5 Flexible Staffing Options for Healthcare Facilities

A group of healthcare facility administrators in conversation
Written by
Jenna Elizabeth
Reviewed by
Miranda Kay, RN
June 4, 2024

5 Flexible Staffing Options for Healthcare Facilities

Nurses are leaving their jobs in swarms, but where exactly are they going?

Some may choose to exit the healthcare sector indefinitely. Others may try out per diem nursing, which offers nurses more flexibility and the opportunity to work exclusively on an as-needed basis. As a result of this exodus, healthcare facilities nationwide are seeking more intelligent and creative ways to manage staffing gaps.

Whether you are a hospital’s Chief Financial Officer (CFO), healthcare administrator, or staffing manager. Keep reading to learn about the best flexible staffing options and some great ways to effectively manage these alternative staffing models in your healthcare facility. 

Is There a Nursing Shortage? 

The short answer is yes. High turnover rates, nurse burnout, and an aging population are the main factors aggravating the current nurse staffing shortage. Moreover, a recent comprehensive study by Nursa, which surveyed 203 hospital executives, showed that 86 percent of hospitals and health systems saw 10 percent or more of their nursing staff quit in 2023. 

For some facilities, these statistics are a harrowing reality; for others, this situation offers a chance to step up and confront the nursing crisis head-on. 

For example, the same study found that 63 percent of health system executives believed they could offer greater flexibility to staff if they had a larger pool of nurses. Luckily, flexible staffing options such as the PRN staffing app, Nursa, local contract nurses, and travel nurses are alleviating nurse shortages and simplifying recruiting in a big way. 

What Is Flexible Staffing?

Flexible staffing is a strategy that healthcare facilities can use to scale their workforce based on growing or shrinking demand. A flexible staffing model can be particularly beneficial in healthcare settings where facilities have different labor needs, for example, varying patient volumes or frequent call-offs from regular nurse staff. Flexible staffing can help healthcare facilities only pay for needed clinicians, reducing costs while offering nurses more control over their work schedules. 

How Can Healthcare Facilities Benefit from Flexible Staffing?

Flexible staffing comes in many forms. From using Nursa to hiring travel nurses to finding contract nurses through nurse staffing agencies, there are plenty of ways a healthcare facility can find nurses to cover gaps in coverage and benefit from the extra “padding” flexible staffing provides. 

Healthcare facilities can also benefit from flexible staffing models in the following ways: 

Building Resilience

Flexible staffing can help a healthcare facility build resilience because managers or schedulers can proactively contract per diem nurses in preparation for projected gaps. Contracting per diem clinicians can ensure enough nurses are working at a given time, building resilience and maintaining safe staffing ratios. Flexible staffing can also build resilience when a facility uses this model to quickly find emergency staff, such as hiring rapid response travel nurses. 

Reducing Total Staffing Costs

Facilities with flexible staffing models can reduce hiring, administrative handling, and payroll costs. These cost reductions are particularly true when hiring per diem nurses, as they do not receive health insurance, retirement, or other benefits, helping facilities save on budget costs. 

Supporting Facility’s Full-Time Staff as Needed

A big perk of contracting nurses is that it can alleviate the workload of permanent full-time employees at a facility. When hospitals are understaffed, permanent nurses may work extra hours and longer shifts, quickly leading to burnout and fatigue. Contracting nurses can help a facility “staff up” by helping to cover vacation time, sick leave, or requests for paid time off (PTO) from regular nursing staff.

Related: Learn how the healthcare c-suite are using 1099 nurses to enhance care teams

5 Flexible Nurse Staffing Options for Healthcare Facilities

As a result of staff crises throughout the country, flexible nurse staffing options are becoming more accessible. The following are some of the most valuable and popular ways that facilities are using flexible staffing to help close gaps: 

1. Per Diem Staffing

Per diem staffing is growing in popularity because it provides nurses with flexible schedules and practical ways to provide consistent patient coverage. Facilities can contract per diem nurses directly using Nursa, allowing clinicians to pick up shifts without a staffing agency or intermediary. 

The following are some pros and cons of the per diem staffing model from a facility standpoint:


  • Most flexible option
  • Lower overall cost to maintain staff levels 
  • Less commitment to nurses
  • More control over nurse schedules
  • Fast scheduling 


  • Lack of continuity of patient care
  • Onboarding challenges 
  • Teamwork challenges

What are some reasons a facility might consider per diem staffing? 

Per diem staffing is an excellent model for healthcare facilities that need to find qualified clinicians quickly and effectively. Moreover, it can dramatically reduce staffing costs, including payroll, administrative tasks, and benefits associated with hiring employees.

2. Local Contract Nurses

Contracting local nurses is another flexible staffing option to help healthcare facilities manage staffing needs. Facilities can find contract nurses through staffing agencies, both online and in physical offices. They may also find contract nurses on online job boards, but this method may be time-consuming for human resources. 

The following are some pros and cons of the contract nurse staffing model from a facility standpoint:


  • Stable staffing option (many contract nurses will commit to long-term contracts)
  • Forced contract terms (increasing retention)
  • Reliable coverage during busy times and emergencies


  • Higher associated costs (i.e., contract termination costs, contractual obligations, agency fees)
  • Less familiarity with a facility’s equipment, policy, and overall needs
  • Lack of continuity of patient care

Why might a facility consider contract nurses for their staffing needs?

Recruiting contract nurses from a reputable online or physical agency can help facilities improve patient care by ensuring enough skilled nurses. In addition, like per diem nurses, contract nurses can provide reliable coverage for healthcare facilities when patient volumes increase and help supplement regular staff in emergencies. 

3. Travel Contract Nurses

A facility can benefit from hiring travel nurses to help cover for permanent nurses during maternity leave, disability, or vacation time. Another huge benefit of travel nurses is that they can often jump from one hospital to another, crossing state lines to provide care in high-need areas. Similarly, travel nurses are versatile and can adapt quickly to new medical settings, picking up skills and learning to work efficiently on new teams. 

The following are some pros and cons of a traveling nurse staffing model from a facility standpoint:


  • Access to a range of nursing applicants with specialized skills (this can be especially helpful for facilities in rural areas) 
  • A longer-term staffing option since most travel nurses commit to extended contracts (from 13 to 26 weeks)
  • Fewer turnover and hiring costs than associated with onboarding a staff nurse


  • Potential contract termination costs (if a nursing shortage is less severe and a facility no longer needs temporary help) 
  • Less familiarity with a facility’s equipment, policy, and overall needs
  • Potential onboarding delays due to cross-state licensing 

What are some reasons why a facility would consider hiring travel nurses?

Facilities may consider hiring travel nurses if they anticipate their regular staff planning vacations, maternity leave, or other time off. Most importantly, facilities use travel nurses during peak seasons, such as winter. Hiring travel nurses can also help facilities recruit professionals for specialty nursing roles at hospitals that require specific skills and credentials to provide safe and quality patient care. 

4. Staffing Agencies

Staffing agencies are traditional temporary staffing models that date back to the 20th century. They are reliable intermediaries connecting job seekers with companies. Staffing agencies have advanced and improved with time, and medical facilities can use them to find highly skilled nurses with various credentials.

The following are some pros and cons of using a staffing agency to find nurses from a facility standpoint:


  • Wide variety of talented nurses and clinicians to choose from
  • Simplified hiring process (outsourcing the “middleman”)
  • Qualified nurses with industry-specific expertise that can help facilities fill difficult positions


  • Less control over the hiring process
  • Potential delays in finding the right nursing candidate 
  • Great variation in talent and skills among agency nurses
  • Potentially more expensive than other flexible staffing options

Why might a facility consider using a staffing agency to hire nurses? 

A healthcare facility may use a staffing agency to quickly recruit qualified, trained, and skilled nurses. Additionally, a staffing agency can simplify the hiring process by taking on the load that would otherwise be done by a facility’s human resources team. These responsibilities include reviewing resumes, interviewing, and even handling the onboarding processes for potential candidates. 

5. Traditional Staffing

Full-time and permanent nursing staff are often in stable positions with fixed contract terms and benefits year-round. Hiring them can provide reliable patient care, improve team dynamics, and foster a more positive workplace. 

The following are some pros and cons of hiring permanent nursing staff from a facility standpoint:


  • More control over hiring 
  • Strong base of full-time and dedicated permanent staff
  • Improved work environment and teamwork
  • Greater familiarity with a facility’s equipment, policies, and practices


  • Higher costs (onboarding, benefits, turnover, etc.)
  • Impractical for temporary staffing needs
  • Least flexible staffing option
  • Very hands-on and resource-intensive
  • Increased burnout and fatigue when nursing shortages occur

What are some reasons a facility might consider hiring permanent nursing staff

Hiring full-time nursing staff can facilitate a dynamic of strong and skilled nurses motivated to work together and provide excellent patient care. Moreover, facilities could consider hiring a base of full-time and permanent nurses while using flexible staffing options during peak seasons or when a clear need for coverage arises.

How Can Facilities Manage Fluctuating Labor Demands?

Facilities can manage fluctuating labor demands by using flexible staffing models that are proven to work. As the social contract of work continues to change, this increasingly involves using 1099 nurses to support primary care teams. For example, per diem nurses can work on short notice, quickly filling staffing gaps and serving as an external float pool that only costs facilities when shifts are filled.. 

Hiring travel nurses and contracting local nurses can also effectively help facilities anticipate and address gaps in coverage. While it’s up to each facility to decide which staffing model is appropriate, flexible staffing can provide an efficient, cost-effective, and resourceful model for contracting new nurses. 

Are you a healthcare administrator looking to tap into a network of skilled PRN nurses? Learn more about Nursa as a partner in PRN staffing.

Jenna Elizabeth
Blog published on:
June 4, 2024

Meet Jenna, a contributing copywriter at Nursa who writes about healthcare news and updates, empathy and compassion for nurses, how to show staff appreciation and increase retention, and guides that help nurses navigate career pathways.

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