I got no extra pay whatsoever. At that hospital, I also had to pay union dues the same as FT nurses. What was really outrageous was that they actually billed me for union dues the two or three times that I didn't even work in a given pay period.

However, in the five years that I have been working per-diem with at least one hospital, I have only been called off once. Sometimes it's challenging getting FT hours, but I can usually make up for it at other times by picking up OT.

To those who say, "don't work per-diem then," or "just get a FT job then," well, that's easier said than done. I've been applying for a FT position for more than a year and it hasn't happened yet. In the meantime, like someone already mentioned, I have the same expenses as everyone else. I also do not have a husband or SO helping with the bills, and any bonus I might get doesn't even come close to paying for healthcare insurance or doctor's bills. Hence, I haven't seen my PCP in more than a year, all while dealing with a serious health issue.

I've made my choices and don't expect any sympathy, but I would ask that others think for a minute before making flip suggestions without knowing all the facts.

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I forgot to mention above that I would be paid for 2 hours if I were to be called off. It's not a lot of compensation, but something.

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I work per diem in MA and at the hospital I'm at, I don't get any extra pay either. And yes per diems are always the first to get canceled, but like many said if you need the security of a regular paycheck, get a regular part or full time position. I do per diem because my kids are little right now and I need to be home for them, but being per diem allows me to keep my "foot in the door" for when they are older and all in school and I can go back to working more.

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Nice attitude towards a fellow nurse. Small wonder nursing will always be considred an unprofessional carreer, mainly taken up by women that can't do anything better. Not to mention there may not be a full time job available for her, or that by having access to a per diem nurse may be the only reason you are allowed off to attend a funeral, get your teeth fixed, ot whatever? Shameful and arrogant. I'm embrassed, really.

I agree with you. This is why facilities walk all over nurses. Nurses do not support each other or stand up for their fellow co-workers. We just go home frustrated or leave the profession. We need to join and participate in our professional groups, state nursing agencies/societies and unions to make sure the are representing the true needs of nurses in our area.

If every nurse picked atopic they were passionate about and actually took the time to participate in legislative or public policy issues we would be an incredible force.

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Specializes in Psychiatry.

Thanks Omsteelo and U2BCool

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Specializes in Med Surg Tele.

You are not guaranteed hours when you are a PRN nurse. They tell you that up front. Get over it. If you want guaranteed hours, don't work PRN.

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Specializes in Psych ICU, addictions.
You are not guaranteed hours when you are a PRN nurse. They tell you that up front. Get over it. If you want guaranteed hours, don't work PRN.

That's why I hold two per-diem jobs...so between the two of them, I usually make my desired number of hours each month. But I know I'm not guaranteed anything from either of them.

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Working per diem in Central FL, I figured I'd chime in.

At my facility, I provide them with a schedule of days I want to work. On those days, I am required to call in 2 hrs prior to my shift to see if I am needed. They are able to flex me for 4 hrs, in which I have to call again to see if I am needed. If there is a last minute change, they are required to call me...it seems a bit fuzzy on the amount of time they have to give but I'd imagine an hour. If I show up and am not needed, the unit is required to pay me for 2 hrs. I think that's fair.

Perhaps things are different because it's not per diem with an agency?

To chime in with everyone else, per diem is per diem. You aren't guaranteed hours. To expect the hospital to know what the census will be like a month in advance is just not possible. Can't expect guaranteed pay for the unknown. Patients get discharged daily. I've been fortunate to only recently be cancelled a lot and I've been doing it for a little over a year.

In the OP defense, however, don't judge someone's situation. It may not be easy or there may not be FT or PT positions available. I am per diem for the flexibility. I use to be full-time but after starting a family, one can imagine the need with a little one. With per diem, I make my own schedule, have no weekend requirement, and am only required to work 1 holiday.

I am paid more b/c I have no benefits with the facility. If I elect to get benefits, I would get paid less. With the new portion of the ACA that went into effect this year, they are required to offer benefits now (I'm guessing it's based on amount of employees employed and it's a large facility).

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I work per diem also. But my hospital is unionized and the cancelation requires an hour notice. If the RN has already reported to the unit, the RN (Per diem or regular staff ) is paid 4 hours. Legislation will take awhile. In the meantime, you should weigh your decision of going per diem if stability is a significant consideration for you. Or, pick a specialty that is in greatest demand and where you can get floated, to somewhat minimize your risk of being cancelled. For my case, I acquired multiple specialties to increase y chance at floating. As for legislation, this forum is good for sharing your thoughts but approaching your local Nursing org rep and your local government representative would be better.

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