PRN Contract vs. Full-Time Nursing Jobs: What’s Right for You?

nurse looking at watch pinned to scrubs
Written by
Laila Ighani
Reviewed by
Miranda Kay, RN
June 17, 2024

Traditionally, most nurses have worked as full-time employees. However, recent years have seen nurses leaving their jobs and even the profession in droves, tired of being overworked and underpaid.

In the context of generalized burnout, full-time nurses are increasingly turning to contract nursing jobs to gain control over their schedules, finances, and mental health.    

Read this article on contract vs. full-time nursing jobs to learn how working as an independent nurse contractor can help you overcome many of the challenges full-time employment presents.

What Are Full-Time Jobs?

Full-time jobs typically refer to W2 employment and imply working 30-40 hours per week.

However, nurses may work full-time without holding a full-time job or even being employees. For example, full-time nursing career opportunities may include holding two part-time jobs or working full-time hours per week by picking up per diem shifts. To learn more about unlocking opportunities, read our article about the ban on noncompetes.

How Many Hours in a Week Is Considered Full-Time?

According to the IRS, a full-time employee provides, on average, at least 30 hours of service per week or 130 hours per month. 

Based on the 2022 National Nursing Workforce Survey, approximately 55 percent of registered nurses work 32 to 40 hours per week, and 19 percent work 41 to 50 weekly hours. In other words, most RNs work full-time, and many work more hours than average for a fulltime job.

What Is a 1099 Contractor?

A “10-99” worker is self-employed. In other words, healthcare facilities don’t hire these independent contractor nurses; instead, they contract them for a specified period to cover short-term needs.

What Are the Rules for 1099 Employees?

Since independent contractors are self-employed, they are solely responsible for paying their taxes. If they choose to obtain health insurance, they are also responsible for sourcing and securing their and their families’ plans, which employers typically provide and subsidize.

On the other hand, independent contractor nurses generally make significantly higher hourly pay, which allows them to cover these expenses.

W-2 and 1099 Analogy: Understand the Difference

Think of the difference between a franchise and an independently owned business. 

A franchisee (W2 employee) operates under the franchisor’s (employer’s) trade name and receives development support and a marketing strategy. These advantages (employee benefits) come hand in hand with control over the franchisee’s actions and decisions and imply a financial cost—the employer (aka franchisor) contemplates the cost of benefits and taxes when calculating employee wages.

On the other hand, an independently owned business stands on its own. The business owner (independent contractor) does not receive the perks that the franchisee has. However, the independent business owner is free to make autonomous decisions, including how to manage their gross income.

What Are the Disadvantages of W-2 Employment?

Just as employment offers attractive advantages, including health insurance and paid time off, it comes with certain disadvantages for nurses: 

  • Staff nurses must work in the same setting day after day regardless of potentially negative work environments or difficult colleagues.
  • Employees may be stuck with a work schedule that doesn’t fit their needs and desires, such as working on holidays or their children’s birthdays.  
  • Staff nurses may feel pressured to work overtime or be on call.
  • Even though staff nurses are entitled to paid vacation, it may be challenging for them to take time off from work when they want to or for as long as they wish.
  • Employed nurses are often unsatisfied with their wages.

Furthermore, W2 employment doesn’t work for everyone. Despite an ongoing nurse staffing shortage, 4.6 percent of registered nurses (RNs) with active licensure are unemployed, based on the 2022 National Nursing Workforce Survey. The following are the reasons RNs gave for their unemployment:

  • Taking care of home and family: 46.8%
  • Inadequate salary: 11.9%
  • Difficulty in finding a nursing position: 10.7%
  • School: 9.5%

Working full-time can be challenging for any parent or caregiver since their homes and families demand so much time and energy. Furthermore, nurses who decide to return to school to earn higher degrees have difficulties managing studies and work, and coordinating both schedules can be a nightmare. 

Even when nurses don’t have significant responsibilities outside of work, and even if they are satisfied with their income, nursing is still a demanding and challenging profession. Nurses often feel emotionally drained, used up, fatigued, burned out, and even at the end of their ropes. The following percentages indicate the prevalence of these feelings among registered nurses, based on the 2022 National Nursing Workforce Survey:  

Emotionally Drained

  • A few times a week: 26.9%
  • Every day: 23.9%

Used Up 

  • A few times a week: 26.4%
  • Every day: 30.3%

Fatigued upon Waking

  • A few times a week: 23.3%
  • Every day: 26.3%

Burned Out 

  • A few times a week: 19.4%
  • Every day: 25.8%

At the End of Their Ropes

  • A few times a week: 14.7%
  • Every day: 14.7%

These statistics are alarming and demand action. Over a quarter of registered nurses are waking up every morning—or evening—and starting nursing shifts feeling fatigued, used up, and burned out. This situation compromises the quality of care nurses can offer patients and compromises nurses’ own mental and physical health.

Addressing Challenges: Contract vs. Full-Time Nursing Jobs

Many nurses facing the previously mentioned situations have typically sought part-time work as a solution to the challenges of full-time employment, but working per diem is becoming an increasingly attractive option. There are many ways in which contract nursing can solve typical difficulties of full-time nursing jobs:

  • Family: Whereas full-time nursing jobs typically demand between 32 and 40 hours per week, contract jobs allow nurses to decide how much they want to work any given week. Contract nurses may simply not pick up shifts for a few days if their kids are sick. On the other hand, if their kids stay with grandparents for a month during the summer, contract nurses can pick up shifts every day if they so desire.
  • School: Nursing students can also take advantage of this flexibility by picking up PRN shifts over weekends or holidays and focusing on school when studying for exams requires most of their time.
  • Pay: Regarding nurse salary, contract work typically pays more than full-time work. 
  • Jobs: Finally, with Nursa, per diem clinicians can easily find jobs by browsing available PRN shifts near them

Aside from addressing these practical concerns, contract nursing allows nurses to protect their mental and physical health.

A contract nurse does not have to ask for a mental health day. They can simply not pick up shifts if they feel fatigued or burned out. Contract nurses work when and where they want to. Their schedules, finances, and mental health are in their control. 

How to Make Extra Income While Working Full-Time 

If you feel underpaid as a nurse, you are not alone. Medscape’s RN/LPN Compensation Report 2023 found that 52 percent of RNs and 55 percent of licensed practical or vocational nurses (LPNs/LVNs) feel they do not receive fair compensation. However, you need not be content with your salary from a full-time job. In fact, the same report found that 32 percent of RNs and LPNs/LVNs worked extra shifts/overtime, weekends, and/or extra holidays to supplement their earnings.  

In other words, even if you’re set on remaining at a full-time job, you can still pick up extra PRN nursing shifts to supplement your income.

1099 vs. W2 Nurses: Which Is Better?

Both work models offer nurses pros and cons. The most notable advantages of 1099 work are flexibility and high pay. On the other hand, W2 nurses receive employee benefits, including healthcare insurance coverage. Ultimately, between contract vs. full-time nursing jobs, the best work model depends on each nurse’s interests, needs, and professional goals.

If you are still unsure which model is best for you, the next step is to try contract work. Remember that you need not leave a full-time job to try out working per diem. Simply sign up with Nursa, pick up a PRN shift on a day off from work, and assess your experience—and your paycheck.

Sources:

Laila Ighani
Blog published on:
June 17, 2024

Laila is a contributing copywriter and editor at Nursa who specializes in writing compelling long-form content about nursing finances, per diem job locations, areas of specialization, guides, and resources that help nurses navigate their career paths.

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