It's Friday at 4 PM. Two nurses just called out for the weekend, your float pool is already stretched across two units, and Monday feels very far away. You have a full census, a skeleton administrative staff, and no agency contract you can activate before morning.
For many schedulers, this is not just a hypothetical situation.
According to a report by the U.S. Bureau of Labor Statistics (BLS), over 1.7 million people resigned from their healthcare jobs in 2022 alone. Contingent healthcare staffing provides a lifeline by providing temporary staff to fill in for permanent staff. It is an increasingly common response to frequent call-outs and heightened turnover becoming the norm at healthcare facilities.
This guide covers what contingent healthcare staffing is, the different worker types available, which strategies work better than others based on facility needs, and how to build a strategy that incorporates contingent staffing without leading to strained budgets.
What is contingent healthcare staffing?
Contingent staffing is the act of using temporary workers to address short-term staffing gaps, manage fluctuating patient volumes, or cover vacancies.
In practical terms for healthcare facility managers, contingent healthcare staffing offers access to a pool of qualified, temporary clinical workers who can be deployed on demand—shift by shift, week by week, or for multi-month contracts—without the facility taking on a long-term employment obligation.
Healthcare organizations use contingent staff for several reasons: seasonal surges in patient demand, unexpected staff shortages, leaves of absence, or simply the difficulty of recruiting permanent employees in a competitive market. It gives facilities staffing flexibility without the long-term commitment of permanent hires.
Contingent staffing vs. contingent workforce management
These two terms are often used interchangeably, but the distinction matters operationally. Most facilities want contingent staffing, but the goal is to build towards contingent workforce management.
Contingent staffing refers to the act of using temporary workers to fill coverage gaps. It answers the immediate question: who is working this shift?
Contingent workforce management refers to the longer-term strategy for using contingent staffing solutions: how a facility sources, credentials, deploys, monitors, and controls the cost of those workers to support their full-time clinical team.
The difference is the gap between a facility that calls an agency when a nurse calls out and one that has a tiered system for addressing staffing needs, often using a float pool that absorbs the first line of demand before turning to an external staffing source.
Contingent workforce management is becoming much more common due to the higher quality of clinicians available from external talent pools. According to a report by Nursa:
- An overwhelming majority (93 percent) of health system leaders do not believe that being employed by a health system makes a nurse more valuable than working as an independent contractor.
- More than half (63 percent) of health system executives believe that with a larger pool of nurses, they could offer greater flexibility to staff.
In a nutshell, a contingent workforce is continuing to prove that it's a robust strategy that can tackle the nursing shortage head-on.
Why is contingent staffing a growing trend?
The demand for contingent workers has exploded, and so has the number of individuals working as independent contractors.
- According to Statista, in 2023, there were approximately 36.6 million independent workers in the United States.
- According to the BLS, around one-third of contingent workers were employed in the education and health services industry.
You have to consider the type of industry for a more specific definition of contingent workers. In healthcare, contingency staffing is the practice of having a pool of temporary workers available on demand.
Contingent staffing is a growing trend, particularly in the healthcare industry, because it is an effective solution for countering staffing shortages.
A contingent staffing talent pool can ensure proper nurse-to-patient ratios even when permanent staff calls out sick. Without the proper nurse-to-patient ratios, patient care can be compromised. In addition, facilities could find themselves with an overwhelmed nursing staff, leading to higher cases of fatigue and burnout.
Contingent labor can help nursing staffing managers meet the operational needs of their facility without risking further alienation from their existing full-time staff.
Pros and cons of contingent staffing
What is contingent workforce ideology, and how does it differ from traditional employment models?
A contingent employee can be considered an independent contractor who is hired on a contractual or project basis. This allows an organization to adapt to fluctuating staffing levels.
Here's a breakdown of the pros and cons of contingent staffing
Contingency staffing can be a great solution for industries such as healthcare and education, but it's not a one-size-fits-all strategy.
Pros of contingent staffing:
- Offers a flexible labor solution that benefits both the staff and staffing manager.
- Provides better cost-efficiency—lower administration costs, don’t pay benefits, etc.
- Requires less onboarding and training—reducing time and resources.
- Requires a lower initial investment compared to hiring a permanent staff employee.
- Offers a faster and more efficient response to urgent staffing needs.
- Access to an extensive talent pool of highly skilled workers.
Cons of contingent staffing:
- It may be challenging for contingent staff to integrate with permanent staff/full-time teams.
- Contingent employees bear responsibility for their own taxes and health insurance.
- Less control over candidate selection depending on company policies and rules.
- Contingent employees may be less invested or committed to their projects.
- Possible higher liability for hiring managers due to contract workers' lack of protections in the workplace (in some instances).
Contingent staffing can be an excellent fit for organizations that may struggle with oscillating staffing levels or are dealing with shortages.
Contingent workers vs. employees
Each facility will have varying policies regarding how they classify contingent workers versus employees. Below are the general differences between contingent workers and employees:
Contingent Workers
- Schedule: enjoy a more flexible schedule; sometimes, they can set their own hours
- Location: can work remotely or for several companies during the year
- Benefits: typically don’t receive the same benefits as permanent staff but may be offered other hire-on incentives
- Payment: usually paid on a per-project basis—sometimes with higher hourly rates
- Tax and liability: most likely classified as 1099 independent contract workers and responsible for paying their own taxes
Permanent Employees
- Schedule: have a fixed schedule that they are assigned long-term
- Location: works from one location and is employed by a single company
- Benefits: receives benefits and perks such as paid leave, health insurance, retirement plans, and bonuses
- Payment: receives a fixed salary, either monthly or bi-weekly—depending on the organization
- Tax and liability: most likely classified as a W2 employee, with tax withholdings such as income tax, Social Security, and Medicare
Read more: How to use Nursa in your own facility's staffing strategy
Types of Contingent Workers
The most common types of contingent workers are in fields such as retail, construction, hospitality, education, and healthcare. However, other industries may hire contingent workers for special projects during peak seasons. Types of contingent workers may fall under different classifications or names, such as:
- Independent contractors
- Seasonal workers
- Consultants
- Freelancers/gig workers
Per diem nursing is a type of contingent worker that a healthcare facility can utilize to fill in for gaps in coverage. These nurses are extremely valuable in ensuring that patients receive consistent care during staffing shortages.
When should you use contingent workers?
Contingent workers are generally hired on a contract, non-permanent, or per-project basis. These workers provide support and "cushion" during certain scenarios. An organization may choose to use contingent workers in the following cases:
To deal with major seasonal fluctuations
Retail or healthcare organizations can hire contingent workers to handle peak seasonal fluctuations, such as the holidays or flu season. Peak seasons often increase hospital admissions, and contingent workers can cover the sudden influx of patients.
Sudden changes in demand for labor
Contingent workers are also beneficial in filling in for permanent staff who are on vacation, sick, or maternity leave. In addition, if several staff members resign at one time, contingent workers can prevent disruptions in workflow and keep tasks moving forward.
Talent needed for short-term projects
Contingent workers can be useful when an organization needs a worker with specialized skills. In healthcare, per diem nurses with specialty licenses can provide expertise in areas such as oncology, pediatrics, or geriatric nursing. This can save a facility time and money by avoiding the need to hire a permanent nurse staff with a special range of skills.
Learn more about contingent staffing in the healthcare industry
The nursing staffing crisis isn't going anywhere—for now. Luckily, there are modern and innovative ways that healthcare facilities across the U.S. are meeting their staffing needs. These include health platforms and apps that allow nurses to pick up high-paying per diem shifts from all over the country.
With the help of Nursa, a growing per diem, contingent staffing marketplace, facilities can save time and money by connecting with verified local clinicians.
Sign up with Nursa today and get the coverage your facility needs by filling short-term staffing shifts quickly and easily.
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