Working the holidays is a particular challenge for healthcare workers.
Sometimes nurses are scheduled for holidays and need to make the best of them. Other times, they choose to pick up holiday work for their own reasons, such as extra income or a lighter January.
Either way, the day goes better when you know what’s coming.
In this article, we cover:
- What a holiday shift is like
- What you gain from it
- Whether you’re paid more
- How to make the day easier
Note: This article isn’t legal advice. Check your employer’s policy, your contract, and your state’s laws for your own situation.
Why do healthcare workers end up working holidays?
Care doesn’t pause for a holiday. Hospitals, long-term care facilities, and home health agencies run 24/7, and the patients still there on Christmas or Thanksgiving are often the sickest or the most isolated.
Someone has to be there during holidays, and in most settings that someone is a nurse.
The major US holidays most facilities recognize include:
- Christmas
- Thanksgiving
- Independence Day
- Labor Day
- New Year’s Day
- Memorial Day
Facility holiday lists vary, though. Some add Christmas Eve or New Year’s Eve, while others skip minor federal holidays like Presidents’ Day.
Your employee handbook lists which days count at your workplace, so make sure that you check it out.
Do nurses have to work holidays?
Usually, some of them. Most facilities spell out a holiday rotation policy in the handbook, and the most common setups are alternating years, a Thanksgiving-or-Christmas split, or seniority-based picks.
Knowing how your unit’s rotation works is the first step to planning around it.
Some roles rarely require holiday work. Clinics, schools, outpatient surgery centers, and many office-based positions close for major holidays, so nursing jobs that don’t require working holidays do exist if that matters most to you.
What is a holiday shift actually like?
Many units run leaner on holidays. Elective procedures are mostly paused, fewer managers are on site, and the nurses on the floor carry the day.
On holidays, the pace is harder to predict. Some clinicians report that acute care census drops around Christmas, though that slowdown has become less reliable as bed pressure has grown, and it varies by setting. Long-term care and emergency departments may not slow down at all.
What does change is the emotional temperature. Patients and families are more open, both grateful and grieving. Families visit with more love and intention than on an ordinary day, and there’s more food on the table and more moments that stay with you.
The hard part is real, too. You may miss a family gathering or feel the day pass you by through a window.
For some nurses, the whole season weighs more heavily than any single shift, and the holidays affect healthcare providers in ways that build over weeks, not just on the day itself.
Benefits of working holidays in healthcare
Ask nurses who regularly work holidays what they get out of it, and the answers are consistent:
- Camaraderie: Everyone on the unit knows they’re in it together. Holiday shifts tend to build the kind of team bond that a regular Tuesday doesn’t.
- More time with patients: With fewer procedures and a lighter administrative load, there’s often room to sit with someone who has no visitors or to take a patient outside for 10 minutes.
- Appreciation: Patients, families, and colleagues go out of their way to say thank you. Many nurses working on Christmas say they take more from the day than they expected.
- Days off around the holiday: Working Christmas often buys you New Year’s off, and holiday trades are more available than most nurses realize. Most units require manager approval, so ask early.
- Pay: Often for employed nurses, but not automatically. We cover when and how in the next section.
Do nurses get holiday pay?
If a facility employs you, full-time or part-time, you’ll most likely get some form of holiday pay. Most hospitals and health systems include a holiday premium in their pay policies to keep holiday shifts covered, though the rate and the eligibility rules vary from one employer to the next.
That said, no federal law requires it. Under the Fair Labor Standards Act (FLSA), private employers aren’t required to provide paid holidays or a premium for holiday work.
So what decides it for employees? Three things:
- Your employer’s policy: Most handbooks list which days count as holidays, what premium applies, and who’s eligible. Ask HR for the current version.
- Your union contract: If a collective bargaining agreement covers you, it typically sets holiday premiums, rotation rules, and guaranteed time off in more detail than a facility policy.
- State law: Massachusetts and Rhode Island have rules that affect premium pay or holiday scheduling. Check your state labor department for current requirements.
When a holiday premium exists, it’s commonly time-and-a-half or double time for designated holiday hours. It usually stacks with your night and weekend shift differentials rather than replacing them, which is why a holiday night shift on a weekend can carry 3 premiums at once.
Does a night shift on Christmas Eve count as a holiday shift?
This is where most holiday pay confusion starts. Many employers define a holiday as a 24-hour window that doesn’t match the calendar day. A facility might count Christmas from 11 p.m. on December 24 to 11 p.m. on December 25, for example.
That window determines whether all, part, or none of a night shift qualifies for the premium. Two nurses working the same 7 p.m. to 7 a.m. shift at different facilities can be paid differently for it.
Find your employer’s definition before you volunteer for a shift you assume is a holiday.
Do PRN nurses get holiday pay?
It depends on how they work. PRN (pro re nata, or “as needed”) nurses employed directly by a facility may be covered by its holiday policy, just like other staff. The distinction between PRN and part-time work matters here, since eligibility often follows employment status rather than hours.
Independent contractors picking up per diem shifts usually don’t receive holiday pay, because there’s no employer holiday policy covering them. The rate you agree to is the rate you’re paid, whether the shift falls on a Tuesday or on Christmas Day.
The exception is when a facility builds holiday pay into the shift itself. Facilities sometimes post hard-to-fill holiday shifts at a higher rate, and clinicians can see that rate before committing. If a holiday shift isn’t posted at a premium, expect the standard rate.
Some facilities also post blocks of shifts across the holiday stretch, so you can cover several days at 1 facility rather than picking up 1 shift at a time.
Remember: If you work as an independent contractor, you’ll owe self-employment tax and should set aside money for quarterly estimated tax payments.
How to make working the holidays easier
Knowing the shift is coming lets you shape it. These 4 habits come up again and again from nurses who have worked a lot of holidays:
- Lean on your unit: Plan the potluck, split breaks so everyone gets a call home, and bring the holiday onto the floor. A little creative medical Christmas decorating goes a long way for staff and patients alike.
- Move the celebration, don’t skip it: Pick another day for the family dinner and protect it. If you can, use your holiday PTO strategically for the days around the shift rather than the day itself.
- Stay connected during the shift: A scheduled video call on your break, a shared playlist, or photos sent afterward can keep you part of the day. Talk to others about how you feel, tell friends and family what is on your mind, and find ways to be present, even virtually.
- Protect your recovery: Sleep before and after, and plan something low-effort to decompress, whether that’s a long bath or a book for joy and stress relief. If the season is weighing heavily on you, say so to someone you trust, including a professional.
There you have it. If you want to work on a holiday but still celebrate it, you can always choose from these options.
Make working holidays in healthcare work for you
How you work also shapes what you earn. Employed nurses usually get holiday pay through their employer’s policy or contract, while independent contractors earn whatever rate the facility posts for the shift.
With Nursa, you can work either way. Clinicians can find full-time and part-time jobs with facilities, or pick up single shifts and blocks of shifts at the rates facilities post when they need coverage most. See what’s available and pick up holiday shifts near you.
Sources:
- U.S. Department of Labor: Holiday Pay
- U.S. Department of Labor: Fair Labor Standards Act
- U.S. Office of Personnel Management: Federal Holidays
- Internal Revenue Service: Self-Employment Tax (Social Security and Medicare Taxes)
- Rhode Island Labor Standards
- Working on Sundays and Holidays ("Blue Laws") | Mass.gov
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