Per Diem Nursing: A Closer Look at One of the Most Flexible Staffing Models in Healthcare

By ShiftMed Team//Healthcare Staffing Solutions, Healthcare Staffing
Per diem nursing professionals walk through hospital

The healthcare industry has been facing an increasing demand for flexible staffing solutions. According to the American Hospital Association, there will be a projected shortage of 3.2 million healthcare workers by 2026. As patient needs fluctuate and the industry contends with staffing shortages, healthcare organizations must adapt by leveraging versatile staffing models.  

Per diem nursing has recently emerged as a viable and flexible solution, offering numerous benefits for healthcare providers. This article explores the details of per diem nursing, its advantages, challenges, cost implications, and strategic implementation.  

What is Per Diem Nursing? 

Per diem nursing refers to a staffing model in which nurses are employed on an as-needed basis. Unlike full-time or part-time nurses, per diem nurses work irregular hours and are called in to cover shifts when patient volume temporarily increases or when regular staff members are unavailable. This model allows healthcare facilities to maintain staffing flexibility and ensure adequate patient care during peak times or emergencies.  

It’s crucial for healthcare executives to explore and understand per diem nursing as it provides a flexible healthcare staffing solution that can enhance operational efficiency. With the nursing shortage and the unpredictable nature of healthcare demands, per diem nursing offers a way to manage staffing needs without the long-term commitments associated with permanent hires.  

Benefits of Per Diem Nursing for Healthcare Organizations 

Maintaining optimal staffing levels is crucial for providing high-quality patient care. Per diem nursing has emerged as a valuable solution for healthcare organizations, offering a range of benefits that extend beyond traditional staffing models. Below, we explore the key advantages of incorporating per diem nursing into your healthcare facility. 

  • Flexibility: Per diem nursing provides unparalleled flexible healthcare staffing options, enabling organizations to adjust staffing levels in response to fluctuating patient volumes. This model allows facilities to quickly address staffing gaps caused by unexpected absences, seasonal increases in patient numbers, or sudden surges in healthcare demand, such as those experienced during the COVID-19 pandemic. 

  • Cost-Effectiveness: One of the primary benefits of per diem nursing is its potential for cost savings. Employing per diem nurses can be more economical than maintaining a full-time staff, as it reduces expenditures related to benefits, overtime, and other employment-related costs. This model allows healthcare facilities to allocate resources more efficiently, paying only for the hours worked by per diem staff. 

  • Operational Efficiency: Healthcare organizations can enhance operational efficiency by leveraging per diem nurses. Per diem staff can be deployed quickly to fill staffing gaps, ensuring patient care remains uninterrupted. This capability is critical for maintaining high standards of care and operational continuity, particularly in high-demand periods. 

Per Diem Staffing Challenges in Healthcare 

While per diem nursing offers numerous advantages, it also presents unique challenges that healthcare organizations must navigate to maintain quality and operational efficiency. Addressing these challenges requires strategic planning and robust systems to ensure that per diem nurses integrate seamlessly into the healthcare team. Below, we delve into the primary challenges associated with per diem staffing in healthcare and explore potential solutions.  

  • Quality and Consistency: Ensuring high standards of care with variable staffing can be challenging. Per diem nurses may be less familiar with the specific protocols and practices of a facility compared to permanent staff. To address this, healthcare organizations must implement robust training and orientation programs to integrate per diem nurses effectively. 

  • Onboarding and Training: The onboarding and training process for per diem nurses can be resource-intensive. Facilities must invest in comprehensive training programs to ensure that per diem nurses are well-prepared to deliver consistent and high-quality care. Additionally, ongoing support and professional development opportunities should be provided to maintain the competency and engagement of per diem staff. 

  • Regulatory Compliance: Regulatory and accreditation issues are another consideration with per diem nurses. Healthcare organizations must ensure that per diem staff meet all licensing and certification requirements and adhere to regulatory standards. This necessitates diligent record-keeping and compliance monitoring to avoid legal and accreditation issues. 

Cost Analysis of Per Diem Nursing 

Direct Costs 

Direct costs associated with per diem nursing include wages and administrative expenses. While per diem nurses may command higher hourly rates than full-time staff, the overall cost can be lower due to the absence of benefits and overtime payments. Healthcare facilities can achieve significant savings by employing per diem nurses to cover short-term staffing needs without incurring the long-term costs of permanent hires.  

Indirect Costs 

Indirect costs, such as training and turnover, should also be considered. The frequent onboarding of new per diem nurses can incur additional training costs. However, these costs are often offset by the reduced need for overtime and the ability to maintain optimal staffing levels without overstaffing during low-demand periods.  


Evaluating the return on investment (ROI) for using per diem staff involves comparing the cost savings from reduced benefits and overtime payments with the expenses associated with higher hourly wages and training. Many healthcare organizations find that the flexibility and efficiency gained from per diem nursing outweigh the costs. For example, SSM Health reported significant savings by using cost-effective staffing models like per diem staffing via ShiftMed.  

Implementing Per Diem Healthcare Staffing Solutions 

Incorporating per diem nursing management into a staffing strategy requires careful planning. Healthcare organizations should assess their staffing needs, identify peak demand periods, and establish a pool of qualified per diem nurses. Developing a strategic plan that outlines the goals, processes, and resources required is essential for successful implementation.  

Staffing software and platforms like ShiftMed are also crucial in per diem nursing management. These technologies streamline the recruitment, scheduling, and management of per diem staff, enhancing operational efficiency. ShiftMed, for instance, offers advanced tools that simplify the staffing process, ensuring healthcare facilities can quickly and efficiently fill staffing gaps.  

Best Practices: 

  • Assess your facility's staffing needs and establish a strategic plan that outlines goals, processes, and resources for effective per diem staffing. 

  • Implement staffing software and platforms like ShiftMed to streamline the recruitment, scheduling, and management of per diem nurses. 

  • Build and maintain a database of qualified per diem nurses to ensure quick access to skilled staff when needed. 

  • Employ predictive analytics to anticipate staffing needs and proactively schedule per diem nurses for peak demand periods. 

  • Develop flexible scheduling systems that allow for rapid adjustments to staffing levels in response to fluctuating patient volumes. 

  • Ensure comprehensive onboarding and training programs for per diem nurses to integrate them effectively and maintain high standards of care. 

  • Create a supportive and inclusive work environment to enhance the engagement and performance of per diem nurses. 

  • Provide ongoing professional development and training opportunities to keep per diem nurses updated on best practices and facility protocols. 

  • Maintain diligent record-keeping and compliance monitoring to ensure that per diem staff meet all licensing, certification, and regulatory requirements. 

  • Regularly monitor and evaluate the performance of per diem nurses to ensure consistency and quality in patient care. 

  • Foster open communication between per diem nurses and permanent staff to promote teamwork and integration. 

  • Establish contingency plans for staffing emergencies to ensure uninterrupted patient care during unexpected absences or surges in demand. 

Case Study: SSM Health’s Success with Per Diem Nursing 

Several healthcare organizations have successfully utilized per diem nursing and flexible healthcare staffing to address staffing challenges. For example, SSM Health used ShiftMed’s on-demand staffing solutions to transition from traditional agency nurses to a more cost-effective per diem nursing model. This move reduced overall labor costs, with the average on-demand bill rate being approximately $25 less per hour than other temporary labor options.  

Healthcare executives and managers often highlight the positive impact of per diem nursing on their operations. Katlin Rose, System VP of Workforce Optimization at SSM Health, noted, "We found that with this model, we could get workers in quickly, efficiently, and up and running to fill our on-demand workforce needs." Such testimonials highlight the effectiveness of per diem nursing in meeting dynamic staffing requirements.  

Leverage Per Diem Nursing for Optimized Healthcare Staffing Solutions 

Per diem nursing offers a flexible, cost-effective, and efficient staffing solution for healthcare organizations. By addressing fluctuating patient volumes and staffing gaps, per diem nursing enhances operational efficiency and maintains high standards of care. As the healthcare industry continues to evolve, embracing innovative staffing models like per diem nursing will be crucial for meeting the dynamic demands of patient care. With healthcare staffing technologies like ShiftMed, healthcare executives can optimize their staffing models.