Effective Onboarding: Best Practices for Integrating Per Diem Nurses into Your Healthcare Team

By ShiftMed Team//Nurse Retention, Healthcare Staffing
Per diem nurse attending orientation session at hospital

Effective onboarding is crucial for integrating per diem nurses into healthcare teams, ensuring they can provide high-quality patient care and feel part of the team. With the growing trend of employing per diem nurses to address staffing shortages and fluctuating demands, it’s essential to develop onboarding strategies. This article explores the importance of effective onboarding strategies and provides best practices for integrating per diem nurses into your healthcare team.  

Understanding Per Diem Nursing 

Per diem nurses are healthcare professionals who work on an as-needed basis, filling in for permanent staff during peak times, vacations, or unforeseen absences. Their flexible schedules allow healthcare facilities to manage fluctuating patient volumes and staffing needs without the long-term commitment of hiring full-time staff.  

Per Diem Nursing Benefits: 

  • Flexibility: The primary advantage of employing per diem nurses is the flexibility they offer. Healthcare facilities can adjust staffing levels based on patient demand, ensuring they have the right number of staff during peak times without overstaffing during slower periods. This flexibility helps maintain optimal patient care standards and reduces the strain on full-time staff, who might otherwise be overworked. 

  • Cost-Effective: Employing per diem nurses can be more cost-effective for healthcare facilities. It reduces the need for overtime pay and minimizes the expenses associated with full-time benefits like health insurance, retirement plans, and paid time off. This allows facilities to allocate resources more efficiently and manage their budgets more effectively. 

  • Experienced Professionals: Many per diem nurses bring a wealth of experience and diverse skills from working in various healthcare settings. This enables them to adapt quickly to new environments and contribute insights and expertise to the team. Their diverse backgrounds can also enhance the quality of care provided and introduce new practices to the facility. 

 Onboarding Challenges in Integrating Per Diem Nurses: 

  • Inconsistent Presence: One of the main challenges in integrating per diem nurses is their sporadic schedules, which can make it difficult for them to integrate with the team fully. This inconsistency can lead to gaps in communication and continuity of care, potentially affecting patient outcomes and team dynamics. 

  • Lack of Familiarity: Frequent changes in staff can disrupt team cohesion and workflow continuity. Per diem nurses may not be as familiar with the facility's protocols, culture, and routines as full-time staff, leading to potential inefficiencies and misunderstandings. This can also affect their ability to form strong working relationships with other team members. 

  • Orientation Needs: Per diem nurses require thorough orientation to adapt to different healthcare environments quickly. Each facility may have unique protocols, equipment, and patient care standards that per diem nurses need to learn quickly. Without proper orientation, there is a risk of mistakes and inefficiencies, which can affect patient care and safety. 

Importance of Effective Onboarding Strategies 

Impact on Patient Care and Satisfaction 

Effective onboarding strategies ensure that per diem nurses are well-prepared to provide consistent care. When nurses are familiar with the facility's procedures, they can deliver care more efficiently. This translates to better patient outcomes, as nurses can respond quickly and appropriately to patient needs. Additionally, patients are more likely to be satisfied. 

Reduction of Turnover Rates 

Efficient onboarding practices can reduce turnover rates by fostering a sense of belonging among per diem nurses. When nurses feel valued and well-integrated into the team, they are more likely to remain with the organization. Reducing turnover saves on recruitment and training costs and helps maintain continuity of care, which is crucial for patient satisfaction.  

Enhancing Team Collaboration

Onboarding strategies that emphasize team integration help build trust and collaboration among staff. A well-integrated team can communicate more effectively, share knowledge, and support each other in delivering patient care. This collaboration enhances the overall work environment, making it more productive and satisfying for all team members, including per diem nurses.  

Best & Most Efficient Nurse Onboarding Practices 

Pre-Onboarding Preparation: 

  • Clear Communication with Staffing Partners: Establish clear communication channels with staffing partners to ensure that per diem nurses are well-informed about their roles and expectations before they arrive. Providing detailed job descriptions and facility protocols helps prepare them for their assignments. 

  • Streamlined Documentation Process: Streamline the documentation process to make it as efficient as possible. This includes ensuring all necessary paperwork, credentials, and compliance checks are completed before the nurse's first day. Using digital onboarding tools can help facilitate this process. 

Nurse Orientation and Training: 

  • Customized Orientation Programs: Develop orientation programs tailored specifically for per diem nurses. These programs should cover essential information such as facility layout, emergency procedures, and key contacts. A condensed yet comprehensive orientation ensures that per diem nurses can quickly adapt to their new environment. 

  • Hands-On Training and Shadowing: Incorporate hands-on nurse training programs and shadowing opportunities into the nurse onboarding process. Pair per diem nurses with experienced staff members who can provide guidance and support as they learn the ropes. This practical experience helps them become comfortable and confident in their new roles. 

Integration into the Team: 

  • Pairing with Mentors: Assign mentors to per diem nurses to provide ongoing support and foster a sense of inclusion. Mentors can help new nurses navigate the facility, answer questions, and offer advice on handling specific situations, ensuring they feel supported. 

  • Involvement in Team Meetings and Activities: Encourage per diem nurses to participate in team meetings and activities. This helps them stay informed about unit updates, build relationships with colleagues, and feel like part of the team, even if they are not there full-time. 

Ongoing Support and Feedback: 

  • Regular Check-Ins and Feedback: Schedule regular check-ins and feedback sessions with per diem nurses to address any concerns and provide constructive feedback. These help identify areas for improvement and reinforce positive behaviors, contributing to their growth. 

  • Access to Resources and Support Networks: Ensure that per diem nurses have access to the same resources and support networks as full-time staff. This includes access to continuing education opportunities, employee assistance programs, and professional development resources. Providing these supports helps per diem nurses feel invested in their roles. 


Effective onboarding is essential for integrating per diem nurses into healthcare teams. By implementing best practices like clear communication, customized orientation programs, mentorship, and ongoing support, healthcare facilities can ensure that per diem nurses are well-prepared, confident, and integrated into the team. This not only enhances patient care and satisfaction but also reduces turnover rates and fosters a positive work environment.  

ShiftMed is well-versed in supporting healthcare organizations with the onboarding process of per diem nurses. Our approach ensures that many of our nurses become regular workers at healthcare facilities, seamlessly blending into existing full-time teams. Moreover, ShiftMed offers a free bridge to hire our nurses full-time, allowing facilities to permanently hire nurses who have integrated well, without any buyout fee. By partnering with ShiftMed, healthcare organizations can enhance their onboarding strategies, ensuring a smooth and effective integration of per diem nurses into their teams.