I began working as a Per Diem Nurse (Read: What is a Per Diem Nurse) in 2018 after burning out from a full-time critical care position I held for five years. I was fed up with the rigid system that prevented me from taking time off when needed. Constantly having to beg my manager for time off or negotiate with other nurses to switch shifts became exhausting. During that time, I was frequently denied vacation requests—even ones I had made a year in advance. I was simply done with the mental torture of that workplace.
At the time, I was young, without major commitments, and had saved enough to leave my full-time role. Per Diem nursing gave me the freedom to choose my shifts. I could work one day per week or four, depending on my preference. Fortunately, where I work, I even have the option to pick up full-time hours, thanks to a hospital policy of no shift cancellations (shoutout to a strong union!). I can take vacations whenever I want, without worrying about seniority or a lottery system deciding when I can take my damn vacation.
However, it’s now 2024, and my carefree nursing days have evolved as I’m now a mom of a toddler. I’ve started to question my Per Diem status—primarily due to the cost of health insurance. According to KFF.org, the average annual health insurance premiums in 2023 are $8,435 for single coverage and $23,968 for family coverage. Premiums rose by 7% in 2023 alone, and since 2018, the average family premium has increased by 22%.
But, if you’re still intrigued by the prospect of being a “Per Diem Princess,” here are a few essential considerations:
You Have a Partner or Spouse with Health Insurance Coverage
This is an ideal scenario and is pretty common among my nurse colleagues. One RN spouse remains full-time to secure health benefits for the family, while the other works Per Diem, enjoying the higher hourly rate. Personally, I sometimes wish I had a partner in healthcare who could cover my insurance. Instead, I pay $800 a month for coverage for myself and my son, while my partner pays $700 for his plan. Well, hindsight is 20/20—lol.
You Live and Work in a State with Premium Per Diem Rates
Pay scales vary significantly by state. If you’re looking for top Per Diem rates, look no further than California. California nurse salaries are already one of top if not the highest in the US. As a Per Diem nurse in Los Angeles, I make $92 per hour, thanks to a recent 2% raise in October.
You Work at a Hospital with Strong Union Protections Against Shift Cancellations
Nothing irks me more than showing up for work—after getting up, getting ready, and commuting 40 minutes—only to have my charge nurse ask, “Do you want to go home?” Absolutely not! Float me if needed (though I’m begging you not to, lol), but I’m here to earn my paycheck. Thanks to a stipulation in our union contract, we can’t be forced to go home due to low census. This is something worth asking about when considering a Per Diem role.
You Have a Profitable Side Hustle
With control over your schedule comes the question: what will you do with all that extra time? Personally, one reason I’ve remained Per Diem is to have the flexibility to work on my side hustle. Although my side hustle income hasn’t yet replaced my per diem earnings, I appreciate the freedom to balance both.
You’re Disciplined with Finances
Per Diem work means variable income, no paid sick days, and healthcare costs—so financial discipline is a must. Aspiring Per Diem nurses should prioritize a healthy emergency fund and contribute pre-taxed income to retirement accounts to reduce taxable income and avoid surrendering a large portion to taxes.
You and Your Family Are Generally Healthy
Maintaining good personal health—and having family members who don’t require frequent medical visits—is critical. Without employer-sponsored healthcare, Per Diem nurses bear the full cost of premiums, deductibles, and out-of-pocket maximums. If you or a family member need frequent medical care, these expenses can pile up quickly, so weigh this risk carefully.
If you’ve checked off “Yes” to most of these, good luck—and enjoy life as a Per Diem Princess!
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