Per-diem nurses

  1. 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
    Last edit by Vishwamitr on Aug 2, '13 : Reason: Syntax error
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    About Vishwamitr

    Joined: Apr '12; Posts: 157; Likes: 168
    RN; from US
    Specialty: 15 year(s) of experience in Psychiatry


  3. by   iLOVEbees
    Per diem nurses get paid more because of the inherent volatility.

    You want the higher pay but want the government to take away all the volatility.
  4. by   ANnot4me
    If I hear Florida and nurse in the same sentence my short-term memory fails. Now, what was I saying?
  5. by   TheCommuter
    I've been working per-diem/PRN at the same place for three years by choice. I am paid $11 more hourly than full-time staff due to the lack of benefits, risk of shift cancellation, minimal commitment to the facility and uncertainty of the hours worked.

    I accepted this per-diem/PRN job knowing that my shifts would be the first to get cancelled. However, my flexibility is far more important at this point in my life, so I deal with this situation willingly.
    Quote from Vishwamitr
    Per-diem nurses have families and bills to pay just like everyone else.
    Are there not any full-time positions available in your geographic area that would either reduce or eliminate the possibility of your shifts getting cancelled at the last minute?
  6. by   Nspirit
    I work per-diem as well and the higher pay makes up for the inconveniences pointed out in your statement. However, I agree we should get a cancellation fee like agency nurses receive. Since I've worked per-diem at my facility, I haven't been canceled.
  7. by   Nspirit
    I worked in Florida for 3 months. The nightmare for me was the pay. I am an LPN and I received $7 less
    than what I get paid up here. I get paid more up here than an RN down there. Needless to say, I migrated back north. I loved the people I worked with in Florida.
  8. by   brownbook
    I hope this is just a vent after a few bad scheduling messes. When you sign up for per diem some of what you describe is what you knew, or should have known, is what per diem means.

    I have had per diem nurses call me (when I did staffing) prior to their shift (if I hadn't called them yet) to confirm if they would be scheduled. I didn't mind at all.

    If there is one particular hospital staffing person who seems to frequently do these late cancellations, always double check with them before you leave your house.
  9. by   NurseDirtyBird
    I agree that it is inconvenient, especially if you have any kind of commute. I think if nurses have to call out of their shift two hours in advance to let management know they won't be coming in, then management should have to let a cancelled nurse know at least two hours in advance. That would be fair. I don't really think a cancellation fee is ever going to happen though. They cancel your shift to save money, and PRN nurses get paid extra for the short notice and lack of benefits.
  10. by   Anniehow
    I believe that is the point of the extra "per-diem" pay. If you feel the extra pay is not a fair exchange for the inconvenience, we still live in a somewhat free country, find a full time position.
  11. by   RNitis
    Perhaps it's bc I work in long term care (or it's bc I was a brand new nurse-RN when they hired me, so they had to train me), but I don't get a "per diem" rate as u all talk about here. I get paid starting rate for a new nurse in the state of CT. Is that normal or did I short change myself?
  12. by   Altra
    Then don't work per diem -- get a job as regular staff, full- or part-time, as meets your needs. There is no injustice here that I see.
  13. by   LadyFree28
    You can always find another per-diem job...

    When I worked per-diem, I always had another in order to make sure if I got cancelled at another facility, I had another way to make money.

    It would be nice for facilities to give 2-4 hours of pay for last minute cancellations; I just don't see it happening.
  14. by   TheCommuter
    Quote from RNitis
    Perhaps it's bc I work in long term care (or it's bc I was a brand new nurse-RN when they hired me, so they had to train me), but I don't get a "per diem" rate as u all talk about here. I get paid starting rate for a new nurse in the state of CT. Is that normal or did I short change myself?
    Most of the LTC facilities in my area do not offer a significantly higher rate to PRN/per diem staff. Sometimes PRN/per diem nurses get the same wage as the full time staff, whereas other facilities may only offer a dollar or two more per hour. This might be part of the reason why LTC facilities have difficulty attracting and retaining quality PRN/per diem staff.

    Many hospital systems, on the other hand, will offer PRN/per diem nurses a significantly higher hourly pay rate to compensate for the many inconveniences surrounding this classification. My proposed full-time pay rate would be $11 less than the current PRN/per diem rate being offered by the hospital where I work.

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