How I Survived My First Day as a Per Diem Nurse

Written by
Miranda Kay, RN
October 22, 2019

Picking up per diem nursing shifts on the fly is a slick way to earn some quick money. In fact, if you find yourself in a situation where you are coming up short on some bills or anything else that you need, you can literally pick up a couple of local PRN nursing shifts and get caught right up.

I have to admit, my first day as a per diem nurse was very random and most nurses do not have nearly the same experience that I did. Although, some have. So let's get to it.

Years of Dedication Lead to Frustration and Burnout

In order to understand how I became a PRN nurse, it's important that I explain a little bit of my background and what lead me to work for a nursing agency. For four long, brutal years, I worked full-time at a local community hospital with a special focus on the pediatric floor. It was my very first job as a registered nurse. However, the only reason I ever became a nurse in the first place is that I wanted to be a travel nurse.

The hospital I had dedicated several years of faithful service to, hardly ever calling in and always working my butt off for, was quite a miserable place to be. I was one of the top workers that could make shifts run smooth and helped out my colleagues to get things done smoothly, yet the nursing manager, Terry, was always riding my case. Over nothing. Always. Every time I wanted to try a new specialty or put in a bid on a job, I was always denied, and it made absolutely no sense. Fed up. Burned out. I decided to leave my job, cash in my 401k, and work for a local nurse staffing agency making $10 more per hour until I was ready to travel as a nurse.

As bad as Terry treated me, I was shocked by how hard she begged me to stay. Even trying to scare me about how hard the work is for travel and contract nurses. It didn't scare me off. I was thirsty for the change. As I would find out later, I led a small revolution of sorts and within weeks of me quitting, there were three more full-time nurses that either left or went PRN.

Picking Up a Shift Late at Night for the Next Morning

As I ventured into the unknown, the travel nursing agency I decided to work for didn't have anything to promise me in terms of contracts or a constant need. It was summertime and my husband and I ran a seasonal tree service, so that didn't matter. The timing was ripe for me to get into the game and get a feel for what it was all about.

I expressed my desire to pick up any and every shift they could throw my way up to an hour's drive away. When my manager Ginger called me up at 7:00 pm on a Tuesday evening offering me a 16-hour shift in a hospital an hour away that I had never heard of before, I was all about it. I couldn't wait for the challenge.

I was going to be working between the Pediatric unit and the Med-Surg floor that day. The plan was for me to arrive at 3:00 am so that I could do a rushed four-hour crash course orientation in Peds then hit the floor on Med-Surg at 7:00 am.

Arriving at the Hospital My First Day

I have to admit, it felt kind of surreal and even a little bit eerie pulling up to this small community hospital in a town I had never even seen before in the middle of the night with a ghost parking lot. As instructed, I came in through the emergency room entrance and got in touch with the manager who showed me to the Pediatric unit.

My early morning "pre-shift" consisted of signing all the necessary HIPAA forms and other mandatory items the hospital needed for me to work. Then I was told to basically play around in the sandbox of the nurse charting system to be able to chart effectively throughout the day. Luckily, learning software has always been my strong suit and I had found everything I was going to need for the day in about 45 minutes. I&O, vitals, nursing notes, assessments, you know, all the basics. This was around 2010 before all of the orders and medications were also on computers.

As Soon as Day Shift Began, I Hit the Ground Running

Have you ever heard the theory that agency nurses are given the worst assignments? I am here to tell you that on a whole in my experience, this is generally not the case - BUT - sometimes it is. When it is the case, it can be a doozy let me tell you.

So I was given a paraplegic going through a vigorous bowel prep that second shift the day before forgot to get started, so I needed to take it to the next level with enemas until clear before noon that day. Thankfully, I had a dedicated LPN on my team who took charge of that patient and administered every last enema for the day, so I was immensely happy for that.

Among my other patients included someone who was receiving pain medication on the hour and always called at least 20 minutes before it was due, a pre-op patient for orthopedic surgery and a post-op patient that arrived right out of a total knee replacement from PACU. These four challenging patients were accompanied by three other random Med-Surg patients that weren't as complex.

How did I get through it? I did what I had to do. I ran the entire shift in order to cross the Ts and dot the Is and made it happen. About 1:00 pm that day, I revealed to my LPN partner who had been assisting me that this was my very first day as an agency nurse, and she was shocked. She told me I appeared very confident and that it was evident I knew what I was doing. Confident I was. Knew what I was doing? Eh, about half-way.

Reflecting on the Experience

I remember taking my lunch break that day and just thinking about the experience. Here I was in a beautiful hospital with a really nice cafeteria with way better food than my previous workplace and working around nurses and doctors who were appreciative of my work and offered plenty of praise. This was a far cry from my previous job and it felt good. The adrenaline rush of the first day was enough to get me hooked. I never went back to a full-time staff nursing position.

I did take on that shift with the notion that it could turn into a three-month assignment. I ended up working a couple of weeks at the facility, but the contract never manifested. It was ok though. More opportunities arrived right after that and in three years, I always had as many hours as I wanted in a week as a PRN nurse. Perhaps one of the things I loved most about per diem nursing is that right after my shift, I could turn in my timesheets for instant pay that same day.

Are you interested in PRN nursing jobs in Utah and Idaho? We want to hear from you. Give us a call today at 208-378-1338 and we will be happy to share with you our current opportunities.

Blog published on:
October 22, 2019

Miranda is a Registered Nurse, Medical Fact Checker, and Publishing Editor at Nursa. Her work has been featured in publications including the American Nurses Association (ANA), Healthcare IT Outcomes, International Living, and more.

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