Because it is viewed as a very "easy" specialized field, even though they want all these certifications in audiometry, spirometry, DOT urine drug screening, BAT, oh, and to know all the OSHA 300 rules and workers comp. etc. Employers regard it as less than acute care, so therefore less demanding. Re: contracts...depends on the type of contract as far as what it does for the employer. If they have a big corporation like Whole Health Management or Johns Hopkins Univ. heading up multiple sites, then the employer gets the benefit of having the corporate physician available for any issues that come up for one price. Also, most corporations are in the business of business, and don't know squat about hiring, screening, employing, etc. nurses. So, they hire an agency who does that all the time, and the employer just gets supplied with the nurse they want-plain and simple. Re: long term contracts: it is definitely a cost savings to a corporation because they do not have the additional financial burden of contributing to the 401K of the nurse, the health insurance, etc. (And most agencies don't really offer good insurance-so you usually end up getting your own or rolling the dice and hoping nothing happens if you take the agency insurance.) There are also no bonuses paid out to the nurse, etc. The thing I have found about working a long term contract for a major employer, is that I finally end up getting angry. One of the things you do is counsel employees on their benefits-for EAP, for FMLA, for vacation, for restricted work duty, for Flexible spending accounts, long term disability, etc. And as a contractor you are counseling these "elite" corporate employees about all these wonderful benefits, then you stop and say...hey, wait a minute...I am fully involved in this company, know all the managers, etc., work with them every day with the object of saving them $$ on getting reasonable return-to-work times, and absence management, etc....and I don't have ANY of these great benefits. What is wrong with this picture??!! So, I make it a point to never work a long term gig as a contractor. Does this help?