Per Diem pros/cons

Been there,done that, ASN, RN · Feb 10, 2021

That day/night rotation is what's really the problem. Could you find a day position?

Whatever, sounds like you need a break. The vaccination clinic could work. But... how would you get your health insurance?

JBMmom, MSN, NP · Feb 10, 2021

If you don't need the benefits, it sounds like a good move overall for your health and family balance. If you are the source of the benefits then going without health insurance would be a deal breaker for me. Too risky these days not to have reliable insurance and private insurance is astronomically expensive.

RNperdiem, RN · Feb 10, 2021

Is it only work that is leaving you so exhausted? Working 2 shifts a week isn't a bad gig for a mom with young kids. Is the workplace toxic? Is there trouble at home? Money issues? Anything outside of work that needs working on? A complete physical?

I guess I am trying to say that it is not normal to be in a flight or flight state for a part time job, unless the job is just that bad.

Per diem is risky if you don't have a backup income full-time with benefits. The hours are not guaranteed. You will be the first on cancelled and the bills will still keep coming. I would recommend that if you do take the per diem vaccination job, you first shop around to buy your own health insurance policy to cover the gap. While you are working the per diem job, have another job lined up so when you finish, you don't end up scrambling for whatever low quality job you can get.

Emergent, RN · Feb 10, 2021

Excellent advice @RNperdiem

I second it. Also don't recommend until you are married and he is working fulltime. If he is worth his salt he will be working his butt off so that you can concentrate on your kids and the home.

Call me old-fashioned, but I have a little life experience here. I also second the idea of you getting a health workup along with labs checking your thyroid, and the rest of your endocrine system. Also, make sure you are eating a very healthy diet, getting physical activity and plenty of sleep.

kitten0509 · Feb 10, 2021

Thanks for the advice so far. I can clarify a few things. I'm on Levothyroxine and Vitamin D supplements and seeing an endocrinologist already for my health. Yes, I'm overweight and have poor energy/fatigue. This is part of the problem. The day/night rotation is also part of the problem, its taking me longer and longer to recover from night shift as time goes on. Working days would help with the problems from nights, but it won't help with the acuity and never knowing whats rolling in the door, which in the ED- happens at all times of day.

I'm in counseling for myself to help with anxiety, work life balance, parenting and my health as well as couples counseling to help with work/life balance, parenting and anxiety around the political climate. My work environment is not toxic, in fact, I get along very well with management and they're extremely supportive. But working in a level 1 trauma ED, I have to be ready at any moment for a cardiac arrest, stroke (or 3), falls, MVC, gunshot, broken toe, COVID PNA, or any and all of the above to roll in one after another, at any moment. Then, when I get home, my girls want my immediate attention, they want to eat dinner with me (read: eat my dinner) or I have to go to sleep- and as soon as I wake up, they want my attention. Or I have to sit with my 6.5yo and keep her on task with her schoolwork (non-school days), or my 4yo is asking me to play with her because she doesn't have enough social/emotional stimulation from kids her own age because of COVID.

So- something has to give. I can't give my family or myself the mental energy they deserve, and ultimately I put myself last- and my health and weight are suffering as a result. As stated, I'm in therapy for this already. I'm literally doing every.thing.I.can. to help sort these things- and something has to go. As someone recommended, my fiance could put the girls on his insurance (he's their dad), so I don't think that would be an issue with per diem. I would just have to figure out insurance for myself.

I don't think I can stay in the ED for another 2 years, we're getting married in 2022. We've also been together for 11 years, so I'm not really sure that waiting until we get married would make sense here. The only reason he works part time is because it allows flexibility in his schedule for me to work long shifts and pick up extra if I choose, since I make more money than he does. It really makes more sense for me to be the one who works more hours since I have the ability to make more money- unless he wants to put himself through college and go on some type of professional/career exploration at this time, which he doesn't, and neither do it (want him to). I don't know. I'm not trying to come up with excuses for not staying doing what I'm doing, but I am trying to figure out what to do that would keep my schedule flexible and allow me to keep making good money, in order to achieve the balance I'm looking for.

Happy to entertain more thoughts/ideas on this!

Sour Lemon · Feb 10, 2021

Why get married in 2022 when you've been together for 11 years and have two children? I'd get to court, get "legal", and get myself on his insurance. Today.

I have two small children and work per diem. My husband works full time and carries the insurance and other benefits, even though I make more than he does. If your husband makes enough to live off, this may be the best option. I could work constantly and have more "stuff", but time is more important to me.

I also have thyroid issues and find that levothyroxine is just not quite enough. I take a small dose of prescription stimulants along with it, and that brings me back closer to normal. I'm not sure how you'd feel about that, but it might be something to explore with your doctor.

I'm a healthy weight and I eat healthy, but I've noticed that when I slip up a bit and overeat sugar, is has a huge draining effect on me. In fact, I feel best when I eat no sugar, at all.

Anyway, those are the things that work for me. I stay in the hospital to keep more doors open. If I need to suddenly flip to full time and support my family, it could be easily accomplished. In my case, just knowing (and choosing) exactly when I work and how often I work is enough to evade most work-related stress.

Side note: I do have a small 401K as per diem staff. I'm not sure how common that is.

Daisy4RN · Feb 10, 2021

I would seriously (re)consider taking the vaccination job as at some point it will more than likely end and you will be job searching once more. There are other per-diem jobs you could get that would be more permanent (even though per-diem is not permanent per se). I worked at a hospital per-diem which also had 2 levels of per-diem so you would want to know the specifics of each per-diem job r/t location and/or level. Also, if you work per-diem in a lg facility (like a hospital) you have a better chance of always having work becuase you can work different units. This could help with the stress because you avoid unit politics etc. Also, it will be harder to get a job later with only (current) vacc experience. If possible, what sourLemon suggests would be a good idea. If not, look into medical insurance options, you can check the gov site to see how much it would be in your area. Before you make any decisions I would do the math and have a talk with your SO since you do indeed plan to marry (2 heads are better than one).

Sounds like a tough situation, hope you can get some relief!

Emergent, RN · Feb 10, 2021

It does sound like you are ready for a different specialty. You have gotten solid experience from that, and you are getting burnt out. Then there is the whole pandemic situation which is definitely stressing out parents of school children. You have a few health problems that you can work on.

Maybe take the vaccine job, which is of course temporary. That would tide you over until you decide your next more permanent career move

speedynurse, ADN, BSN, RN, EMT-P · Feb 10, 2021

Actually I totally understand the flight of fight response in the ER. I think at a certain point it is time for a different speciality - mentally, physically, and emotionally. I am in surgical services and honestly, it’s really nice knowing what to expect coming in.....if you need something different, then do it! You can always go back to the ED if you want to.

Nunya, BSN · Feb 11, 2021

Can you get a part time job that's straight days and not temporary like the vaccination job, one that's not as stressful as the ER? Working nights is tough even if you like nights, switching between the two shifts every 2 weeks is crazy and should be outlawed. I LOVE nights and I would never take a job where I had to switch every two weeks, and I'm old enough to know that I should never say never but that's something I know for sure I won't do. Are your night shifts both in a row or spread out? It might be easier to get them both in a row if they aren't. Have you talked to your fiance about your need for some quiet time when you get home? Maybe he can help with that. Of course your kids will want to see you but you need/deserve a little down time too, even if it's only 30 minutes to go take a shower. And if you're on nights you don't get home till after 7 (probably) so your girls shouldn't be eating YOUR supper, they should have already had theirs and if anything they can have a snack. If your fiance doesn't cook there's easy meals he can make (my dad always made us hot dogs and pork 'n beans when Mom was sick) or frozen pizza or fish sticks with mac 'n cheese etc. And seriously consider getting married now so you can get on his health insurance, then if he can increase his hours at least until you get a less stressful job that'll help. You can always do a big wedding/reception in 2022, many others are doing that. Good luck!

kitten0509 · Feb 11, 2021

Any thoughts about PACU??? I just found and applied to a 20 hour position, evenings. This would be the minimum I could work, still maintain benefits, come off nights. Would this be less of a stressor you think?