The term “per diem” has become common terminology within the healthcare industry, particularly in hospital staffing discussions. Originating from Latin, the phrase translates literally to “by the day” and describes a specific employment model designed to offer flexibility for both the healthcare facility and the worker. This arrangement is utilized by hospitals to maintain appropriate staffing levels in the face of unpredictable patient volumes and scheduled or unscheduled absences of permanent staff.
Defining Per Diem Employment
Per diem employment in a hospital setting signifies an arrangement where an individual is hired on an “as needed” basis, rather than with a traditional fixed schedule. These employees are not considered full-time or traditional part-time staff and are generally classified as non-exempt workers paid by the hour. The primary function of this workforce is to serve as a floating pool of personnel to cover immediate staffing deficiencies.
Hospitals rely on per diem staff to manage unexpected spikes in patient census, which can happen suddenly in emergency departments or during flu season, for example. They also fill in for regular employees who call out sick or are on vacation, ensuring patient-to-staff ratios remain safe and compliant. This employment status provides the hospital with a cost-effective mechanism to adjust labor hours dynamically without committing to long-term staffing overhead.
Hospital Scheduling and Commitment Structure
The practical application of per diem status involves a delicate balance between the employee’s flexibility and the hospital’s operational needs. While the employee has a large degree of control over their availability, most hospitals impose a minimum shift requirement to maintain clinical competency and commitment to the facility. This requirement often mandates a certain number of shifts per schedule period, such as four shifts every six weeks, or a specific number of weekend and holiday shifts per year.
Employees typically submit their availability preferences to a centralized staffing office several weeks in advance, and shifts are assigned based on the unit’s greatest need. However, per diem staff are often the first to have their shifts canceled if the patient census drops unexpectedly, making their schedule and income inherently unstable. This dynamic means that while the employee can decline shifts offered, they must also remain available for short-notice requests, which often come with premium pay incentives to fill sudden gaps.
Compensation and Benefit Trade-offs
The financial structure of per diem employment is specifically designed to compensate for the lack of traditional job security and benefits. Per diem employees typically receive a significantly higher hourly wage, often referred to as premium pay, compared to their full-time and part-time counterparts working the same role. This elevated rate is the primary trade-off for not receiving employer-sponsored benefits.
These employees are generally ineligible for comprehensive benefits packages that full-time staff receive, including health insurance, paid time off (PTO), or retirement savings matching contributions. The higher hourly rate is intended to allow the per diem employee to cover the costs of these necessities independently. Since they do not accrue sick time or vacation days, an employee is only paid for the hours actually worked, meaning a cancelled shift or a personal day results in a direct loss of income.