How is it fair to put PRN nurses on call?

~PedsRN~, BSN, RN · Jan 24, 2016

That is part of being PRN - you are only guaranteed your required minimum hours. For example, I am required to work 24 hours in a 6 week period. As long as I get those shifts in, everything else I work is "extra". I am not going to get extra hours while full timers are called off, so they do not get THEIR hours. Does that make sense?

If you are wanting to work more hours, why not go part time? Then you'll be guaranteed shifts.

Pangea Reunited, ASN, RN · Jan 24, 2016

Full time people get their hours first. If you only want to work when it's convenient for you, I think it's fair that that hospital only pays you to work when it's convenient for them.

On the bright side, staffing usually varies and there will probably be times when you can work as much as you want- even into overtime.

heron, ASN, RN · Jan 24, 2016

That's what prn means - as needed. You are not getting any guarantee of hours in return for the flexibility of setting your own schedule, with no obligation to work when you can't or don't want to. This is why many agency nurses work for more than one agency.

You might consider asking to change to part-time, or signing up with an agency.

I'm curious - what did you want to accomplish by switching to prn? Knowing that might give some hints as to how to proceed from here.

crazin01 · Jan 24, 2016

I used to work in a smaller hospital in my hometown years ago. I'm not sure if this is the same everywhere, but they used to give PRN/flex employees a significantly higher hourly wage compared to FT'ers. So, of course the facility will call off those PRN folks before others, to save the almighty buck. The difference in pay is extremely higher, which allows PRN to purchase their own benefits via the insurance folks/company directly. Thus is was usually a win-win situation for employer & employee alike.

Especially if a PRN employee is in good health & won't require a really good health insurance plan, minimizing the out-of-pocket costs for employee.

I am not sure about other facilities policy for on-calls & cancellations. But at this small hospital I mentioned, we did not have too many PRN employees. So, we had a 'call-off' binder at front nursing station and everybody would take their turn at being called off. The previous shifts charge nurse would go through this binder and compare incoming staff members to determine who was called off the longest time ago. And then that person was called off/cancelled. (hope that makes sense).

The charge nurse would speak with the supervisor for entire facility to ensure other floors were not short, and would often not cancel that PRNs' shift, ensuring entire facility has adequate staffing. It was always the employees responsibility to notate the date of most recent cancellation to ensure it is not always the same folks losing shifts or being pulled to another floor with poorer staffing.

I hope I explained that satisfactorily.

I agree with PP's about possibly looking into becoming PT. But then you don't usually get to pick which days you are off and which ones you will be scheduled for. Are other floors staffed inappropriately on a regular basis? Maybe you could tell HR and other managers you really would like more hours instead of being placed on-call or cancelled and be willing to cross train (if necessary since you're in ER). I'm also curious if you get paid a tiny wage/hour just for being on-call. And then if you are actually called in, would you only received your normal wage, or 'bonus/OT time'? As Heron said, I am also curious what prompted the change in status. Depending on the factors that prompted you to change to PRN, PT might be a good way to go. (sorry I don't have any words of encouragement!)

RNperdiem, RN · Jan 24, 2016

I have worked per diem for a long time now. Life is about trade-offs.

What matters most? For me, I wanted the higher pay for the fewer hours a week I would work and the complete freedom of schedule I could work around my family needs. In return, I am not quite part of the team the way I was when I was full time. I joke to myself that per diem is a high end day laborer. The hours are not guaranteed and I am familiar with the 0500 ringing of the phone.

I wonder if you are working in a department that doesn't really need extra nurses right now. You can wait it out; someone is bound to go on maternity leave or leave for another job. You can try signing up for less "popular" shifts- wherever there tends to be a shortage. I know some per diem nurses who pick up shifts in a chronically short staffed unit to avoid being called off.

roser13, ASN, RN · Jan 24, 2016

Absolutely it's fair. What wouldn't be fair and wouldn't make sense is for full-time folks to be called off, while calling in more expensive PRN folks.

sarabear44 · Jan 24, 2016

Thank you very much for your replies, for taking the time to write! It really helps me put things in perspective.

I switched to PRN, so I could go down to one shift a week. As opposed to other PRNs, I committed to one shift per week, so that's probably why I feel entitled to that, but there isn't a PT contract available for that, so I had to take. PRN contract... The reason was my second child was born and we didn't want to hire out child care.

So I pick up hours on weekends and evenings when my spouse is home.

I only earn $4 more per hour, so it doesn't make up for the lost PTO and benefits...

The he thing I this is unfair is that FT staff can use their PTO to make up for lost income while on call and I don't have any PTO, so my family goes without......

I think I'll make a meeting with my mgr to talk about PT.

KelRN215, BSN, RN · Jan 24, 2016

That's how PRN works. PRN employees are as needed. When you are not needed you are canceled or put on call. When full-timers are called off, they have to use their PTO. So if you work while a full-timer is canceled, the hospital has to pay you both. PRN employees have been canceled first everywhere I've ever worked.

nutella, MSN, RN · Jan 24, 2016

Working PRN is with the understanding that you have no responsibility to work besides whatever the minimum is that you agreed on. It gives you all the flexibility and you can just say "no" - but of course - no benefits and no guaranteed hours.

I worked PRN for a couple of months when I was not able to work full time. It was really great to be flexible but my hours really varied a lot. Once my personal situation improved I went back to at east 30 hours/ week for a steady income.

VANurse2010 · Jan 24, 2016

I don't have an issue with PRN nurses being cancelled for low census - that's how it should work. I don't agree with PRN being put "on call" unless you are given the option to take call or be cancelled altogether.

mightynurse4 · Jan 24, 2016

My hospital doesn't always call of PRN first. So I think it varies. I work PRN and I have came into work and saw that 2 full time staff were called off and we worked with only PRN staff. Yesterday was an example of that, actually. A full time nurse was called off and we had myself and one other PRN nurse working. We are a small unit with only 2-4 nurses staffed at one time depending on census.