"Per Diem" means "by the day." In other words, nurses working in a per diem role are essentially working on call.

Working on call means different things based on the facility or organization. For example, the nurse may be called same-day for sick calls. Shifts may vary from a partial shift to an eight to twelve-hour day (depending on the organization). Per diem nurses can also be pre-scheduled to fill in for regular staff who will be off on vacation, etc.

Per diem nurses can also be hired for seasonal staffing coverage; for example, during cold and flu season where patient care demand spikes, or summer when many nurses go on vacation. Holiday coverage is also sometimes considered "seasonal," as many nurses request that time off.

The benefits of working on call are that nurses can choose when they want to work. They can decline offered shifts if they are not available and accept work on days when they are. They can pick up holidays where the pay will be higher. They can be available for their children's daily needs. Also, they are not tied to any specific schedule. Per diem nurses also are typically paid higher than regular staff as they do not have set hours and sometimes have no benefits such as health insurance.

One of the disadvantages of working per diem is that sometimes nurses may not be needed. They may go a week or two without an offered shift. This can result in financial strain if the nurse has no other source of income. Also, per diem nurses are typically not benefited. They may not have health insurance, paid vacation or sick time, etc. Again, this may cause financial strain if the nurse has no other income or health coverage.

Amanda Bucceri Androus, RN, BSN

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