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Nurses seeking schedule flexibility and premium hourly wages should consider per diem nursing. Although the majority utilize per diem shifts to supplement their existing incomes, there are some who work per diem as their full time job. In order to work per diem, a nurse becomes the employee of a per diem staffing agency or "registry", which is usually contracted with multiple healthcare facilities in a given marketplace. When a facility lacks the staff to provide sufficient coverage, they call upon the agencies to provide supplemental staff. As needs come in from facilities, agency staffing coordinators find available nurses qualified to meet the facilities' needs. This system of giving availability each week and accepting or rejecting shifts gives the per diem nurse a high degree of flexibility in creating their own work schedule.

Another benefit to the per diem nurse comes with payroll. First, per diem nurses can expect to earn a premium as compared to the staff nurses they work beside. In fact, some per diem nurses earn more than $500 per shift. Of course, there is a trade-off here as staff nurses enjoy consistent full time scheduling and benefits not available to most per diem workers. Be that as it may, another nice perk of per diem payroll is pay frequency. Most per diem agencies offer weekly pay and some now even offer daily pay on a pay card which can be used as a debit card.

Finally, many nurses are attracted to working on a per diem basis because, to at least to some extent, they can choose where they want to work. Nurses who work per diem can choose not to return to facilities or units which are not a good match. Alternatively, per diem nurses can make themselves more available to facilities where they enjoy working and can sometimes "block schedule" when the facility has sufficient need.

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